Daniel J. Fox - The Borderline Personality Disorder Workbook An Integrative Program To Understand A
Daniel J. Fox - The Borderline Personality Disorder Workbook An Integrative Program To Understand A
pragmatic set of tools designed to help clients with borderline personality symptoms identify
and work toward change through a variety of multidimensional activities and exercises.
Supplemented by extensive online content, the positive approach of this workbook is sure to
inspire hope for the most discouraged of clients.”
—Sherry Cormier, PhD, professor emerita in the department of counseling and
counseling psychology at West Virginia University, author of Counseling Strategies
and Interventions for Professional Helpers and Sweet Sorrow, and coauthor of
Interviewing and Change Strategies for Helpers
“Daniel Fox has bridged the gap between the classic understanding and contemporary appli-
cation of the authoritative findings concerning personality pathology. In his latest book, Fox
has unraveled the dual construct of personality development toward more accurate identifi-
cation and effective intervention—now and for future generations. The inclusion of the
information addressing online behavioral expression is timely and crucial for a culture driven
by social media. Online users have practical tools to alert them to unsuspected predators,
and/or dating prospects who may have underlying personality pathology. The academic,
mental health, and social communities will be forever indebted to Fox.”
—Verdi Rountree Lethermon, PhD, retired director of the Houston Police
Department’s psychological services division, previous adjunct professor at
the University of St. Thomas and Houston Baptist University, and private
practice clinician
“Daniel Fox won’t let you off easy. The Borderline Personality Disorder Workbook is truly a book
that expects you to WORK! If you think you might have some symptoms of borderline per-
sonality disorder (BPD), and are willing to address these problems, and, most of all, are truly
committed to working hard at fixing them, this is the book you need.”
—Jerold J. Kreisman, MD, author of Talking to a Loved One with Borderline
Personality Disorder, and coauthor of I Hate You - Don’t Leave Me
“When working with clients who present with personality disorders, it is sometimes difficult
for our clients to grasp the concept of a personality disorder, and even more difficult for them
to acquire, execute, and maintain the skills necessary to successfully navigate their everyday
lives. As a psychologist and mental health professional, I am always seeking better and more
efficient resources that assist my clients on their journey in therapy, as well as providing some
structure when developing treatment plans. Well, I hit the jackpot with this resource! Fox has
done a marvelous job creating a resource that really helps to better facilitate this work! This
workbook is user friendly and can either be used while someone is currently in treatment
with a mental health professional, or independently attempting to improve their lives. This
workbook does an excellent job breaking down the who, what, when, where, and how of
navigating the diagnosis of BPD, and will definitely be an excellent addition to my referral
resources for both clinicians and patients!”
—Meagan N. Houston, PhD, licensed psychologist; owner of Houston
Behavioral Health, PLLC; police psychologist for the Houston Police
Department located in Houston, TX; and author of Treating Suicidal Clients
and Self-Harm Behaviors
“Fox has created an outstanding, comprehensive workbook for individuals suffering from
BPD that is both accessible and inviting. It provides a straightforward approach to developing
the skills and understanding needed to overcome this painful and emotionally crippling dis-
order. If you suffer from BPD, this book offers you a clear path toward creating stable and
meaningful relationships, developing a compassionate and clearer understanding of yourself,
and shedding your feelings of being alone and hopeless. This book will make lives better!”
—Russ Wood, PhD, founder and director of Clear Fork Psychology Services;
has treated individuals suffering from BPD and other personality disorders
since the 1980s
“Fox has written a superb book that helps both people with borderline personality and the
therapists who work with this disorder. In this workbook, Fox lucidly integrates evidence-
based techniques and tools to help with thoughts, emotions, behaviors, and relationships—
treating those with borderline personality as whole people who can achieve and maintain
success and recovery. Fox’s work is a must-have for those who want to understand, treat, and
recover from borderline personality. Enthusiastically recommended!”
—Lane Pederson, PsyD, author of The Expanded Dialectical Behavior Therapy
Skills Training Manual, Dialectical Behavior Therapy, and DBT Skills Training for
Integrated Dual Disorder Treatment Settings
“Daniel Fox has taken his extensive knowledge of this challenging clinical population and
has synthesized the literature with his own therapeutic experience and style. The Borderline
Personality Disorder Workbook challenges the individual with this disorder to change through
a series of self-examination exercises of one’s beliefs and behaviors, and why these behaviors
are maintained. Through a systematic process of exploring what BPD is, to understanding
the nature of the problem and acting on what has been learned, the person with BPD is
guided to conquering their conflicts and building and eventually maintaining a new self. The
workbook may also be used by mental health professionals working with persons with the
challenge of BPD.”
—Roy H. Tunick, EdD, licensed psychologist in West Virginia; past president
of the West Virginia Psychological Association (WVPA); and professor emeritus
in the department of counseling, rehabilitation counseling, and counseling
psychology at West Virginia University
THE
Borderline
Personality Disorder
Workbook
AN INTEGR ATIVE PROGR AM TO
Lorna Smith Benjamin’s sequence of early experiences contributory to BPD (Figure 1, page 19) is used by
permission of Guilford Publications, Inc.
21 20 19
10 9 8 7 6 5 4 3 2 1 First Printing
This book is dedicated to my three heartbeats:
my wife, Lydia, and my two children, Alexandra and Sebastian
Contents
Acknowledgmentsvii
Introduction: A New Way to See Borderline Personality Disorder (BPD) 1
PART 1
BPD and Successful Treatment
1 BPD 1017
2 Where Does BPD Come From? 17
3 Attachment and BPD 25
4 What Is Your BPD Type? 33
5 BPD Symptoms 39
PART 2
First Steps for Growing Beyond BPD
6 Where You Are in the Process of Change 49
7 Beliefs, Behaviors, and Benefits That Keep You Stuck 61
8 The Eight Trigger Categories 73
9 Recognizing Positive and Negative Relationships 81
PART 3
Addressing and Changing Negative Behaviors and Patterns of BPD
10 Freedom from the Trap of Emotional Buttons 99
11 Controlling High-Risk Situations 115
12 Challenging and Changing Dysfunctional Beliefs 123
13 Self-Soothing to Enhance Personal Control 133
14 Strengthening Love and Resolving Relationship Conflict 141
PART 4
Reconstructing Your World and Building a New You
15 Getting to the Heart of the Issue 157
16 Distortions That Keep BPD in Place 167
17 Growing Beyond Destructive Fears, Beliefs, and Wishes 181
18 Defense Mechanisms and Healthy Coping and Responding 193
19 Conquering the Internal Love/Hate Conflict 209
20 Letting Go and Moving On with the New You 223
PART 5
Maintaining Your Success and Personal Power
21 Maintaining Your Gains 237
22 Life Beyond Your BPD 247
Epilogue
Letter from Dr. Fox 251
References 253
Acknowledgments
A huge thank you to the following individuals for all of their insight and help throughout this
process:
Clancy Drake for your thoughtful suggestions and edits on multiple versions.
Katherine Fox (no relation to author) for your invaluable early edits and feedback.
Borderline personality disorder (BPD) was once seen as a disorder that defied treatment.
Many individuals who meet criteria for this disorder, as well as those who have traits, are still
inclined to believe this even today. However, this is not the case! BPD is a treatable disorder,
and with proper treatment, skill building, enhancement of insight, and many other factors
we’ll discuss and explore throughout this workbook, you can put yourself on a path to reduc-
ing BPD’s impact and growing beyond it.
The hope for change can be a scary thing, and it may feel like a risk to have hope that
something that has been with you for so long could be weakened. I have spent the majority
of my career trying to educate mental health professionals, clients, and clients’ friends, family
members, and significant others that it’s possible to successfully treat BPD.
As you go through this workbook, challenge yourself to see yourself and your BPD differ-
ently. Encourage yourself to see it as a treatable disorder, something you can grow beyond
with the right treatment and skills.
perceptual distortions; challenging your destructive feelings, beliefs, and wishes; and examin-
ing the internal defense mechanisms that prevent psychological growth and perpetuate BPD
symptoms. You’ll confront your internal love-hate relationship and be encouraged and chal-
lenged to give up your “old ways” and to welcome new adaptive and healthy response
patterns.
In part 5 you’ll learn about the types of stress you experience and implement the best
coping strategy for dealing with them. This will help you build upon your newly found self-
acceptance, as well as maintain the insights, tools, skills, and awareness of your past, present,
and future that you’ve gained from the work you’ll have done in this book
There is extensive online content to help strengthen the skills you develop from this
workbook. All five parts of this workbook have online summaries that pull together the con-
cepts and skills from the chapters in each part. Please use them, because they will reinforce
the growth you’ve made. These accessories, as well as other material for the book, are avail-
able for download at http://www.newharbinger.com/42730.
E—Exit the situation or consider another way to deal with them instead of reacting
negatively.
P—Pursue help from a trusted and positive friend or mental health provider if the
intensity of your emotions, thoughts, or memories isn’t reduced and you feel pressured to
harm yourself or others.
If emotions, thoughts, and memories overwhelm you, remember to use the HELP steps.
PART 1
BPD 101
Many people misunderstand what borderline personality disorder (BPD) is and how it impacts
people’s lives, including those who have it and the family members, friends, loved ones,
coworkers, and others who are in their life. Perhaps you were diagnosed by a mental health
professional, or, having felt that something just wasn’t quite right in your life, you researched
BPD and found that some of its symptoms seem to reflect how you see yourself, others, and
situations. In this chapter we’re going to clear away the clutter and confusion and identify the
criteria that fit for you. Getting a clear picture of your BPD is the start of a journey of self-
exploration, which will allow you to grow beyond your BPD.
As you already know, BPD shows up differently for different people. So to start, I’d like to
introduce you to Betty. Betty struggled with BPD for many years, but she was able to over-
come it by developing an understanding and skills that empowered her to take control of her
BPD symptoms and her life. We’re going to talk about her a lot as we make our way through
this workbook.
Betty
Betty was a twenty-two-year-old woman who had always had difficulty making and
keeping friends. Multiple relationships with friends, significant others, family members, and
coworkers had ended because of intense arguments and even physical fights. Many people
were frustrated with her strong need to control them and dictate what they did, her
demanding style, and her immediate and intense reactions. In many ways she was like a
chameleon, as she tended to change her views and values to fit in with the different types of
people, such as people who liked politics, were part of the goth subculture, or were sexually
adventurous. She changed to avoid being rejected and to feel understood.
If her friends wanted to do something other than what she wanted, Betty often became
visibly angry and then ditched them. Yet her friends also enjoyed spending time with her
because she was usually the life of the party and never backed down from a dare. However,
8 The Borderline Personality Disorder Workbook
sometimes Betty was slow to respond to her friends’ texts or emails and would stay at
home for days at a time for no obvious reason. She’d regularly say, “I’m usually alone in a
crowded room.” When she wasn’t around friends, Betty often cried and searched the
Internet for her next romantic encounter.
Betty was head over heels in love with Steven the instant they met and wanted to talk
with him every day. She broke up with him when he didn’t immediately respond to her texts
about a gift she’d left on his doorstep. She began referring to him as “the devil.” This was a
difficult breakup for Betty, and though she ended it she felt rejected, alone, lost, conflicted,
and confused about her feelings about Steven, as well as about herself.
Betty had issues outside of her relationships, too. When she was highly stressed, she
often felt detached from her body and the world around her. She said that she often felt like
a puppet with a stranger working her strings. She drove recklessly and had two DWIs, and
she shoplifted if things got “too boring.” Betty had seen numerous psychologists and
psychiatrists since turning twelve years old, and she was diagnosed with obsessive-
compulsive personality disorder, impulse control disorder, and major depressive disorder.
Medication was helpful for some things, but not for others. Her problems persisted, and
medications kept changing as issues arose and dissipated based on what was going on in her
life.
After Betty broke up with Steven, she cut her arms and her coworkers saw the scabs.
She was embarrassed, and she decided to reenter treatment. This time in therapy she
discovered that she met criteria for borderline personality disorder. This diagnosis made
sense to her, and having it (and the help of a skilled therapist) allowed her to embark on a
journey of healing.
Many of the approaches and techniques you’ll find in this workbook helped Betty grow
past the harmful patterns of BPD that had been holding her back for so long. They worked
for her, and they can work for you, too.
Betty’s experience of BPD may resonate with you, but you may be doubtful that you can
successfully manage it. Before Betty could manage her BPD, she first had to know what it is
and that she wasn’t alone in suffering from it. The same is true of you, so let’s explore what
BPD is and how common it is.
What Is BPD?
BPD is one of ten personality disorders identified in the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5; APA 2013). This is the standard reference
that therapists of all specialties use to diagnose mental disorders of all kinds. A personality
disorder is broadly defined by the inability to adjust one’s behavior, thinking, and pattern of
BPD 101 9
responses in relation to particular situations or feelings, or both. In the words of the DSM-5,
BPD is “a pervasive pattern of instability of interpersonal relationships, self-image, and affects,
and marked impulsivity, beginning by early adulthood and present in a variety of contexts”
(APA 2013, 663). Many individuals who meet the criteria for BPD can look back at their
childhood and adolescence and see the beginning of these symptoms and patterns. However,
a diagnosis of BPD is often inappropriate for children and adolescents, because they’re still
growing and developing and learning how to manage and respond to life circumstances. For
someone under the age of eighteen to be diagnosed with a personality disorder, including
BPD, their symptoms must have been present for at least one year (APA 2013).
There are nine criteria listed in the DSM-5 related to BPD. An individual needs to meet
five or more of these to qualify for the diagnosis. You may have received a diagnosis from a
mental health professional, and hopefully that individual went over the criteria that relate
specifically to you. To help you gain a clearer understanding of your BPD, the exercise below
will help you identify criteria that are specific to you. I paired each with an example from
Betty’s story.
Impulsivity in at least two areas that are potentially self-damaging (for example,
spending, sex, substance abuse, reckless driving, binge eating) (APA 2013, 663).
When she wasn’t in a relationship, Betty compulsively searched the Internet for her next
encounter. She drove recklessly and had two DWIs, and she shoplifted if things got “too
boring.”
Affective instability due to a marked reactivity of mood (for example, intense epi-
sodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely
more than a few days) (APA 2013, 663).
When she wasn’t around her friends, Betty often curled up on her bed and cried, or grasped
for ways to calm herself and feel connected, such as going on texting sprees or scouring
dating sites for her next hookup.
Did you check five or more criteria above (circle your response)?
YES NO
Based on the exercise above, do you feel that the symptoms of BPD fit with how you see your
world, interact with others, and respond to people and situations (circle your response)?
YES NO
If you marked four criteria or fewer but still identified some BPD traits that you recognize
in yourself, this workbook can still be of great value to you. It can help you learn how to
reduce the harmful impact they’re having in your life.
BPD Is a Spectrum
As you went through the preceding exercise, you may have noticed that some of your behav-
iors, feelings, and thoughts are not as intense—or perhaps are more intense—than Betty’s.
That’s normal, because no one’s BPD is identical to anyone else’s. The intensity or severity of
each criterion is unique to each person, as is how it impacts one’s life. Betty’s behavior as it
relates to some of the criteria is severe or extreme, serving as important sources of pain and
possibly even danger for her. The same may not be true for you. This difference in presenta-
tion is what helps therapists determine where an individual falls on the BPD spectrum, which
ranges from mild to extreme.
If Betty is an example of someone who falls at the extreme end of the BPD spectrum,
where do you think you fall? In the exercise below, circle where on the spectrum you think
you fall for each BPD criterion. Take your time and just answer what feels right for you. There
are no right or wrong answers, only what you think, and that’s good enough.
Impulsivity in at least two areas that are potentially self-damaging (for example, spending, sex,
substance abuse, reckless driving, binge eating).
Affective instability due to a marked reactivity of mood (for example, intense episodic dysphoria,
irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
Inappropriate, intense anger or difficulty controlling anger (for example, frequent displays of
temper, constant anger, recurrent physical fights).
When you look at your responses, where would you put yourself on the BPD spectrum?
Now that you’ve identified the symptoms that impact you the most, the ones that influ-
ence how you see yourself, the world around you, and those within it, let’s piece together what
influenced your answers and describe it below.
Why did you rate yourself (mild, moderate, severe, or extreme) as you did? (You can consider
the number of symptoms marked at a particular level, specific symptoms that cause you to judge
yourself harshly, and so on.)
In what part or parts of your life (for example, relationships with family and friends, work, how
you see yourself, and so on) do these symptoms cause the greatest problems?
When you look back at your responses to the questions above, and your ratings, what have you
learned about your BPD?
14 The Borderline Personality Disorder Workbook
Learning about and exploring your BPD will help you grow beyond it, but sometimes it
can make you feel like you’re alone. You may feel like you’re the only one having these feel-
ings, thoughts, memories, and reactions, but it’s important to remember that you’re not alone.
BPD is a disorder that many people experience.
1.
2.
3.
This workbook is for and about men and women like Betty and you who have to deal
with issues related to BPD, be they traits or the full diagnosis. Throughout this workbook I
use the term borderline personality disorder (BPD) when discussing the thoughts, feelings, reac-
tions, beliefs, and wishes of people who fall somewhere on the BPD spectrum. However, it is
not my intention to define or label individuals based on this term or diagnosis. It’s important
to remember that a diagnosis is used for treatment and not for self-definition. It’s my hope
that you’ll find this exploration of BPD to be a route to healing and growth, along which
you’ll find ways to control and overcome it.
Now that you know more about what BPD is, let’s explore its possible roots and causes.
CHAPTER 2
This chapter offers insight into the various causes, or roots, of BPD, including genetic factors,
brain differences, psychological and social influences, and early experiences. The exercise I
included will help you understand your own history, as well as the history of those in your life
who may also exhibit BPD symptoms.
Genetics
Research indicates that 37 to 69 percent of BPD diagnoses are related to genetic inheri-
tance (Ahmad et al. 2014; Distel et al. 2008; Gunderson et al. 2011). Individuals who have a
first-degree relative (parent, sibling, or child) with a BPD diagnosis are five times more likely
to be diagnosed (APA 2013; Gunderson 1994) themselves than those who don’t have such a
relative. The BPD symptoms—impulsivity, anxiousness, difficulty controlling mood, and
problems with interpersonal relationships (Reichborn-Kjennerud et al. 2013; Zanarini et al.
18 The Borderline Personality Disorder Workbook
2004)—one displays tend to have a strong family link. For example, if your mom had a ten-
dency to be impulsive, you might as well.
In short, if a close relative has BPD, you’re more likely to also display BPD symptoms or
to be diagnosed. But keep in mind that we’re not simply an expression of our genetics.
Figure 1
20 The Borderline Personality Disorder Workbook
Brain Functioning
Research has shown that individuals with BPD have similar brain functioning. For people
diagnosed with BPD, areas of the brain that impact their ability to control impulses and
aggression, to accurately recognize emotional expressions in others, to calm down after
getting excited or angry, or to reason through problems when agitated or angry tend to show
activity (Goodman et al. 2014; Lenzenweger et al. 2007; Sala et al. 2011; Soloff et al. 2008).
These findings, that individuals with BPD have a brain that functions differently from
those who do not have BPD, hasn’t been attributed to just one cause. It’s believed that the
roots of genetics, psychological and social influences, and early experiences play a part in the
development and functioning of your brain and how it, and you, act and react when you
think about, evaluate, and perceive yourself, others, and situations. This connection is a good
thing: if situations, experiences, actions, and reactions influenced how your brain developed
and now operates, then you can change your brain functioning by doing things differently,
such as employing new strategies to overcome your BPD.
Now that you’ve identified some people with whom you may share a BPD-related genetic
link, let’s consider the psychological and social influences and early experiences that may
have contributed to the development of your BPD. Make a checkmark next to each item in
the list below that seems relevant.
I experienced abuse or abandonment when I was younger.
The abuse I experienced occurred more than two times and was severe.
I was neglected as a child.
I struggled as a child in school.
The following people in my life were inconsistent and not dependable:
Mom
Dad
Brother(s)
Sister(s)
Other family members:
Friends
Others:
Based on what you explored in this exercise, think about what percentage of your BPD is
related to genetics and brain functioning versus psychological and social influences and early
experiences. Write these percentages in the blank circles in figure 2; they should add up to
100 percent. This is not a scientific formula, but rather a way to visualize what you learned
from this chapter and this exercise.
Psychological and
Genetics/Brain Social
Function Influences/Early
Experiences 100%
________%
________%
Figure 2
24 The Borderline Personality Disorder Workbook
It’s unlikely that you wrote 100 percent in only one of the bubbles, because part of you
knows that genetics, brain function, psychological and social influences, and early experi-
ences combined make us who we are.
As you remember or uncover these influences, and think about the ways they combined
to create BPD, you may feel like you’re doomed to always have issues with BPD. This doesn’t
have to be the case—if it were, no one with unhappy beginnings would ever overcome past
hurts. BPD doesn’t mean you’re destined for loss, suffering, and pain forever. Rather, knowing
the roots of the disorder will help you overcome its impact. You have to know where you’re
from to know where you’re going.
1.
2.
3.
Next, we’ll explore how a BPD diagnosis affects the emotional and physical bond you
create with others, also known as attachment.
CHAPTER 3
Attachment is an emotional motivator we all have inside us that connects us to others. Each
of us starts developing a pattern, or type, of attachment in our earliest days based largely on
how our caregivers behave toward us. Your attachment style not only influences how you see
yourself and the world around you, but also how you act and react in situations. In this
chapter you’ll learn how attachment types develop and motivate people, identify your own
attachment type, and work on skills to form secure and strong relationships.
In chapter 1 I introduced you to Betty, and in this chapter you’re going to meet Tony and
explore his experience with BPD. Throughout the rest of the workbook you’ll learn more
about Betty and Tony and their challenges growing beyond BPD. You may experience similar
challenges as you make your way through this workbook. Let’s get to know Tony.
Tony
Tony’s mother often told him that he was a burden, a disappointment, and a failure. As
early as Tony can remember he wanted his mother to love and care for him, but the harder
he tried the more she rejected and scolded him. She put all of her energy into her boyfriends
and alcohol. He always wanted to be recognized by her but could never “get it right.” He
tried very hard in school and got good grades to make her proud, but one time he came
home with a report card with As and Bs, and his mother said, “Don’t be a show-off. No
one likes a know-it-all.” This really stuck with him, and he stopped trying to excel in school,
a habit he carried forward into college and his first job.
After the report card incident Tony turned his focus to sports. He was a very good
baseball player, and coaches really liked him. One coach pulled Tony aside and said that he
could help him be even better, but he’d have to practice more, and for longer. Tony declined
the extra help because he didn’t feel that he was worth the coach’s extra time and
attention—and being praised made him uneasy and question the coach’s motives. Tony
26 The Borderline Personality Disorder Workbook
always tried to get his mother to come to his games, but she refused—except for one time.
At this game, Tony struck out once, got on base twice, and made three runs. When he got
home, his mother complained about what a waste of time the game had been. She told him
she was embarrassed that he spent his time on a sport he wasn’t even good at, because he
had struck out whereas many of the other kids hadn’t. Tony quit baseball.
Tony really liked his first girlfriend, Pam. After one week together he knew he was in
love with her. But he had a feeling she would never love him the same way he loved her.
He often asked her how she felt about him and tried to please her by doing things she liked.
He would respond to her texts and emails immediately, so she knew she was a priority.
Tony focused all of his time and energy on being close to Pam, rearranging his schedule and
responsibilities to be with her while ignoring his other friends. When Pam had other things
she needed to do, Tony felt alone, lost, and desperate to be with her, but he was also
conflicted, because he didn’t feel important enough for her to spend time with. He created
“tests” often to prove that she loved him. For example, Tony purposely posted a negative
message about himself on Facebook to see if she would defend him. After three hours of
checking continuously she still hadn’t responded, so Tony drank a bottle of Vodka. Pam
found him passed out. Unable to wake him, she called an ambulance.
Tony was very confused and conflicted about his feelings for Pam. He had developed
an insecure attachment type based upon his relationship with his mother and how she
treated him. He felt a push and pull inside of him: he was motivated to be close with
someone and to feel liked and valued, but he questioned his worthiness to be loved—or
to be valued at all. He couldn’t really trust that he was genuinely loved and valued because
he didn’t really believe he was lovable and valuable. This insecure attachment and longing
drove his behavior in school, baseball, jobs, and relationships.
around them, and they carry this ability into their relationships as they grow. This is a secure
attachment type. People who exhibit this attachment type see themselves as valuable, as
important, and as having worth in the world; see others as genuine and caring; and are able
to develop and maintain healthy and stable relationships (Bartholomew and Horowitz 1991).
When a baby’s caregivers don’t meet her need to be seen and cared for, her ability to trust
herself and others is compromised. Consider Tony’s experience. He tried and tried to develop
a loving connection with his mother, but she wasn’t willing or able to provide this for him. As
a result he developed an insecure attachment type that affected many areas of his life.
Like Tony, perhaps you didn’t have a safe and soothing environment growing up and
weren’t able to develop a secure type of attachment. Having an insecure attachment type
increases a person’s likelihood of developing problems with anxiety, anger, depression, self-
worth, self-esteem, and emotional connection and control (Bowlby 1977). Insecure attach-
ment types are common among people with BPD (Agrawal et al. 2004). There are three
types (Bartholomew and Horowitz 1991):
3. Fearful: Wanting to be with others but being afraid one is not worthy of love and
affection
Box 1 Box 2
I find it easy be close to others.
I’m uncomfortable not being in a close
I’m comfortable depending on others. relationship.
I’m comfortable with others depending
I want a lot of intimacy and approval in
on me. my relationships.
I’m not worried about not having a close
I worry that others don’t value me as
relationship. much as I value them.
I’m okay with others not accepting me.
I want complete emotional intimacy with
my significant other.
I feel that others don’t get as emotion-
ally close as I would like.
Box 3 Box 4
I am comfortable not having emotional
I’m uncomfortable getting close to
relationships. others.
Independence is very important to me.
I want to be close to someone, but I’m
I don’t need anyone else’s help to get afraid of being close.
things done.
It’s difficult to trust significant others
I don’t see a lot of value in emotional completely.
relationships.
I’m afraid I’ll be hurt if I get too close to
I never feel truly close to someone else. someone emotionally.
I feel unworthy of my significant other’s
time and attention.
Add up the number of checkmarks in each of the four boxes above and write the number
in the appropriate box below. For example, if you marked 3 of the 5 statements in box 1, write
a 3 in box 1 below.
Box 1 Box 2
Box 3 Box 4
Attachment and BPD 29
Each box represents one of the four attachment types, and the box with the highest
number identifies yours. If you have the same number in more than one box, then you have
features of both attachment types. Each of the four attachment types is defined below. Circle
the type (or types) that is the best match for you.
People with BPD are likely to develop a preoccupied or fearful attachment type, or both.
These two attachment types are similar in that people experience a high degree of anxiety
associated with the fear of abandonment, but they differ in how people interact with others
in order to feel safe. Individuals with a preoccupied attachment type tend to seek out others
to help them feel safe when they’re stressed or afraid, and those with a fearful attachment
type tend to distance themselves from others out of fear of not being worthy of taking the
other person’s time or attention when they need it. Both of these insecure types create a lot
of internal conflict. If you scored high for both preoccupied and fearful, it means you have an
internal push and pull to be close while fearing being hurt and abandoned.
Attachment conflict may be something you feel, as Tony did. He wanted his mother to
love him, notice him, and appreciate him for his deeds and successes, but she only saw his
mistakes and failures. His fearful attachment type left him conflicted inside, feeling a push
and pull between the love he wanted and needed and the expression of love he received. This
attachment type showed up in his life as conflict—his changing emphasis on grades, his
inability to accept help from his coach, his strong need to be with Pam coupled with feeling
unworthy of her and her attention, and his attempts to gain approval and love from his
mother by trying different things to please her. His attachment type was the source of a lot
of confusion, and it worsened his experience of BPD.
30 The Borderline Personality Disorder Workbook
Have you felt like Tony did? This conflict motivates and affects how you behave, feel, and
act toward yourself and others and in relationships. At the heart of it is your attachment type.
Attachment is the motivator that drives us to try to connect, get close, and be vulnerable, but
it also causes us to feel afraid, lonely, abandoned, and scared as a result of that same connec-
tion. But it didn’t have to be this way for Tony, nor does it have to be this way for you.
Attachment styles can change over time. With effort you can learn new skills to attach dif-
ferently (Levy et al. 2006).
How do you think your attachment type explains your motivations for connecting to others? How
does it affect your fear of being close to others—or your fear of losing them?
Attachment and BPD 31
How do you think your attachment type affects how you see yourself? List some words you’d use
to describe yourself in relation to other people, and write a little about how those descriptions
match up with your attachment style.
How do you think your attachment type affects your relationships? Reflect on a couple of your
most significant and more casual relationships through the lens of your attachment type. Do you
behave differently in casual relationships versus deeper ones?
Describe what push and pull you feel the most as a result of your attachment type. For example,
do you feel the desire to be closer to others but are afraid to do so, so you isolate yourself?
These questions may have confused or frustrated you, leaving you unsure of what
responses to put down. Or you may have started writing one thing and veered off into other
territory altogether. Or the answers you came up with may have left you feeling discouraged
32 The Borderline Personality Disorder Workbook
or overwhelmed. These are all common experiences, and it’s fine if any of them happened.
We’re just starting our exploration, and that involves looking at ourselves in new ways and
seeing what we discover. Your BPD doesn’t want you to explore; it wants you to stay stuck.
But you recognized a need for change, to do things differently, and working to change your
attachment type is a part of that journey. The process of changing your attachment type is
not an easy one. If it were easy, there wouldn’t be BPD workbooks, and some psychologists
might be out of a job. But it is possible.
1.
2.
3.
As you explored the roots of your BPD and your attachment type, you probably wondered
if all BPD is the same. It isn’t, and in the next chapter we’re going to explore the four BPD
subtypes and identify the subtype (or subtypes) that best reflects your experience.
CHAPTER 4
You learned a lot about BPD in the preceding chapters, including how it develops and pres-
ents itself in your life. No single process created your BPD, and as we continue to explore this
disorder you’ll learn there’s no singular type of BPD either. In this chapter, we’re going to
explore the four subtypes of BPD. A subtype is a different presentation or form of an idea or
concept. For our purposes, “borderline personality disorder” is the general term we use for
this disorder, and the subtypes are the specific presentations, or forms, of BPD. In this chapter
you’ll also complete an assessment in which you identify the subtype (or subtypes) that best
represents your BPD. Learning about your subtype will help you better understand your BPD,
and the more you know the more prepared you are to grow beyond it.
Discouraged: These individuals tend to have difficulty making up their mind, have a
strong need to be around others, have intense internal anger that builds until they
explode, and act out when they feel “pushed” to defend themselves or when they feel
they’re not being heard.
Impulsive: These individuals are often flirtatious, tend to focus on the surface of things
rather than going deeply into any one issue, have high energy but lose interest in things
and people easily, and act without thinking. Others tend to not know what these
individuals will do next.
34 The Borderline Personality Disorder Workbook
19. I tend to see the worst side of things or believe that the worst
0 1 2 3
will happen.
*Please remember that this is a tool to identify which subtype on the BPD spectrum (see chapter 1 for an explanation of
the BPD spectrum) best fits your view and approach to the world. This is a tool to increase your insight into BPD, not to
diagnose it.
Scoring Chart
Write in the value you circled for each question below the question number. For example, if you
circled 3 for question 1, write a 3 under the block for question 1. Do this for all the questions.
Then add up the values to determine your score for each BPD subtype. The subtype (or subtypes)
that has the highest value fits you best.
1 5 9 13 17 Total
Discouraged
subtype
2 6 10 14 18 Total
Impulsive
subtype
3 7 11 15 19 Total
Petulant
subtype
4 8 12 16 20 Total
Self-destructive
subtype
Once you’ve determined which subtype (or subtypes) fits you best, go back to the defini-
tions above and see how much you feel the subtype fits. Answering the following questions
can help you explore your thoughts, feelings, and memories related to having identified your
BPD subtype.
What do you think about yourself and your life now that you’ve identified your BPD subtype (or
subtypes)?
How do you feel having identified your BPD subtype (or subtypes)?
To the best of your ability and to the degree you feel comfortable, describe any memories
related to your BPD subtype (or subtypes).
38 The Borderline Personality Disorder Workbook
1.
2.
3.
Now that you’ve identified your subtype (or subtypes), we’re going to identify and explore
your BPD symptoms and prognosis.
CHAPTER 5
BPD Symptoms
In this chapter we’re going to explore the symptoms associated with your BPD and identify
those that are most problematic for you. We’ll then examine the likelihood of you over
coming BPD. This knowledge will expand your awareness of BPD and how it impacts you and
your life, and it will hopefully encourage you to continue this journey of growth and
self-discovery.
Symptoms Intensity
None/Mild/Moderate/
Severe/Extreme
Highly reactive 0 1 2 3 4 5 6 7 8 9 10
Lack empathy 0 1 2 3 4 5 6 7 8 9 10
Quick to intimacy 0 1 2 3 4 5 6 7 8 9 10
Easily influenced 0 1 2 3 4 5 6 7 8 9 10
Feel abandoned 0 1 2 3 4 5 6 7 8 9 10
Unsure of who I am 0 1 2 3 4 5 6 7 8 9 10
Impulsive 0 1 2 3 4 5 6 7 8 9 10
Now that you’ve rated the intensity of your symptoms, circle those that you rated a 7 or
above. These are your primary symptoms, the ones with the greatest impact on you and those
around you.
Primary Symptoms
Feel a strong sense Feel intense anger Feel paranoid when stressed
of emptiness
Engage in self-harm
behavior, threats, or gestures
42 The Borderline Personality Disorder Workbook
When you look at the primary symptoms you circled, how do you feel about yourself and your
BPD?
Can you identify the situations and memories that encourage these primary symptoms?
What can you say to yourself so you don’t use this information to attack yourself and encourage
your BPD?
Betty completed the same symptoms expression form and identified her primary
symptoms.
BPD Symptoms 43
Feel a strong sense Feel intense anger Feel paranoid when stressed
of emptiness
Engage in self-harm
behavior, threats,
or gestures
Now that you’ve identified your primary symptoms, answer the following questions to
increase your awareness of the thoughts, feelings, and memories related to this exploration.
Describe how seeing Betty’s rating form, and comparing it to yours, makes you feel.
44 The Borderline Personality Disorder Workbook
What do you think about Betty, having seen her primary symptoms?
Avoid the tendency to self-attack. It’s not uncommon to feel like you marked the most
symptoms ever in the history of the world. This judgment is a form of self-attack that most
people with BPD engage in, but it’s false. Remember, don’t use these symptoms to judge your-
self. Choose instead to tell yourself that these are just your BPD symptoms, and remind your-
self that you’re using this knowledge to do it differently in the future. I listed Betty’s responses
so that you’d see that other people circle lots of symptoms on this form. Even if you circled
more symptoms than Betty, it doesn’t mean you’re hopeless or a lost cause. As you move
through this workbook, you’ll learn to counter such false beliefs and reduce your symptoms
and replace them with accurate assessments of who you are as you grow beyond your BPD
and develop adaptive and healthy response patterns.
life, but something that you can control and grow beyond by building your awareness and
using the right tools.
Take a moment to reflect on your own prognosis by answering the following questions.
Circle the prognosis you’d give yourself today regarding your BPD?
GOOD POOR
What supports this prognosis? Think of what you’ve learned in this workbook so far, or of experi-
ences you’ve had in life.
1.
2.
3.
You made it to the end of part 1 of the workbook! This is a great accomplishment.
Developing knowledge, awareness, and skills is the starting point of your journey to overcome
BPD. To help strengthen what you’ve learned, there’s a summary available for download at
http://www.newharbinger.com/42730. This summary pulls together the concepts, activities,
and exercises from part 1 of the workbook, so I highly recommend that you take the time to
go through it before moving on to part 2.
In part 2 of the workbook we’re going to focus on addressing and changing the problem-
atic beliefs, behaviors, and patterns that affect how you see yourself, feel about yourself, and
interact with others in various situations.
PART 2
In this chapter I’ll introduce you to the stages of change and explain how they relate to your
BPD. I included an evaluation for you to complete, which will help you determine where you
are within the stages of change, as well as questions to help you move forward.
11. I want to learn more about how my life would change if I did
things differently.
13. I’m not sure what will cause me to fall back into my old, unhealthy
behaviors.
18. I had some success doing things differently but fell back into my
old ways of doing things.
Now score yourself. True answers are 1 point and false answers are 0 points. Write the
points for each statement in the scoring sheet below. For example, to determine your precon-
templation score you’d total the points for questions 3, 7, and 10.
Precontemplation 3.
7.
10. Total:
Contemplation 1.
9.
14. Total:
Preparation 5.
11.
16. Total:
Action 2.
12.
15. Total:
Maintenance 6.
8.
17. Total:
Relapse 4.
13.
18. Total:
52 The Borderline Personality Disorder Workbook
You may find that you have two stages with the same score. This indicates that you’re
within or between these two stages, and that’s okay. Betty scored highest in the preparation
stage. She had tried a few things in the past, had picked up a workbook because she knew she
needed to learn and then practice skills to grow beyond her BPD, and felt ready to move
forward. With her results she prepared to move into the action phase. Now that you know
where you’re at in the stages of change, let’s look at each stage.
Precontemplation
At this stage you’re not considering changing anytime soon. You’re unaware that a
problem exists, but family, friends, and coworkers are aware that there’s a problem. If you seek
help at this stage in the process it’s due to pressure from others.
If you rated this stage of change the highest, what thoughts and feelings do you have about
changing?
What are you uncertain about when you think about changing?
Where You Are in the Process of Change 53
What would it take to make you start thinking about addressing and changing your problem?
Contemplation
At this stage you’re aware that problems exist but remain uncertain if you want to change
or what’s involved with changing. You may be weighing your options: should you stay where
you are or invest effort in doing things differently. You may have purchased this workbook
because you’re thinking about doing things differently and you want to know what’s involved
in the process.
If you rated this stage of change the highest, what’s keeping you from changing?
Do you see benefits for staying where you are with the problems and issues you have related to
BPD? What are the benefits?
54 The Borderline Personality Disorder Workbook
What might you gain by changing your negative beliefs, behaviors, and patterns?
Preparation
In this stage you’re testing the waters of change. You’ve committed to doing things differ-
ently and are getting ready to challenge your BPD symptoms and address issues. This may be
why you’re going through this workbook. You may have developed a plan or a timeline for
incorporating the exercises, techniques, and worksheets of this workbook into your
schedule.
If you rated this stage of change the highest, what areas of your BPD do you want to be sure to
address and overcome?
Who can you consult for social support as you begin this journey of change?
Where You Are in the Process of Change 55
As you prepare for action, what obstacles may be in your way and how can you minimize their
interference?
Action
In this stage you’re engaged and ready to challenge, control, and defeat those negative
beliefs, behaviors, and response patterns related to BPD. You’ll go through the workbook and
use the skills you learn, incorporating them into your views of self and others and the situa-
tions you’re in. You’re committing time and effort to change and growth. At times during this
process of change you may feel a sense of loss for the old negative beliefs, behaviors, and
response patterns that you’re leaving behind. Remember that this is a normal reaction, and
you should continue to commit yourself to the process of defeating your BPD.
If you rated this stage of change the highest, what particular BPD issues do you want to change
first?
What can you do to empower yourself to get around barriers to your growth?
56 The Borderline Personality Disorder Workbook
What can you do to remind yourself of the long-term benefits of adaptive and healthy change?
Maintenance
By this stage you’ve made the changes you need to make to develop adaptive and healthy
response patterns, behaviors, thoughts, and skills for self-control. You’re committed to adap-
tive and healthy functioning.
If you rated this stage of change the highest, what can you do to remind yourself about the gains
you’ve made and the successes you’ve had?
Who can you keep in your life who will help you remain on this course of adaptive and healthy
functioning?
Where You Are in the Process of Change 57
What can you do to prevent yourself from sliding back into old beliefs, behaviors, and
patterns?
Relapse
It’s natural to slide back into old habits. It might happen while addressing significant trig-
gers (drugs, alcohol, and difficult relationships) or when encountering new barriers to change.
You may not relapse, but it’s a stage of change because everyone has a unique change process
and encounters very individual situations. The most important point about relapse is this:
A research study found that of those who relapse, 15 percent fall back to the precontem-
plation stage but 85 percent go back to the contemplation stage (Prochaska, Norcross, and
DiClemente 2013). What this means is that the majority of people who relapse into old nega-
tive beliefs, behaviors, and patterns go back to thinking about changing and then reenter the
change process. If you relapse while tackling your BPD, have faith that this is okay and
expected. Eventually you’ll resume the process of change and can and will do things differ-
ently and better in the future.
If you rated this stage of change the highest, what triggers and barriers do you think caused you
to relapse?
58 The Borderline Personality Disorder Workbook
What has helped you control your triggers and overcome barriers?
Can you identify a mantra, quote, or saying that motivates you to change? If so, put it in your
phone, on your fridge at home, or anywhere you’ll see it regularly.
The stages of change and the process of moving through them are fluid. Change doesn’t
really remain still but flows like water in a river. Your growth will be a fluid process, and
because of that you should feel free to return to the preceding evaluation as many times as
you like as you go through this workbook in order to assess where you are in the process of
change. It’s available for download at http://www.newharbinger.com/42730.
1.
2.
3.
1.
2.
3.
Next we’ll explore the negative beliefs, behaviors, and benefits that have kept your BPD
in place for so long.
CHAPTER 7
This chapter is going to help you identify the beliefs that drive your behaviors, and how both
come together to form negative response patterns. We’ll also examine the short-lived benefits
that keep your negative response patterns active and in place. These benefits are the real
goals behind negative behaviors, but they come with long-term costs. Learning about these
negative response patterns and figuring out how to control them are major steps toward
empowering yourself and growing beyond your BPD, making it more likely that you’ll get both
the short-term and long-term benefits you want and need more often.
his mother. Even though this pattern would end with him losing his objects of love, he did
receive short-lived benefits. Both Pam and Meg made him feel seen, heard, and loved, and
they both offered physical affection and verbal acknowledgment (that is, “I miss you too,” “I
think you’re special too”)—until they broke up with him.
In order for Tony to change his negative response patterns, he had to explore the beliefs
that prompted his behaviors and came together to form his pattern, from which he reaped the
short-term benefits that caused this cycle to continue—over and over again. You probably
have a pattern yourself, so let’s see if we can identify it. To do this, we need to start by uncov-
ering your beliefs.
Beliefs
A belief is an idea or principle that we judge to be true. Beliefs develop over time from experi-
ences, thoughts, feelings, and memories. You may believe that a Ferrari is a fast car or that all
people are untrustworthy, and they may be the result of you having seen a Ferrari in a race or
of having people in your life who have betrayed your trust. You have beliefs about all aspects
of life, including how you see yourself, others, your past, your present, and your future, and
they are directly related to your BPD. To change your BPD, you have to explore what impacts
how you see and interpret life, and your beliefs are a big part of that. To help develop your
awareness of your beliefs, please finish the prompts below. Don’t hold back or evaluate your
responses. Just write your true beliefs.
I believe I am…
Describing your beliefs will help you understand how you see the world and yourself in it. Your
BPD doesn’t want you to do this; it prefers you to have unexplored beliefs. They cause you confu-
sion and uncertainty, which drive you to engage in the negative response patterns that keep you
connected to BPD. You’ve taken the first step—identifying your beliefs—so now let’s go a little
deeper by exploring your behaviors and patterns.
Behaviors
Behaviors are the activities we engage in that are motivated by our beliefs, and your BPD
beliefs tend to drive unhealthy reoccurring behaviors. Take some time to identify the behav-
iors that are responses to the beliefs you have about yourself, others, the past, the present, or
the future, which you listed in the preceding exercise. You can download a blank copy of this
exercise at http://www.newharbinger.com/42730, so you can explore each belief you identified
above and its influence on your behavior as much as you like. The more you do this, the
greater your awareness will become.
64 The Borderline Personality Disorder Workbook
I believe I am
, which leads me to (write
I believe my past is
, which leads me to (write
Doing this exercise can reveal the influence that your beliefs have on your behaviors.
When unhealthy beliefs and behaviors come together, they create negative response patterns.
These patterns are what cause continual problems, as they tend to be hurtful—both for your-
self and those around you
be loved” drove him to call Pam continually, as well as engage in other behaviors, to see if she
cared about him. He named this pattern “See how much I love you so you’ll love me.”
Belief
"I'm not important enough to be loved."
Behavior 1
Call her continually to see if she cares.
Behavior 2
Leave messages that let her know how much I love her.
Behavior 3
Show up with a gift showing my love.
Behavior 4
Do things for her to show how valuable I am in her life.
Figure 3
To control and change his pattern, Tony needed to be aware of what he was thinking and
doing. Now it’s your turn to identify what makes up your patterns. In this workbook, we’re
only going to identify one pattern, but most people have several patterns they fall into each
and every day, and the more patterns you identify the more aware you’ll become of what fuels
your BPD. You can download this worksheet, Identifying Negative Response Patterns, at
http://www.newharbinger.com/42730, so you can identify more patterns. I encourage you to
do this. Take your time putting all the pieces of your pattern together. Don’t worry about the
name. You can name the pattern anything you want, because the name is just for you. The
name is usually very personal.
Beliefs, Behaviors, and Benefits That Keep You Stuck 67
Belief
Behavior 1
Behavior 2
Behavior 3
Behavior 4
We all use patterns to try to get benefits out of them. Some patterns are adaptive and
healthy, and some are harmful and hurtful, and this can determine the type of benefit we get
from them. Individuals with BPD tend to have default patterns that are harmful, that keep
BPD present, and keep you feeling stuck with your BPD due to pull of the short-term benefits.
To grow beyond your patterns and your BPD, you have to recognize the benefits that cause
you to keep using your negative response patterns.
Benefits
You may be reluctant to identify the benefits you get from your negative response patterns
because you’re afraid of losing the benefits. But in order to grow beyond these patterns and to
develop more adaptive and healthy ways to receive the benefits you desire, it’s crucial to do
so.
Tony identified three benefits from his negative response pattern “See how much I love
you so you’ll love me” (see figure 5). These were the strong short-term benefits for him that
came with long-term consequences—that is, he alienated those he cared for. This cycle
repeated itself, leaving him feeling unfulfilled, alone, worthless, and invisible.
Beliefs, Behaviors, and Benefits That Keep You Stuck 69
Pattern:
"See how much I love you so you'll love me."
I get to see her. She'll say "I love I feel heard and
Long-Term Consequences:
She feels suffocated and overwhelmed and breaks up with me, leaving me
feeling worthless, invisible, and unable to find someone who cares about me,
Figure 5
70 The Borderline Personality Disorder Workbook
Now that you’ve seen Tony’s short-term benefits and long-term consequences from one of
his patterns, it’s your turn to identify the benefits and consequences of one of your patterns.
Be as honest as you can, and remember that the goal is to understand what drives you to fall
back into negative beliefs, behaviors, and patterns. You can download this worksheet,
Identifying Short-Term Benefits, at http://www.newharbinger.com/42730 and perform this
exercise for all of the patterns you identify.
Long-Term Consequences:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Beliefs, Behaviors, and Benefits That Keep You Stuck 71
Now that you see how beliefs, behaviors, negative response patterns, and benefits interact
with each other, can you see why your negative response patterns remain in place? Do you
have a better understanding of the long-term consequences you have to deal with? The next
time you find yourself in a situation in which you’re trying to get some benefits, stop and work
backward through the process we discussed in this chapter: acknowledge your pattern by
name (if you’ve named it), explore your behaviors, and see what belief prompted you to act
this way. Then ask yourself if there’s another way to get these benefits.
If it seems like this is a difficult question to answer, don’t feel down about it. You’re not
alone, and this workbook is here to help you develop adaptive and healthy ways of overcom-
ing BPD. Being able to identify the beliefs, behaviors, and negative response patterns, as well
as the related short-term benefits and long-term consequences, is another major step in the
process.
1.
2.
3.
1.
2.
3.
72 The Borderline Personality Disorder Workbook
In the next chapter you’re going to identify triggers—stimuli inside and outside of your-
self and in the world—that impact your behavior and beliefs the most, and learn skills to
manage them so they influence you less.
CHAPTER 8
In this chapter we’re going to go over the eight trigger categories and help you identify which
ones impact you the most. We’ll then explore your triggers and go over techniques to help you
manage them.
explored beliefs in chapter 7, a trigger that falls under the “thoughts and memories” category.
For each trigger category in the chart below, place a checkmark in the box that feels most
appropriate for you.
What people, places, and things fit into the trigger categories you identified?
Why do you think one or more of the trigger categories do not impact you?
76 The Borderline Personality Disorder Workbook
List two or three behaviors you can engage in when you’re triggered instead of your default, or
immediate, responses?
Many individuals with BPD tend not to explore their triggers, which empowers their
BPD. Having done this exercise, in which you explored your trigger categories, you’ve weak-
ened your BPD and empowered yourself to grow beyond it. Now it’s time to gain control over
your triggers.
0 1 2 3 4 5
What about yourself, others, and the world did you consider when circling your answer?
What prevents you from having more control over your triggers?
Enhancing your control over your triggers is one component of managing and growing
beyond your BPD, and the helpful and healthy response techniques below are to help you
manage how you want to respond when you’re triggered.
78 The Borderline Personality Disorder Workbook
Mindfulness
Mindfulness is a technique designed to help you calmly focus your awareness on your
bodily sensations, thoughts, and feelings. Mindfulness will help you lessen or eliminate that
drive to respond when you’re triggered. The very first step in our exercise is to find an object
that has value to you. It can be a smooth or rough rock; a stuffed animal; a special pen,
pencil, or crayon; a fidget spinner—anything you want. Once you have your object, follow
these steps:
3. Focus your attention on the object, and only the object. Let words, thoughts, and
feelings float out of your head, as if they’re attached to a hot-air balloon.
5. Imagine one of your triggers and focus on the words, thoughts, and feelings that come
up, but don’t react.
6. Imagine a response, other than your default response, that is positive, helpful, and
encouraging.
1. Go to a place that’s private and away from others (for example, your car or another
room).
2. Open an app on your phone or computer or use a piece of paper to start your “let it
out” list.
4. Don’t edit your list. Don’t worry about spelling, grammar, or tense. Just let it out!
5. Put everything on the list. Let all your words, thoughts, and feelings flow.
6. Do this until you’ve exhausted your words, thoughts, and feelings about your trigger.
7. Imagine another response, other than your default response, that is positive, helpful,
and encouraging.
8. Engage in this alternate response.
The key to growing beyond BPD is to practice such skills on a routine basis. Think of a
football team. Players practice all week long to master skills so they’re ready for the big game
on Sunday. Through practice they master skills so they’ll be available when they need them.
You need to do the same to grow beyond your BPD. Just as it takes a lot of exposure to the
same situations and people for your triggers to develop, propelling you to respond, you need a
lot of exposure to these new and healthy skills to master them. If you practice them regularly,
you’ll be ready when you need them most—when it’s game time.
1.
2.
3.
1.
2.
3.
80 The Borderline Personality Disorder Workbook
In the next chapter we’re going to examine positive and negative relationships, which are
often intense triggers for people with BPD.
CHAPTER 9
Relationships are difficult to maneuver through and control. Although they are important to
us, we sometimes have a hard time distinguishing between the positive ones and the negative
ones. What do you think about the various relationships in your life? Do you classify them as
positive or negative? Most of us think about them this way, but we never go beyond that,
instead choosing to remain in negative relationships that are unhealthy and overlooking or
not fully engaging in the positive ones.
In this chapter you’ll identify the people you’re closest to, whether your relationships are
negative or positive, and what makes them that way. We’ll also look at the shades of gray in
relationships and determine where yours fall on a relationship scale. It’s hard to look at rela-
tionships to determine if they keep you stuck in negative feelings, beliefs, and BPD, but build-
ing your skill at identifying the positive and negative people and relationships in your life is
an important part of growing beyond your BPD.
Exploring Relationships
In this exercise we’re going to explore your negative and positive relationships, looking at how
close you are to each person, the impact he or she has on you, and the degree to which you
feel connected to that person. You can download a blank copy of each worksheet at http://
www.newharbinger.com/42730. Don’t overthink these worksheets or worry about leaving
someone off one, because you can do this exercise as often as you like. You can add as many
people as you want at each level. Try to avoid having the same person on both the Negative
and Unhealthy Relationships and Positive and Healthy Relationships worksheets, because
82 The Borderline Personality Disorder Workbook
you’re trying to identify who falls into one or the other category to get a clearer view of how
this individual impacts your life. If you have difficulty determining where to place a person,
ask yourself where this person falls most of the time? Is he or she more often a negative or a
positive influence?
Let’s start by identifying how close you feel to certain people using the People in My Life
worksheet. People at this level know you very well and know a lot about you and have had a
lot of experiences with you. For example, you can place a child, parent, caregiver, loved one,
or significant other at the first level. These people are connected to you in a very personal
way, such as in a sexual or familial way or through a long-standing friendship. Tony listed
Meg (his girlfriend at the time) at this first level because of how close he felt to her.
The second level can be people you work with or close friends you spend a lot of time
with and who have a direct impact on you and your life. Tony listed his baseball coach at this
level because he saw him regularly and felt he could talk to him about personal issues. At the
third level you may place someone whom you see periodically and may have conversations
with but you don’t go into great detail about your personal life and feelings. People at this level
are acquaintances you don’t spend a lot of time with. Tony listed John, a friend of his from
the baseball team whom he only saw during practice and games.
Recognizing Positive and Negative Relationships 83
People in My Life
_____________
Third Level
_____________
Second Level
_____________
First Level
_____________
Your Name
84 The Borderline Personality Disorder Workbook
Now, let’s move on and identify your negative and unhealthy relationships. You can
include people from the People in My Life worksheet or add different people. The three levels
of closeness are the same for this worksheet, but you’re looking for individuals who pressure
you to engage in behavior that creates regret and remorse. These are people who bring forth
feelings of resentment, anger, and rage that lead you to do things that have adverse outcomes
for you. Tony listed his mother at the first level because of the immense negative impact she’s
had on his life. He placed Pam in the second level because he felt she didn’t love him enough
or try to understand him. Lastly, he listed Ms. Stevens, his supervisor at work, at the third
level. She was often rude and demanding and made him mad, sad, and frustrated on a regular
basis.
Recognizing Positive and Negative Relationships 85
_____________
Third Level
_____________
Second Level
_____________
First Level
_____________
Your Name
86 The Borderline Personality Disorder Workbook
Next, let’s identify your healthy and positive relationships. The individuals you include on
this worksheet should instill in you a sense of hope, pride, and self-respect. These people
encourage you to do things that are good for you and help you reach for your dreams. Tony
listed Meg at the first level because he was in a close romantic relationship with her and was
in love. At the second level was his baseball coach, who encouraged him to do and be his
best. At the third level Tony listed Mark, a funny coworker he often vented to about how
horrible Ms. Stevens was.
_____________
Third Level
_____________
Second Level
_____________
First Level
_____________
Your Name
As you went through this exercise, did you find that some people were harder to classify
than others? This is not uncommon, especially for individuals with BPD, and that’s why going
through this process is so important. Now that you’ve identified the degree of closeness for
the people in your life, let’s explore the factors that make your relationships positive or
negative.
Relationship Factors
When we look at our relationships and determine if they’re negative or positive, we need to
identify what makes them that way. Ask yourself, What makes my relationships negative or posi-
tive? The answer has to do with relationship factors, those issues and circumstances that are
unique to you and the other person, as well as the connections the two of you create. As you
read through the following list of relationship factors, think about the characteristics that
make the relationships you listed in the preceding exercise negative and unhealthy or positive
and healthy.
88 The Borderline Personality Disorder Workbook
Now it’s your turn to identify relationship factors that play a role in some of your relation-
ships. In the following exercise, write the name of someone from one of your relationship
circles and identify the relationship factors that cause it to be positive or negative. In this
exercise you’re considering both sides, the positive and negative, so you can see what makes
the relationship unhealthy or healthy for you. Unhealthy relationships are often what encour-
age the negative beliefs, behaviors, and patterns that fuel your BPD, whereas healthy relation-
ships discourage them. You can download a blank copy of this worksheet in the summary for
part 2 at http://www.newharbinger.com/42730, so you can do this exercise for as many rela-
tionships as you like.
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
90 The Borderline Personality Disorder Workbook
Name:
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
Recognizing Positive and Negative Relationships 91
Name:
1. 1.
2. 2.
3. 3.
4. 4.
5. 5.
6. 6.
Now that you have a better grasp of your negative and positive relationships and their
relationship factors, the last step is to determine where each relationship falls on the relation-
ship scale.
Classifying Relationships
Positive relationships are empowering, supportive, caring, and trusting. They make you feel
secure with who you are. Negative relationships leave you feeling alone, hurt, uncertain, con-
fused, and bad about yourself. Individuals with BPD tend to have more negative relationships
than positive ones, and as you grow out of your BPD you’ll learn how to cultivate and benefit
from positive relationships.
92 The Borderline Personality Disorder Workbook
However, determining what’s positive and what’s negative is tricky, because relationships
are a mixture of both positive and negative aspects. If they weren’t, the positive ones would
be easy to maneuver through and hold on to, and the negative ones would be easy to discard
because it would be apparent how terrible and unhealthy they are. The truth is that relation-
ships fall in a gray area, as you’ll see in the exercise below. A “perfect” relationship would have
a balance of positive and negative factors, but very few relationships are balanced, which
means they tend to lean in a positive or negative direction. Relationships in the gray area may
sound frustrating, confusing, and frightening to identify and live with, and they can be, espe-
cially for those with BPD. You may want your relationships to be black and white, and
attempting to force them to be so is a part of your BPD holding you in place.
Tony examined his relationship with his mom and found the confounding gray area we
just discussed. Though she provided him food and shelter growing up, she was also verbally
and emotionally abusive. This reality forced Tony to grapple with how to characterize his
relationship with her. In the end he determined it was highly negative (see figure 10).
Figure 10
Using the Relationship Scale (figure 11), write the names of three people you’re in a rela-
tionship with. They can be people you identified in the previous two exercises, such as a
family member, a child, a romantic partner, or a coworker, or someone you didn’t identify.
Then, determine where on the scale you think the relationship falls and make a slash. The
slash doesn’t have to occur in one of the bubbles. As I mentioned, most relationships are not
black and white—that is, they fall in the gray area between absolutes. You can download a
blank copy of the scale at http://www.newharbinger.com/42730, so you can do this exercise
for as many relationships as you like.
Recognizing Positive and Negative Relationships 93
Relationship Scale
Keeping in mind how you rated the three relationships you identified, answer these self-
exploration questions.
Tony tended to engage in behaviors that kept him in difficult and abusive relationships,
feeling overwhelmed and lonely, and stuck in place with his BPD. He was often confused
about how he felt about himself and the behaviors he engaged in, and he felt powerless to
change how he treated himself and others, and he couldn’t understand why. When he
explored his relationships, he was able to discover that he kept negative people around him,
and that these relationships kept him stuck in a cycle of self-destruction and dependency on
others for love and care. Using the exercises in this chapter, Tony identified those people who
were healthy, made him feel good about himself, and encouraged him to grow.
Remember, most relationships operate in the realm of shades of gray, not all good and not
all bad. The key factor in all of your relationships is you, and that’s a good and powerful thing.
You’re the one who can continue to build your relationships, and you can choose to change
or end the negative ones. Changing negative relationships doesn’t entail allowing, accepting,
or making compromises for the negatives, rather the goal is to try to make more positive
Recognizing Positive and Negative Relationships 95
factors. If you choose to do this, keep in mind that encouraging positive factors isn’t possible
in all relationships, and those are the ones you have to leave behind. Your BPD is comfortable
in those negative relationships, because they feed it, and your BPD is always hungry. The goal
of this workbook is to help you grow beyond your BPD, and discarding negative relationships
is a critical factor for doing this.
1.
2.
3.
1.
2.
3.
You made it to the end of part 2 of the workbook! Strengthening your readiness and
taking steps to grow beyond your BPD is an awesome achievement. To help strengthen what
you’ve learned, there’s a summary available for download at http://www.newharbinger.
com/42730. This summary pulls together the concepts, activities, and exercises from part 2 of
the workbook, so I highly recommend that you take the time to go through it before moving
on to part 3.
You’ve completed the first two parts of this workbook. Good work! It’s time to address
and change those negative beliefs, behaviors, and patterns that cause you problems and hold
you back. Before we move forward, I want you to take a break and reward yourself with some-
thing fun and positive. I like to reward myself with a slice of cheesecake. What will you
choose?
PART 3
In this chapter you’re going to learn how to break free from emotional buttons—those things
that hit you to your core, that bring up all those past thoughts, feelings, and memories that
make you feel like you’ve been pulled back in time to a past experience. We’ll explore their
roots and how they influence your thoughts, feelings, and memories today, and you’ll learn
ways to control and respond to them.
worldview became distorted, and she tended to see present-day situations and circumstances
through the lens of a past full of loneliness and failed attempts to get her needs met.
For example, when some of Betty’s friends didn’t respond to her text quickly enough, she
cut her arms. When her boyfriend failed to show up on time, she went online to find someone
to hook up with. Had she instead explored these situations in the present moment, she would
have realized that poor cell service prevented her texts from going through, and that her
boyfriend was late because he’d been stuck in traffic and his cell phone battery had died.
Instead, when he arrived and saw that she was online looking for a hookup, they argued, and
he walked away very angry, leaving Betty feeling even more abandoned and empty inside.
When they’re pushed, emotional buttons act like a fog rolling in over your senses, causing
you to misinterpret the present and react based upon the past. You feel an intense emotional
push to react, and this is due to being caught up in what was and not what is.
Identify your button-pushing situations. What happens in your life today that sets you off,
making you feel like you did when you were younger and in a particular situation? Identify as
many button-pushing situations as you can. We’ll start with an example from Betty.
My emotional buttons are pushed when: My friends don’t text me back. Also, when my
boyfriend is late and doesn’t call me. When people don’t respond to me when and how I
expect them to.
Freedom from the Trap of Emotional Buttons 101
The situations you listed above push your emotional buttons. Now that you’ve identified
them, let’s take a look at what thoughts, feelings, and memories are connected to them.
Identify the thoughts, feelings, and memories that come up. In the spaces below, write
down the thoughts, feelings, and memories that you experience when your buttons are
pushed. Give as much detail as you can, and try not to edit your responses too much. You’re
just gathering information here. We’ll start with an example from Betty.
Emotional button: My friends don’t text me back or my boyfriend doesn’t show up when
he’s supposed to.
My emotional button thoughts: No one cares about me. I’m not important to anyone. I’m
useless—not worth a text or call.
My emotional button feelings: I feel alone, abandoned, forgotten, unimportant, and empty
inside.
Emotional button:
Emotional button:
Emotional button:
Identify the negative beliefs, behaviors, or patterns that are connected to your emotional
buttons. These beliefs, behaviors, and patterns can include outward reactions toward others,
such as yelling, throwing things, hitting walls and other people, and so on. They can also
involve inward reactions, such as using drugs or alcohol, self-harming, saying bad things
about you to yourself, and so on. We’ll start with an example from Betty.
Emotional button: My friends don’t text me back or my boyfriend doesn’t show up when
he’s supposed to.
My emotional button beliefs: My belief is that I’m going to be alone forever, and no one will
ever want to be close to me.
104 The Borderline Personality Disorder Workbook
My emotional button behaviors: My behaviors are that I’ll write a flaming text to my
friends who I think are ignoring me, or I’ll cut my arms. Or if my boyfriend’s late and
doesn’t call, I might go out and look for hookups and not even care if I’m safe.
My emotional button patterns: My pattern is that every time I feel abandoned and empty
I act self-destructively—cutting myself or having unsafe sex and cheating on my
boyfriend.
Emotional button:
Emotional button:
Emotional button:
Identify the associations between your emotional buttons and your past, present, or
future. Breaking down the associations between past pain and present behavior helps you
understand what drives you to have negative beliefs or to engage in the negative behaviors
and patterns that have kept your BPD active for so long. Understanding past pain, present
106 The Borderline Personality Disorder Workbook
behavior, and future expectations helps you to control your emotional buttons by slowing
down and choosing to not engage in default, immediate, and unhealthy responses when
you’re triggered. But first you have to know everything your buttons are connected to.
By doing this exercise, Betty was able to work out that her fear of abandonment and
feeling of emptiness were related to the neglect she’d experienced (past). This fear and feeling
influenced her perception of the intentions of her friends and boyfriend (present). Her
repeated experience of feeling abandoned and empty fed her beliefs that she’d be alone forever
and would never be treated with respect (future). Here’s how she answered this part of the
exercise.
Emotional button: My friends don’t text me back or my boyfriend doesn’t show up when
he’s supposed to.
My emotional button’s connection to the past: I remember my mom leaving me all alone at
home or locked in my room while she spent time with her boyfriends. I felt abandoned
and empty when my mom chose her own needs over mine—which was almost all the
time.
My emotional button’s connection to the present: I feel abandoned and empty when my
friends and boyfriend blow me off, or when I think they’re blowing me off, which is not
always true.
My emotional button’s connection to the future: I feel so sure this is how it’s always going
to be. Because why would it change? How could it?
Let’s explore how your emotional buttons connect to your past, impact your present, and
influence your expectations of the future. Be as descriptive as you can, be patient with your-
self, and take breaks if you need to. Do this at your own pace and in a way that fits for you.
Emotional button:
Emotional button:
Emotional button:
Being able to uncover the sequence from emotional button to thoughts, feelings, and
memories to beliefs, behaviors, and patterns to how they’re linked to your past, present, and
future is a powerful skill. When you know what your emotional buttons mean, and the influ-
ence they have on you, you’re empowered to manage your responses and to choose to not
engage in negative patterns. This lessens the control BPD has over you. Now that you know
what some of your emotional buttons are and all that they impact, you’re ready to learn skills
to manage how you respond to them.
In other words, when you’re first learning to manage your responses, don’t work on them
while they’re happening. Only work on them when you’re not activated or overwhelmed.
When the “iron” of your emotional reaction is hot, it’s hard to handle. When it has cooled
down, it’s manageable—you can “touch” it without getting burned. There’s room to maneu-
ver, emotionally speaking. Black belts in karate approach training like this. They train for
countless hours, building new skills. Then when they have a match—when things are “hot”—
their mind and body are ready. It’s best to approach learning how to manage emotional
button responses the same way. You practice and train so when the challenge comes, you’re
better able to control yourself, act differently, and influence the outcome so it’s more likely to
be in your favor.
Before we get to the specific strategies, we have to plan when and with whom we’re most
likely to need these strategies—when our iron is likely to heat up. Karate masters think about
possible scenarios in which they may have to use their training, and so should you. Use the
space below to identify the people and situations that push your buttons.
The situations in which I’m most likely to have my emotional buttons pushed are:
Below are three management strategies that will help you when your emotional buttons
get pushed. Pick the one (or ones) that feels like a good fit with your lifestyle and interests,
and practice it every day, several times a day.
Break Time
This strategy is about taking a break when your buttons have been pushed, so you can
stop what you’re doing and remove yourself from the situation. Depending on the context, to
get your break time you could say, “Excuse me, I need to go to the restroom,” or “I need to
make a call,” or “I want to hear what you’re saying, and I’ll be back. I just have to take care
110 The Borderline Personality Disorder Workbook
of something first, and then I’ll be able to give you my full attention.” Once you’ve removed
yourself from the situation, find a safe place to collect your thoughts. For example, if you’re at
work or at a restaurant, you can excuse yourself, go to the bathroom, and breathe.
During your break, remember that your emotional buttons are about what was and not
what is. Stay aware of the here and now, and allow the emotional buttons to deactivate. It
might help to imagine that you’re a karate master, floating on a cloud in the here and now,
focusing on the present, and deactivating your emotional buttons as your iron grows colder
and colder and you become more and more in control. You might also look online for images
that represent your break time and your iron cooling down.
Practice these techniques multiple times during the day. In the spaces below, design your
break time in advance by writing out the places you can go, what you can say to remove
yourself, and what images will work for you when your emotional buttons are pressed. Try to
imagine the people (friends or family members) who and situations (at work or while online)
that tend to push your buttons. The more preparation you do, the more likely you are to
maintain your focus and control when your buttons are pressed.
Self-Statements of Truth
Self-statements of truth are the positive and honest things you say to yourself when your
emotional buttons are pressed, such as I’m safe, I don’t have to do anything I don’t want to do,
I’m in control of my choices, or This is just my past talking. This isn’t really what I think it is. These
statements are meant to calm you, but they also empower you to manage the situation. Use
the space below to list your self-statements of truth (you can use the ones above or make up
Freedom from the Trap of Emotional Buttons 111
your own) and when and where you plan to practice them. Remember, lots of practice in lots
of different situations is the best way to build this skill.
My self-statements of truth:
Strategic Distraction
Strategic distraction is a great technique for when you feel your emotional buttons have
been pressed. Some examples include starting a conversation with a safe and positive person
(someone who’s encouraging, who isn’t going to focus on the negatives), reading a book, going
for a walk, playing a game on your phone, going to an AA or NA meeting (if you’re in either
program), and so on. The purpose is to direct your attention away from your thoughts, feel-
ings, and memories so you can, in a controlled manner, collect yourself and reengage with the
person or situation that pressed your emotional button. Try to think of some strategic distrac-
tion techniques that might work for you.
The more you plan for and practice button-pressing situations with different people, the
more skill you’ll develop and the more choice and control you’ll have so you can respond
differently.
Emotional button:
Freedom from the Trap of Emotional Buttons 113
Your BPD has used emotional button responses to control you, but this chapter has given
you some powerful new ways to manage them, and to grow beyond your BPD. As you develop
the skill of being able to clearly see situations and circumstances through the distortion of
your emotional buttons, you’ll have more opportunities for control and success.
1.
2.
3.
114 The Borderline Personality Disorder Workbook
1.
2.
3.
Controlling your emotional buttons is very empowering, and taking this skill forward
with you is important because you’re going to continue to encounter situations that will chal-
lenge and stress you. In the next chapter, as you continue your journey of overcoming BPD,
we’re going to discuss these high-stress situations.
CHAPTER 11
As you’ve made your way through this workbook, you’ve learned to challenge your BPD
beliefs, behaviors, and patterns and to grow beyond them. In this chapter, we’ll continue this
journey by identifying and exploring the typical high-risk situations in which you lose control
and your BPD makes decisions for you, decreasing the probability of a successful outcome.
You can probably think of a few of these situations right now. Perhaps they are with a family
member at dinner, a significant other when you’re out on a date, a coworker in the breakroom
or during a meeting, or with a stranger in line at the grocery store. To manage these high-risk
situations in your life, you need to understand what they are, plan for what you’re going to do
when they arise, and learn to respond using adaptive and healthy behaviors that decrease the
probability of you falling into your negative beliefs, behaviors, and patterns. I’ll cover these
topics in depth in this chapter.
Interpersonal Interactions
High-risk interpersonal interactions tend to involve a lot of conflict and are linked to
specific individuals and associated thoughts, feelings, or beliefs. They typically occur when
you feel you’ve lost the support of a friend, loved one, or family member and feel worthless,
abandoned, rejected, and so on.
One of Tony’s high-risk interpersonal interactions involved wanting to be closer to his
girlfriends than they wanted to be to him. This interaction activated his fear of being alone,
worthless, and unrecognized. For example, when he tried to get closer to Pam too quickly, she
distanced herself from him. As she pulled away, he then tried harder to win her love and be
closer to her—calling and texting her repeatedly when asked not to, showing up unan-
nounced at her work and professing his undying love for her. But his efforts only pushed her
further away—the opposite of what he wanted.
In the space below, identify the individuals and associated thoughts, feelings, and beliefs
that tend to make up or create your high-risk interpersonal interactions, and describe what
tends to happen in these interactions. Put in as much detail as you can, and use more paper
if you need to.
Negative Emotions
Negative emotions include anger, anxiety, stress, guilt, loneliness, helplessness, shame,
and feelings of being trapped, to name a few. With BPD, these emotions tend to overwhelm
you, causing you to have a hard time seeing anything adaptive or positive about yourself,
others, and situations. This may cause you to fall into your negative beliefs, behaviors, and
patterns, destroying your ability to see clearly and to grow, which is what your BPD wants so
it can continue to thrive.
Controlling High-Risk Situations 117
Tony’s negative emotions of self-hate, doubt, and contempt for his life and his abilities
came up after talking to, or spending time with, his mother. When he felt this way, he fell
into his negative patterns of calling himself worthless and incompetent, and he tended to
neglect all other things in his life. This caused other people to feel neglected and to pull away,
because he appeared inconsistent and uncaring, the opposite of how he felt and of how he
wanted to be perceived.
In the space below, write about the negative emotions, such as fear, loneliness, abandon-
ment, and anxiety, that prompt you to engage in your negative beliefs, behaviors, and pat-
terns, and about how you tend to react when you have these emotions. Put in as much detail
as you can, and use more paper if you need to.
Life Events
High-risk life events include divorce, unemployment, death of a loved one, end of a rela-
tionship, personal injury, financial problems, imprisonment, or anything that causes signifi-
cant physical or psychological pain and discomfort.
Tony experienced a cascade of high-risk life events. He was fired from his job and had to
move back in with his mother. She then criticized him for his “laziness,” making him feel
worthless, even though he was continually trying to find work. In the middle of all this, his
girlfriend left him. Eventually, Tony fell back into his negative pattern of abusing alcohol and
intensely trying to find a new girlfriend.
In the space below, describe your high-risk life events in as much detail as you can and
what you did when they occurred. Put in as much detail as you can, and use more paper if you
need to.
118 The Borderline Personality Disorder Workbook
Cognitive Distress
Cognitive distress entails negative thoughts and memories you can’t get out of your mind
that are related to fear, danger, past trauma, or stressful events. It causes intense anxiety,
uneasiness, agitation, and so on.
Tony would often say that he was “haunted” by the loss of his father. His guidance coun-
selor in elementary school had to tell him about his father’s death because his mother refused
to speak about it. When Tony had memories of being in elementary school and learning of
his father, they were intense, like a flashback. As a result, he often would drink alone until
he passed out, but when he woke up he still remembered why he drank so much.
In the space below, in as much detail as you can or feel comfortable doing, write about
your high-risk cognitive distress and what you tend to do when you feel it. If this gets too dif-
ficult or you feel overwhelmed, take a break, talk to a positive friend or a mental health pro-
vider, and come back to this exercise when you feel ready. Use more paper if you need to.
When Tony went online to look at social media, he would often see his friends and ex-
girlfriends having good times with others, going exciting places, and doing things he wished
he was doing (his cue). As he looked at these images, he felt compelled to call and text his
girlfriend to try and have the experiences and perceived happiness he was seeing online (his
urge). This cue and urge started a sequence of thoughts about being alone and unloved, and
these thoughts led to feelings of isolation, worthlessness, and depression. These feelings felt
valid because of memories of his mother saying hurtful things, and of past girlfriends leaving
him and wanting nothing to do with him. In response to these feelings Tony would repeatedly
call and text his girlfriend until she responded, and if she didn’t, he’d go to her job and try to
talk to her, which pushed her further away, when all he wanted was to be close to her and to
experience the great lives he believed he was seeing online.
In the space below, write about your high-risk cues and urges. Put in as much detail as you
can, and use more paper if you need to.
Make a list of things you can do that are healthy, such as take a walk, play with your dog
or cat, play a game on your phone, or go to the bathroom to have a moment to catch
your breath.
Make a list of all the benefits of not falling into your negative patterns.
Make a list of what you’re grateful for and then review it.
Treat yourself to a reward for not engaging in your negative patterns. For example, buy
yourself a latte or an ice cream cone or go to a movie (something funny and positive
that encourages a positive mood).
Smell an essential oil, such as lavender, cinnamon, or cedarwood, that helps you refocus
and calms you down.
Smile—it actually reduces the body’s stress response (Kraft and Pressman 2012).
Other:
Other:
Other:
Controlling High-Risk Situations 121
Hopefully you found some behavior options for your high-risk situations. To master these
new behaviors and make them your default responses, you’ll need to practice them as often
as you can. Now we’ll move to applying your new alternative behaviors to your high-risk
situations.
Learning new skills takes time and patience. I understand that it can be difficult, particu-
larly for individuals with BPD, but replacing negative beliefs, behaviors, and patterns with
adaptive and healthy ones is an important part of the growth process. If you can, practice
using the alternative behaviors you identified above two to three times a day. If you can’t
physically do this, then practice them in your mind; this is a great way to build skills too.
122 The Borderline Personality Disorder Workbook
1.
2.
3.
1.
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3.
Now that you’ve learned about managing high-risk situations and developed a plan for
engaging in adaptive and healthy alternative behaviors, you’ll have greater control over your
BPD when those high-risk situations occur and be better equipped to make choices that
increase the likelihood of positive outcomes. This helps to set the stage for challenging and
changing the dysfunctional beliefs that support your BPD.
CHAPTER 12
Many of your negative patterns are rooted in dysfunctional beliefs that developed alongside
your BPD. It’s time to start changing those beliefs.
Much of the content of this chapter is derived from self-determination theory, which
proposes that people are driven to better themselves and correct areas of difficulty in life—to
which dysfunctional beliefs certainly contribute (Ryan and Deci 2002). In this chapter, you’re
going to learn to recognize your dysfunctional beliefs, challenge their accuracy, identify evi-
dence that shows they’re untrue, and counter them with healthy and adaptive beliefs. This
process will help you weaken them and grow beyond them, allowing you to continue on this
path of growth beyond your BPD.
When Betty started a new nursing job, it seemed to her that all of her new coworkers were
very close to each other but not accepting of her. She drew these conclusions because, as
her first day on the job progressed, people greeted her but wouldn’t really stop to talk and
get to know her. She watched everyone else laugh and joke with each other, and she started
to believe that they were laughing and joking about her and sharing their judgments about
how “stupid” she must be. As these thoughts gained force, she couldn’t focus on her job.
She made a minor mistake on a patient’s chart, as parts of the computer system used in
the office were new to her, and other employees had to help her fix it. This mistake, coupled
with her inexperience, only justified the accuracy of her dysfunctional beliefs, causing
increased anxiety, frustration, and anger. One of the nurses who had helped her told her,
“If you need anything, just let me know.” Betty misinterpreted this, and heard, “I know
you’re too stupid to do this job, so when you need more help, which you will, I will fix your
mistake again.” Feeling she had to defend herself against the attack, Betty jumped up and
pushed the other nurse. Her new boss saw this and fired Betty on the spot.
Have you ever been in a situation similar to Betty’s, in that your dysfunctional beliefs had
a significant negative impact on how you interpreted your environment? If so, you’re not
alone! Change is possible, and it comes about when you build your sense of self-determina-
tion, learning what is true about yourself and what you want to achieve, and then using that
knowledge to challenge dysfunctional beliefs to have better control of yourself and how you
see the world. Here’s the process:
dysfunctional beliefs took over, and she got caught up thinking that people were talking
about and judging her. Anxiety quickly overwhelmed her, and she couldn’t clearly see what
was happening or accurately hear what the other nurse had said to her. Her intense anxiety
pushed her to react inappropriately, in service of her dysfunctional beliefs.
Had she identified her dysfunctional beliefs before her first day on the job, she would have
known when they were triggering her and seen that they were causing her to stray from her
goal: keeping her new job. If she’d been able to challenge her dysfunctional beliefs and replace
them with functional beliefs (“I’m a great nurse,” “I can do this job well,” “Everyone makes
mistakes and no one is perfect, so it’s possible to be liked even if I’m not perfect all the time”),
she might have navigated her first day successfully. Instead, her dysfunctional beliefs pushed
her to be painfully, disastrously reactive, and she was fired.
As this story shows, dysfunctional beliefs can have severe consequences, so it’s of utmost
importance to identify yours. Below is a list of common dysfunctional beliefs. Circle the ones
that fit for you, being as honest and open as you can. There are spaces to add your own
unique beliefs to the list.
• People, including me, can’t change. • You disrespect me by not doing what I
want.
• People are always unkind.
• If you valued me, I would be earning
• I’m lazy. more money.
• I must be perfect at all times. • I must not make a mistake.
• I’ll never be happy. • I must cope with everything.
• If anything can go wrong, it will. • I must be in control of all situations.
• I’m stupid if I make a mistake. • Things must go well.
• I should have done better. • Others must always treat me well.
• Life, the world, and other people should • I’m just no good.
be fair.
•
• I must get everything done today.
Identifying your dysfunctional beliefs can bring up many thoughts, feelings, and memo-
ries, which are important to recognize. Many of your dysfunctional beliefs have origins in
your past, and identifying the connected thoughts, feelings, and memories can help clear the
confusion and conflict these distorted beliefs bring to your world. Using the prompts below,
identify the thoughts, feelings, and memories the exercise above brought up for you.
My dysfunctional belief is that I must be liked at all times, but it’s untrue because even when
my friends and boyfriend get mad at me, we end up making up, and they don’t leave
me forever.
My dysfunctional belief is that I must be perfect at all times or no one will like me, but it’s
untrue because I’ve had many fights with Sara, and we’re still friends after all these
years. When I dented the fender of James’s car, he didn’t like it, but he told me he still
loved me, and I believed him.
• I have the power to achieve my goals. • I deserve to feel good and happy.
• I deserve to be treated kindly and with • I can choose my own thoughts and
care. beliefs.
• My kindness is my strength.
Now that you’ve identified adaptive and healthy beliefs, it’s time to pair them with your
weakened, old dysfunctional beliefs. By doing this, you’re zeroing in on replacement beliefs
that will encourage, empower, and vitalize the accurate and honest part of you—the part
that’s not connected to your BPD.
Here’s an example of Betty’s:
My old dysfunctional beliefs are I must be liked at all times and I must be perfect at all
times or no one will like me.
My adaptive and healthy beliefs to counter these are I am good and I have value, regardless
of who likes me. Mistakes don’t define me; I define me, and that’s enough for people to
like me.
When Betty challenged and replaced her dysfunctional beliefs, they lost their power. By
doing this routinely, and learning other techniques, she was better able to control them and
her associated BPD behaviors. As she built up her skills, she was able to maintain employ-
ment; to enjoy interacting with her friends, family, and boyfriend; and to achieve more in life.
In other words, she was able to reach her goals and grow beyond her BPD, as you’re learning
to do.
It’s your turn to replace your old dysfunctional beliefs with adaptive and healthy beliefs.
In the spaces below, list your old dysfunctional beliefs first. You can use the ones you identi-
fied above, or new ones you want to weaken and replace. You can download a copy of this
exercise at http://www.newharbinger.com/42730.
Now it’s time to strengthen your adaptive and healthy beliefs using the same method your
dysfunctional beliefs have used all these years—repetition, repetition, repetition. I want you
to repeat your adaptive and healthy beliefs to yourself as often as you can. Say them in the
morning when you get up, say them on your way to lunch, say them when you lie down to go
to sleep, and say them everywhere in between. Write them on sticky notes and post them
around your room. Sing them in the shower. The more you say them and the more you read
them, the more you will live them. As you live your adaptive and healthy beliefs, you’ll find
that you have greater self-control and self-understanding and less of what has empowered
your BPD for so long.
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2.
3.
Challenging and Changing Dysfunctional Beliefs 131
1.
2.
3.
Now that you’ve developed the skills to challenge your dysfunctional beliefs and change
them into adaptive and healthy ones, it’s time to learn valuable self-soothing techniques that
will further enhance your self-control.
CHAPTER 13
Self-Soothing to Enhance
Personal Control
Can you think of times when an event or an individual triggered you, and you reacted in a
way that caused you to lose a relationship, hurt yourself, fall into a depression, become over-
whelmed with anxiety, and then fall back to default negative beliefs, behaviors, and patterns?
What if I told you that in these situations there’s a way for you to calm down, reassess the
situation, and engage in a manner that increases the probability of a positive outcome? Would
you be interested in learning how? Most people would answer yes, and that’s what this chapter
is about: teaching you self-soothing techniques to enhance your personal control in challeng-
ing situations.
Personal control is the ability people have to influence their beliefs, behaviors, and pat-
terns in order to achieve particular outcomes. For example, when Tony felt worthless and
invisible, he seemed to have little personal control over his drive to connect with romantic
partners; he would text them at all hours and show up at their workplace unannounced as if
he didn’t have a choice. Once he learned to slow himself down using self-soothing tech-
niques, he increased his personal control in difficult situations and was able to approach them
differently.
Self-soothing is the ability to comfort yourself when you’re upset or distressed, and self-
soothing techniques can help calm you down, allowing you to refocus when you’re triggered
or your buttons are pressed. These techniques are easy to learn and don’t take much time at
all, which makes them very useful and beneficial. I used the analogy of striking when the iron
is cold when talking about controlling your emotional buttons, and this is good advice for all
the skills and techniques in this workbook, including self-soothing techniques. Striking when
the iron is cold entails practicing skills and techniques multiple times a day when you’re calm,
not when you’re in distress. Practicing before you’re triggered is critical, so you’re ready when
someone or something is getting under your skin.
134 The Borderline Personality Disorder Workbook
Self-Soothing Techniques
You should use the first two self-soothing techniques, mindfulness and yoga, to reduce the
likelihood of your iron heating up in the first place, and the venting journal and distraction
techniques are for those instances when you feel your iron heating up—when you’re about to,
or have been, triggered. Practice these techniques as often as you can to build a sense of
mastery, so you’re prepared and ready to reach the best possible outcome with a clear head,
enhanced personal control, and adaptive and healthy beliefs, behaviors, and patterns.
Mindfulness
Mindfulness is the art of focusing your attention on the present and calmly recognizing
and accepting your feelings, thoughts, and bodily sensations as they are in that moment. By
doing this, you decrease the likelihood that you’ll respond to triggers using your default nega-
tive beliefs, behaviors, and patterns that have sustained your BPD for so long. Try this seven-
step mindfulness technique for one minute, or for as long as you can and need to, until you
feel calm, focused, and relaxed. Like any other skill, the more you do this one the better you’ll
get at it.
2. Sit comfortably, with your back straight but relaxed. Close your eyes, if doing so feels
comfortable.
3. Focus your attention on your breath going in and out—in through your nose, and out
through your mouth.
4. Don’t judge what comes to mind. Let it float in and float out.
5. Let distractions come and go, and stay as focused as you can on your breath and being
in the present moment, nothing else.
6. When you feel relaxed, notice your breath and how you feel. Open your eyes and be
mindful of the present.
what it was like for you (scary, uncomfortable, relaxing, empowering) and what made it that
way (“I wasn’t sure what was going to happen,” “I felt my anxiety lower and I could control
my thoughts”).
Yoga
Yoga has been around for a very, very long time, and kings and kids and everyone in
between have used it. Yoga can be beneficial no matter your age or mental state. It provides
mental calmness, stress reduction, and body awareness, which leads to increased self-confi-
dence and personal control. The skills you learn in yoga—controlling thoughts and focusing
on breathing—can improve your mental health before, during, and after you’ve been
triggered.
You don’t have to go to a yoga class or buy the outfits, and all that other stuff, if you don’t
want to. You can learn about and practice yoga using free YouTube videos. These offer privacy,
which might be important to you. Regardless of how you decide to give yoga a try, be it
through videos or classes, try practicing yoga as often as you can to reap the most benefits.
Venting Journal
When you’re triggered, do you feel the pressure build until you just can’t hold it any longer
and you explode in anger, either verbally or physically? The venting journal is a technique for
releasing all of your negative thoughts and feelings without editing or holding back. It offers
unrestrained opportunities to get it out, express yourself, examine what upset you, and develop
a sense of calm and relaxation in a safe and secure way.
Your venting journal can be written or recorded, and you can keep it in a notebook, on
your computer, or on your phone—anywhere you like. One great benefit of the venting
journal is that you can do it any time, day or night, go on for as long as you want or need, and
136 The Borderline Personality Disorder Workbook
review it to understand yourself in the moment. It’s a great tool for monitoring how you
respond to particular situations.
The following prompts might help you get started, but you don’t have to use these. You
can write your own or freestyle without prompts, if you prefer. Do whatever works for you.
Try using this technique whenever you feel your iron heating up, even if you’re only trig-
gered a little bit. When you’ve used the venting journal steadily for a week or so, decide if it’s
something you’d like to keep using going forward.
Distraction
Distraction is a very effective self-soothing technique that physically or mentally, or both,
removes you from a triggering situation. Pick two or three distraction techniques from the
following list that you think might really absorb you, that might pull your attention away from
a triggering event or individual:
• Listen to music.
• Make lists of everything you have to do, things you’ve done, things you may want to
buy, how you’re going to achieve your dreams, healthy adventures you’d like to have,
and so forth.
• Go dancing or play your favorite song and dance in your living room.
• Count things around you, such as floor tiles, cracks in the street, chocolate chips on
the top of a cookie (my favorite), and so on.
• Smell an essential oil. (Find an essential oil you like, that you find soothing, and save
it for distraction purposes. Some popular examples include lavender, cedarwood,
lemon, mandarin, and jasmine. These oils can be found online or in many grocery
stores.)
• Other:
• Other:
These techniques are great for when you’re triggered, but you should practice them when
you’re not triggered as well, to build your skill for using them when you need to be distracted,
calm, and in control the most. Here are the four steps for using the techniques:
3. Reassess your thoughts and feelings to see if the drive to react negatively has
lessened.
a. If the drive has lessened, and you’ve identified an adaptive and healthy response
to engage in, go to step 4.
b. If it hasn’t, go back to step 2.
138 The Borderline Personality Disorder Workbook
4. Reengage in the situation, or with the individual, in a clearer state of mind: relaxed,
calm, and focused using your adaptive and healthy response patterns.
Self-Soothing Rating
Techniques
Mindfulness 0 1 2 3 4 5
Yoga 0 1 2 3 4 5
Venting journal 0 1 2 3 4 5
Distraction 0 1 2 3 4 5
As you complete the log, you’re likely to notice that your skills for personal control and
identifying better outcomes improve as you practice using self-soothing techniques. Remember,
the more you practice, the greater control you’ll have over your BPD and your negative beliefs,
behaviors, and patterns.
1.
2.
3.
1.
2.
3.
Now that you’ve started to use skills to self-soothe and increase your personal control,
you’re ready to continue this journey and explore ways to strengthen love and resolve rela-
tionship conflict.
CHAPTER 14
Many individuals with BPD struggle with relationship conflicts, issues, and satisfaction,
which are connected to what we’ll call relationship habits. To understand what these are, we
have to first define habits and recognize their influence. Habits are learned behaviors that
people automatically engage in when they encounter an activating event (for example, biting
your nails when you’re nervous about having an unexpected meeting with your boss). Habits
can be bad or good, and it’s possible to resolve and reduce bad habits and develop the good
ones to give yourself a sense of empowerment, courage, and confidence.
Relationship habits are automatic reactions we have to people we’re in relationships with,
not only romantic relationships but those with friends, coworkers, and acquaintances. These
responses involve our beliefs, behaviors, and patterns. Do you experience and engage in a
particular belief, behavior, or pattern when you go home for the holidays and you’re around
your family, when you see your boss at work, or when you see a certain look on your signifi-
cant other’s face? These responses probably occur without you even noticing or thinking
about them, because they are developed relationship habits. These responses can be destruc-
tive forces that cause chaos and conflict, or they can be empowering and strengthen the love,
tenderness, confidence, and care you feel for yourself and others.
Your BPD has been using your relationship habits to flourish, but in this chapter you’re
going to learn how to strengthen the good relationship habits and reduce and resolve the
destructive ones. I’m going to define the ten destructive relationship habits that reduce your
relationship satisfaction and success, as well as the ten empowering relationship habits that
strengthen the love and resolve you experience (or want to experience) in your
relationships.
142 The Borderline Personality Disorder Workbook
Habit Impact
Yelling When we yell and scream, others close down and block out
what we’re trying to say, instead preparing for a counterattack.
It’s a misconception that the louder we are, the more others
hear us.
Refusing to When you believe firmly that you didn’t or couldn’t make a
admit you made mistake, others tend to see you as having less integrity, which
a mistake lowers trust and openness.
Finger-pointing When we blame others for our relationship problems, they tend
to become defensive, and over time this habit builds resentment.
Cussing When we use very strong and negative language, others tend to
get defensive, and they don’t hear what we’re trying to say or
understand the emotions we’re trying to communicate.
Strengthening Love and Resolving Relationship Conflict 143
Habit Impact
Name-calling When we call people hurtful names, they become angry and
defensive, and over time this builds resentment. This includes
“playful” name-calling, such as calling a friend a “loser” as a
joke.
Seeing only one When we refuse to see the other person’s viewpoint, we get lost
side of the story in our own perspective of the situation and the relationship and
are limited to only seeing half of what’s going on.
Expecting Expecting others to fill our “love tank” puts a lot of pressure on
someone else them and the relationship. It also makes us dependent on
to fill our others, and we might tend to be very anxious and cautious for
“love tank” fear of losing people whom we depend on.
If you marked most or all of the destructive relationship habits, don’t be angry with your-
self or attack yourself, because these habits are common. Please take a moment and explore
your responses.
Describe how the destructive habits you marked impact how you feel about yourself.
Describe how the destructive habits you marked impact relationships with your significant other,
your children, your parents, your friends, your coworkers, and other people in your life.
144 The Borderline Personality Disorder Workbook
How do you tend to feel after you or someone else uses a destructive relationship habit?
How do you think your significant other, your children, your parents, your friends, your cowork-
ers, and other people in your life feel after you use a destructive relationship habit?
Let’s take a look at how destructive habits contributed to the chaos, conflict, and nega-
tive intensity in Betty’s relationship. In parentheses I inserted specific habits she and Michael
engaged in.
When Betty arrived home late one evening, having worked a fourteen-hour shift at the
hospital, her boyfriend, Michael, calmly and clearly asked, “What happened at work? How
come you’re late?”
Betty was tired and felt attacked. She thought Michael was accusing her of being
dishonest and unfaithful (a triggering event) and said, “I’m tired, and I don’t have to justify
myself to you! You’re not my daddy! Who do you think you are?” (Refusing to apologize)
Michael raised his voice and sarcastically said, “Here we go again, causing problems
when there aren’t any! Just shut it down already!”
Betty yelled back. “You shit-heel! I hate you! You don’t know a thing about what I go
through each day and you just don’t care.” (Cussing, name-calling, yelling, seeing only one
side of the story, statements of hate, speaking in generalities, and finger-pointing)
Strengthening Love and Resolving Relationship Conflict 145
Michael’s guard went up, and he yelled, “Why are you jumping all over me! I didn’t
even do anything wrong!” (Cussing, yelling, refusing to apologize, refusing to admit you
made a mistake)
Betty continued to get upset and threw books at him, followed by the TV remote. She
started to think that Michael was going to rush out of the house and leave her forever, and
a feeling of emptiness began to build inside of her (expecting someone else to fill our “love
tank”). The argument continued until Betty ran into the bathroom and cut herself while
Michael beat on the door for her to come out.
When destructive relationship habits are used, it’s not uncommon for negative reactions
to intensify until there’s an explosion, like the one between Betty and Michael. But relation-
ship interactions don’t have to go this way. Because personal relationships are a significant
part of everyone’s life, we want to develop relationship habits that empower them and resolve
and reduce those habits that destroy them. Identifying your relationship habits is an impor-
tant part of doing this, and of continuing to grow beyond your BPD.
It’s important to mention that both Betty and Michael used destructive relationship
habits. Betty was not 100 percent responsible for the relationship problems even though she
was the only one working to grow beyond her BPD. You can change your relationship habits
to empowering ones, but others may continue to use destructive ones. Using empowering
relationship habits will increase the likelihood of a better outcome for you, and for your rela-
tionships, but you can’t make someone else use them. As you make your way through this
chapter and the rest of the book, remember that you can model change and growth, but it’s
up to other people to make their own changes.
Habit Impact
Using a calm and When we talk to others with a tone that is low volume, slow, and
collected tone steady, others are more likely to hear what we’re saying, understand
what we mean, and take us more seriously.
Statements of When we talk to others with kindness and tenderness, they’re more
compassion open, relaxed, and likely to do what we ask and provide us with
what we want and need.
Admitting when This is a healthy and honest thing to do. Others will trust you more
you make a mistake and feel open when talking with you.
Speaking in specifics When we’re clear and specific, we’re more likely to have our wants
and needs met because others are more likely to understand what
we want and need. Specifics remove the need for mind reading.
Apologizing When you apologize, others tend to feel that they can trust you and
that you’re open and honest, which increases the likelihood that they
will be the same.
Separating Focusing on the problem and not people and their character
the person from reduces the likelihood that they’ll feel compelled to defend their
the problem pride and self-esteem.
Examining unmet Many arguments are not about the problem but unmet needs or
needs that are hidden hurts. Communicate your needs clearly using I-messages.
making you angry (For example, “I feel unimportant when you don’t call to tell me
you’re going to be late.”)
Believing in a Argue with a focus on a solution, not on the argument itself and
solution winning. Know your goal for having the argument and how you, and
the other person, are going to achieve a positive resolution. Getting
there hand in hand is easier than having a tug-of-war to win.
Loving yourself Do things that build self-confidence and an appreciation for yourself.
outside of the Learn to value your self-worth without external validation. The best
relationship relationships are with two whole people, not two halves who need to
connect to feel whole.
Strengthening Love and Resolving Relationship Conflict 147
As you went through the empowering relationships habits, were you able to identify some
of yours? If you found a few, that’s great, but if you didn’t, that’s okay, because you’re here to
learn these skills, and you care enough about yourself and your relationships to do things dif-
ferently. Please explore the impact that empowering habits have on your relationships now, or
will have on your relationships as you practice using them.
Describe how the empowering habits you marked impact how you feel about yourself.
Describe how the empowering habits you marked impact relationships with your significant
other, your children, your parents, your friends, your coworkers, and other people in your life.
How do you tend to feel after you or someone else uses an empowering relationship habit?
148 The Borderline Personality Disorder Workbook
How do you think your significant other, your children, your parents, your friends, your cowork-
ers, and other people in your life feel after you use an empowering relationship habit?
Let’s look at the argument Betty and Michael had, but this time through the lens of
empowering relationship habits.
Betty came home from working a fourteen-hour shift at the hospital. She recognized that
she was tired because she had stayed an extra two hours due to a patient emergency. As
she pulled into her driveway, she took a deep breath and remembered that she had not
called Michael and that he was probably worried about her (separating the person from the
problem, using a de-escalation approach). She walked into the house and Michael calmly
and clearly said, “What happened at work? How come you’re late?”
Betty took a deep breath, recognized his statement of concern and compassion,
remembered that she didn’t have to prove anything, and responded, “I’m sorry. I totally
forgot to call you. A patient had a seizure and someone else from the treatment team called
in sick, so I stayed until we could get it under control” (using a calm and collected tone,
statements of compassion, admitting when you make a mistake, speaking in specifics, and
apologizing).
Michael paused for a moment, looking at her from the couch. “I know you work a lot
and you give a lot to your job, but I worry that you’re hurt when you don’t call me. Please
try to call next time, and I’m glad you’re okay” (examining unmet needs that are making
you angry).
Betty replied, “Thanks for understanding. I appreciate you very much. I’ll be sure to
call next time” (believing in a solution). As Betty walked to her room to change her clothes,
she thought about how proud of herself she was that she had maintained control, addressed
the issue, and avoided an argument (loving yourself outside of the relationship).
This interaction has a very different feel to it, don’t you think? It doesn’t feel contentious,
hostile, and attacking, but calm, patient, and caring. This is what using the empowering
relationship habits can do, and why they’re so beneficial, encouraging you to grow beyond
your BPD.
Strengthening Love and Resolving Relationship Conflict 149
When you compare the destructive and empowering relationship habits, can you see how
differently they might affect how you feel about yourself and your relationships? The destruc-
tive habits have a fierce and negative impact, while the empowering habits have a calming
and “clearing of confusion” type of impact. We’re now going to turn our attention to imple-
menting these empowering relationship habits in your adaptive and healthy response patterns
through imagery and practice.
2. Imagine the other person or people (your significant other, children, parents, friends,
or coworkers).
3. Imagine the environment you’re in. Are you at home, at the office, in the car, on the
street, or somewhere else altogether?
4. You and this other person are engaging in a discussion of your choosing. Perhaps you
came home late, like Betty. Perhaps you forgot to call the other person. Perhaps your
child is acting out.
150 The Borderline Personality Disorder Workbook
5. Visualize the empowering relationship habits you marked previously, as well as the
ones you want to learn and use going forward: using a calm and collected tone,
making statements of compassion, admitting when you make a mistake, speaking in
specifics, apologizing, separating the person from the problem, using a de-escalation
approach, examining unmet needs that are making you angry, believing in a solution,
loving yourself outside of the relationship.
6. Imagine with as much detail as you can that you’re responding to this other person
using the empowering habits you chose.
7. You can see their response. Perhaps this person is respectful and listens to you, or
perhaps he or she refuses to stop using destructive habits, but you stay the course. You
stay true to your empowering habits.
8. Take a moment and scan your body to see how you feel. Take a few deep breaths and
allow yourself to relax, then reengage in your imagery.
9. How does the situation end? Do you use the empowering habits all the way through?
Does the interaction de-escalate? Do you resolve the situation calmly? Does the other
person walk away?
10. Evaluate and scan your body for how you feel after having used and stayed true to the
empowering relationship habits. Do you feel less tension, anger, and rage and more
hope, control, and empowerment?
Now it’s your turn to identify some imagery details and scenarios you can use to practice
implementing empowering relationship habits. You can download a copy of this worksheet at
http://www.newharbinger.com/42730.
Strengthening Love and Resolving Relationship Conflict 151
3. Describe the environment you’re in. Are you at home, at the office, in the car, on the street,
or somewhere else altogether?
4. Describe the discussion or argument you and this other person (or these other people) are
engaged in.
5. Circle the empowering relationship habits you want to use going forward:
Statements of compassion
Speaking in specifics
Apologizing
Believing in a solution
6. Describe in as much detail as you can how you’re going to respond using the empowering
habits you chose.
7. Describe the other person’s (or people’s) response in as much detail as you can.
8. Describe how your body feels having gone through this exercise.
Strengthening Love and Resolving Relationship Conflict 153
10. Describe how you feel having used and stayed true to the empowering relationship habits.
You can do this writing activity as often as you like. Practice the empowering relationship
habits and go through the ten imagery steps as often as possible. You can use imagery while
you’re in your car, in the shower, on hold on the phone—really, any time you want. Try to
practice at least two to three times a day, and as you master the habits you chose to work on
you can choose new ones to practice with. Betty was able to do imagery exercises several
times a day while she was bringing materials to nurses and doctors in the hospital, when she
was in the shower, and while working out at the gym. By doing the imagery exercises, she
found it was easier to implement and use the empowering relationship habits when she needed
them most, and this practice helped her to continue growing beyond her BPD.
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3.
154 The Borderline Personality Disorder Workbook
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3.
You made it to the end of part 3 of the workbook! This is a wonderful accomplishment,
and my hat’s off to you. In this part of the workbook you gained extensive information about
negative behaviors and patterns related to your BPD and learned methods to reduce their
occurrence and replace them with adaptive and healthy alternatives. These empowering
skills will help you to keep moving forward in a clear and motivated manner. You’re now
ready to go deeper and explore and change the core issues that have kept your BPD in place
for so long.
Before you move on to part 4, I recommend that you go through the summary for part 3
that’s available for download at http://www.newharbinger.com/42730. This summary pulls
together the concepts, activities, and exercises from part 3, and it will help strengthen what
you learned.
PART 4
At the heart of many BPD issues is the core content that was put in place by developmental
experiences, those that happened in childhood and as you grew up. Core content influences
how you see, feel, think, and react when you feel stressed, depressed, anxious, elated, aban-
doned, prideful, threatened, confident, happy, trapped, scared, and so on. Not all of your core
content is negative, but the negative content has contributed to the development of your
BPD, and negative core content is activated when people, statements, memories, beliefs, and
situations cause you to feel like you’re repeating past experiences and are emotionally trapped
in them. This results in a flood of intense negative emotions, confusion, and conflict that
people attempt to reduce any way they can. Unfortunately, people with BPD usually default
to negative beliefs, behaviors, and patterns that strengthen and maintain their BPD.
In this chapter, we’ll explore your core content, including its origins and influence on
your default negative beliefs, behaviors, and patterns, and then develop a strategy to reduce
its influence on your life. We’re going to focus on reconstructing your world and building a
new you who’s even more impactful and powerful, and give you the skills to help you continue
to grow beyond your BPD.
Remember, if you feel triggered or overwhelmed while working on your core content, you
can use the strategies you learned in the earlier parts of this workbook to cope. Stop if you need
to, and get the help you need. Do this work at your own pace, and only when you feel ready.
First, let’s look at Tony and some of his core content so you can see how he did it.
My early experience: My mom always paid more attention to her boyfriends and alcohol
than she did to me. She put them first, whether I needed help with homework, a ride to
practice, or anything else. She would tell me what a mistake I was, what a failure I was,
and how I just took up space.
Tony has memories of his mother saying hurtful things to him, neglecting him, and
judging him harshly. These memories created feelings of worthlessness and of being invisible,
core content that still affects Tony today. But this isn’t Tony’s entire core content. He also
had developmental experiences with teachers and coaches who believed in him and encour-
aged him to achieve goals. These experiences created a sense of ability and determination,
positive core content areas that also influence how he feels about himself and sees the world
today.
So, Tony’s complete core content comprises worthlessness, feeling invisible, ability, and
determination. You may be thinking, How can you have conflicting core content? How can you
feel worthless and invisible, but have a sense of ability and determination? Great questions. Many
individuals—and you may feel this way too—who have been diagnosed with BPD experience
internal conflict and confusion, which is core content trying to make sense of itself. Your
BPD is rooted in your confusion and conflict, and to loosen its grip and grow beyond it, you
have to reduce the conflict and clear the confusion.
The first step is to find the link between your core content and early experiences. Using
the following exercise, try to pinpoint no more than five core content areas, and then use one
or two words to sum each up, just as Tony did. This will likely be a unique experience for you,
so be patient, take a break if you need to, and come back to the exercise when you feel ready.
It’s perfectly normal for this exercise to take some time to complete. You can download a copy
of this worksheet at http://www.newharbinger.com/42730.
My early experience:
My early experience:
My early experience:
My early experience:
My early experience:
When my core content areas of worthlessness and feeling invisible are activated, I feel (add
emotions) angry, sad, broken, confused, hopeless, and shattered. These emotions drive me
to (add beliefs, behaviors, and patterns) drink until I pass out and try to meet someone to
love, in order to feel like I have some value and importance.
The short-term rewards are that I feel better for a little while. I feel less alone, less broken,
and I forget how hurt I feel. I forget my scars. If I do find someone, I feel like I am valued
for a little while.
The long-term consequences are that I’m an alcoholic and healthy people don’t want to be
around me. I have trouble holding down a job and keeping a relationship. I just keep
feeding my BPD until its stomach is full, and then it pukes me out and I’m left angry,
sad, broken, confused, hopeless, and shattered all over again.
By completing this exercise, Tony was able to identify the emotions attached to his nega-
tive core content. He saw that these emotions drove him to engage in negative beliefs, behav-
iors, and patterns in an effort to reduce their intensity. He was also able to see that he does
these things to try and get a sense of relief and control, but they only provide short-term relief
while encouraging long-term problems, such as drinking, promiscuity, and disrupted
relationships.
Tony’s BPD tricked him, and yours tricks you too. It makes you believe short-term relief
is worth it, but the long-term cost to you, your life, and your world erases that benefit. You
can live differently. You can break this sequence, reducing the effects of your core content
while also learning to use adaptive and healthy beliefs, behaviors, and patterns. Be patient
with yourself while completing this exercise. Take your time, and if it becomes too much,
stop, take a break, seek help if you need to, and come back to it when you’re ready. You can
download a copy of this worksheet at http://www.newharbinger.com/42730. You may need to
try several times before your sequence becomes clear.
Getting to the Heart of the Issue 161
Now that you’ve explored the origins and costs of your core content, you’re ready to learn
strategies to control and reduce its influence.
One way to reduce and control negative content is to use countermeasures. Typically, a
countermeasure is an action to prevent or weaken a danger or threat. For our purposes, a
countermeasure is information you can use to oppose your negative core content. Tony’s core
content is rooted in childhood experiences with his mother. She said hurtful things to him,
making him feel worthless, and she neglected him, his interests, and his successes, making
him feel invisible. To challenge his core content, Tony had to identify information proving
his negative core content was wrong—his countermeasures.
1. I was the first in my family to graduate from college, and I received many job
offers.
3.
1. My friends come to me for support and encouragement, and they help me when
I ask for it.
Now it’s your turn. If you have trouble identifying countermeasures, think about the posi-
tive things people say about you, the positive and strengthening experiences you’ve had, and
the challenges you’ve overcome that prove your negative core content is wrong. This exercise
may feel odd or challenging, and that’s understandable. If it feels false, that’s your BPD trying
to trick you into believing only negative things about yourself. You can download a copy of
this worksheet and the following one in the summary for part 4 at http://www.newharbinger
.com/42730.
Getting to the Heart of the Issue 163
My core content:
1.
2.
3.
My core content:
1.
2.
3.
Your BPD wants you to believe that all core content is negative, but that’s not true. BPD
distorts how you see yourself, others, and situations, and, in turn, this distortion influences
how you see and interpret your core content. We’ll examine this distortion in more detail in
the next chapter, but for now it’s important for you to be aware that core content can be both
negative and positive, and that breaking this content down into its components, to counter
the negative and support the positive, will help you gain control over your BPD. One way to
bolster positive core content is to use supportive evidence, information that proves your posi-
tive core content is correct. When Tony explored his positive core content without the dis-
tortion of BPD, he uncovered supportive evidence for two areas of his core content.
Supportive evidence:
Supportive evidence:
1. Once my goals are defined, I plan them out and I do not allow myself to be
deterred.
2. I refuse to fail. I do not give up, like with college, baseball, and work.
3.
Now it’s your turn to identify supportive evidence for your positive core content. As
always, take your time.
My core content:
Supportive evidence:
1.
2.
3.
My core content:
Supportive evidence:
1.
2.
3.
Getting to the Heart of the Issue 165
Growth Scripts
Controlling and reducing negative core content is never a “one and done” exercise. Now that
you’ve identified countermeasures for negative core content and supportive evidence for posi-
tive core content, it’s time to learn a technique for promoting your wellness and personal
empowerment. Growth scripts are reassuring statements you say to yourself to encourage posi-
tive development. Here’s one of Tony’s growth scripts. He recorded it on his phone in New
York City, one of his favorite places:
When my core content of feeling worthless is activated, I know it’s untrue, because I was
the first in my family to graduate college, I received many job offers, and coaches and
colleges recruited me for my baseball-playing abilities. I am NOT worthless. I have
endless worth.
Tony made several scripts related to each of his core content areas, and one longer one
pertaining to all four. Tony played these anywhere he wanted or was able to—while walking
the streets in New York City, on a business trip, on a plane, on vacation. He played them
when he felt strong and confident, and he played them when he felt tired and exhausted. He
played them to boost his sense of empowerment and his ability to continue growing beyond
his BPD.
The following script starter can help you write your own growth scripts. Keep in mind
that you don’t have to record them yourself. You can ask your significant other, a friend, a
therapist, or anyone who is supportive of you growing beyond your BPD to recite your scripts
for you. They can be audio or video recordings, or both. The important thing is to listen to
them as often as possible. Repetition will help you get the most out of them, reducing the
impact of your negative core content and supporting your positive core content. You can
download a copy of these scripts in the summary for part 4 at http://www.newharbinger
.com/42730.
is accurate because
166 The Borderline Personality Disorder Workbook
1.
2.
3.
1.
2.
3.
Now that you’re aware of your core content and how it affects your negative and positive
beliefs, behaviors, and patterns, we’ll go a step further and explore how it keeps your BPD in
place by distorting your view of yourself, others, and the world.
CHAPTER 16
In this chapter you’re going to learn about your BPD lens; how it distorts how you see yourself,
others, and situations; and how it keeps your BPD in place and encourages you to maintain
your negative beliefs, behaviors, and patterns. The skills you’ll learn in this chapter will help
you see yourself, others, and situations more authentically, which will empower you to use
adaptive and healthy response patterns and to see yourself and the world in a clear and bal-
anced way.
Betty and Robert had a very intense and volatile relationship. Robert put Betty down
whenever he had the chance. For example, while she was in nursing school getting her
master’s degree, he’d tell her how “stupid” she was since nurses didn’t need, and shouldn’t
have, master’s degrees. “They just give out pills and check blood pressure,” he’d sneer.
One afternoon Betty arrived home early and found Robert online Skyping with
another woman. They were laughing and joking, and when Betty walked in he started
making fun of her, calling her “Nurse Einstein.” The woman he was online with laughed
along with him.
When Betty decided to challenge her BPD and grow beyond it, she had to take a long
look at what her BPD lens was causing her to see and feel regarding herself, others, and situ-
ations. These are the answers she gave for an exercise I had her do related to the incident
above.
My BPD lens causes me to see myself as: A failure and being lost, empty, trapped, and
alone. I see how my mom makes me feel, like no one cares about me and that I’m not
good enough to be a nurse or anything else. I’m stuck in “another lost and dead-end
relationship,” as my mom used to say.
When I think of (name an important person in your life) Robert, my BPD lens causes me to see
and think: He’s someone I have to have in my life or I will be all alone. I have to put up with
his shit because no one else will have me. He’s the best I’m going to get and I should just
be happy with that. I deserve no better, so I should just take it.
When I think of (name a situation) him making fun of me with other women, my BPD causes
me to see and think: I want to hurt myself, cry, and scream. I want to go off on him and
make him feel like I feel. I want to just hook up with somebody—anybody—just to feel
okay, even if for only a little while.
Betty’s BPD lens caused her to feel stuck within her BPD, with few options and mounting
negatives. This is what your BPD wants you to believe and feel, as well, so it can continue to
exist. To counter it, take some time to identify how your BPD lens influences how you see
yourself, others, and the world. Write freely, holding nothing back. There are no wrong
answers. You can download a copy of this worksheet at http://www.newharbinger.com/42730.
Distortions That Keep BPD in Place 169
In the space below, list the people (significant other, family members, boss, coworkers,
friends) and situations (standing in line, a staff meeting, disciplining your child) you’d like to
work on using this exercise.
170 The Borderline Personality Disorder Workbook
You’ve identified how your BPD lens influences what you see, think, and feel about your-
self, others, and situations. This was likely not an easy thing to do, but it was a brave thing to
do, and you should give yourself credit for sticking with it.
We know that your BPD lens helped your BPD continue to thrive; kept your negative
beliefs, behaviors, and patterns in place; and caused you to be reluctant to do things differ-
ently. It did this by creating a cycle of negatives, which has been at the heart of what has kept
you stuck.
Betty’s BPD lens cycle supported her beliefs by reminding her of how painful, lonely, dan-
gerous, and frightening the world is, and that everyone around her was a source of pain who
would eventually leave her lonely and afraid. Her reward for keeping people at an emotional
and physical distance, and for accepting her loneliness and how Robert treated her, was the
perception of less stress and anxiety. Let’s examine the rewards Betty received from her BPD
lens using her answers to an exercise she completed.
If, based on my BPD lens, I see or believe that I am all alone and no one wants to be with
me because I’m so broken, bad, harmful, and unnecessary, then (beliefs, behaviors, and
patterns) I push people away before they can abandon me and break my heart. The benefit
of doing this is that I (BPD lens short-term reward) protect myself and I feel safe.
If, based on my BPD lens, I see or believe that people always hold me back and prevent me
from succeeding and achieving my goals, and do nothing but lie to me, then (beliefs,
behaviors, and patterns) I am ready to fight and defend myself for when they are going
to hurt me or leave me. The benefit of doing this is that I (BPD lens short-term reward) hurt
them before they hurt me, and I feel safe because they were going to leave me anyway.
From Betty’s examples, can you recognize the progression from seeing something through
her BPD lens to her beliefs, behaviors, and patterns to her rewards? It’s an “if/then” cycle. If
Betty sees and believes these things about her world, she then responds in a way that leads to
the short-term reward of feeling safe and in control, which causes the cycle to continue.
Let’s examine your BPD lens cycle to help you recognize the perceived short-term rewards
you get from it that keep it in place. You can download a copy of this worksheet at http://
www.newharbinger.com/42730.
By identifying your BPD lens cycle, you’re able to see the distortion it creates, which gives
you the power to break the cycle using your authentic view.
If I’m using my authentic view, then I feel relaxed and calm. I can concentrate, and my
thoughts are at a pace slow enough for me to understand them. If I feel less stress about
the future then I am aware of where I am and how I feel at this moment. If I feel my
breath go in and out, and it’s under my control, then I can see the situation I am in
clearly, and I can balance my thoughts to determine the best outcome for me.
174 The Borderline Personality Disorder Workbook
These were very empowering thoughts and feelings for Betty. Because her authentic view
reduced or removed the distortion, conflict, and confusion associated with her BPD, she
could choose to respond to people and situations differently using the adaptive and healthy
patterns she developed in part 3 of the workbook. When she started using these, she was able
to see that her wants and needs could be met, and that she didn’t have to hurt or harm herself
or others, increasing the likelihood that she’d receive both short-term and long-term rewards.
Now it’s your turn to describe your authentic view. To help you identify a calm, collected,
and clear state, follow these relaxation steps:
2. Take a typical breath, followed by a deep breath. Breathe in slowly through your nose,
allowing your chest and lower belly to rise as you fill your lungs. Let your belly fully
expand.
3. Slowly breathe out through your mouth or nose—whatever feels natural. Do this a
few times, until you feel calm, collected, and clear.
Now just write what comes to mind when you imagine yourself feeling calm, collected,
and clear. Don’t hold back. If your BPD lens starts to interfere with negative, stressful, and
distorting thoughts, images, and beliefs, imagine them on a greasy floor slipping right out the
door of your mind. Allow only thoughts that promote calm, collected, and clear thinking to
stick around. If you have trouble finding this balance, give the mindfulness technique you
learned in chapter 13 a try, or any of the others you learned. After you’ve written out your
authentic view, take a few moments to examine the experience by answering the prompts
that follow.
Describe what it was like mentally (thoughts and images), emotionally (feelings), and physically
(body sensations, such as a slowed heart rate) when you reached a calm, collected, and clear
state.
Distortions That Keep BPD in Place 175
Describe what you learned about yourself (the power of your authentic view, the strength of your
personal control, and so on) having identified your authentic view.
Now that you’ve identified and explored your authentic view, let’s go over ways to enhance
it so you have even greater control over how you see the world and react to it.
When I look at myself using my authentic view, I see, feel, and think:
When I see, feel, and think of (name a situation, such as an argument, being at work, being
talked down to) using my authentic view, I see, feel, and think:
Now that you’ve identified your authentic view and the way it influences how you see
yourself, others, and situations, you can generate your authentic view cycle. This cycle sup-
ports positive beliefs, behaviors, and patterns and encourages healthy connections with your-
self and others.
Distortions That Keep BPD in Place 177
If I use my authentic view, then I see that Robert is mean to me, doesn’t respect me, and is
unkind, unfaithful, and abusive. I see that he talks to other women online, doesn’t help
with the bills or with cleaning the house, and makes me feel like my mom made me feel.
If I believe these things, then (authentic view rewards) I know I have to make changes. I see
that I don’t deserve to be treated this way and that I can meet someone who will be kind,
caring, and respectful. I am smart, skilled, strong, and worthwhile. I know I have
options.
Using her authentic view, Betty recognized that she’s smart, skilled, strong, and worth-
while. She determined that she was the best person that Robert had ever been with, and she
knew that the abuse had gone on long enough. Knowing all of this, she put a plan in place to
separate from Robert and move on. She felt powerful, in control, and able to make positive
changes. Her authentic view rewarded her with good feelings and good results, and thus she
wanted to use it more often and in many other situations.
Do you see how the authentic view cycle follows an “if/then” sequence? If Betty sees the
world using her authentic view, and she believes what she sees and acts accordingly, she then
is rewarded with a positive view of herself, which encourages her to go out and get positive
things she deserves, such as a boyfriend who is kind and caring. This cycle can work the same
way for you. The opposite is also true: when you see the world through your BPD lens, a nega-
tive cycle is promoted. Now it’s your turn to examine your authentic view cycle, so you can
see the rewards you get from using it. You can download a copy of this worksheet at http://
www.newharbinger.com/42730.
Many people feel empowered by their authentic view and the cycle it creates, but also a
little scared. This is a normal reaction, as trying new things can be intimidating. You’ve been
seeing the world through your BPD lens for a long time, but that time is coming to an end,
and a new perspective is emerging—along with a new you.
The skills you’re learning take practice and patience, and like building any skill, the more
you use it, the easier it becomes. Use your authentic view cycle when you’re having difficulty
communicating with your significant other, a family member, or your children. Try it out
when you’re in a frustrating or triggering situation at work or with friends. Redo the exercises
in this chapter over and over again, whenever you need to. Using your authentic view is a skill
that will build your sense of self-control and personal power. It’s a major piece of this journey
to grow beyond your BPD.
Distortions That Keep BPD in Place 179
1.
2.
3.
1.
2.
3.
Now that you’re beginning to see the world without your BPD lens, it’s time to address
the destructive fears, beliefs, and wishes that have been holding you back.
CHAPTER 17
Destructive fears, beliefs, and wishes are based on negative emotions, such as hate and
anxiety, that support or encourage negative thinking, such as that you deserve to be broken
and harmed and that the world is full of pain and loneliness. These destructive emotions
were created right along with your BPD and your core content, and they’re usually linked to
people in your life who were involved in the negative experiences that generated your core
content. Destructive fears, beliefs, and wishes, along with your negative core content and
your BPD lens, keep your BPD in place by supporting negative beliefs, behaviors, and pat-
terns. They cause you problems in relationships and in the situations you find yourself in
every day, leaving you with short-term rewards and long-term consequences. This chapter is
going to help you identify, uncover, challenge, and change them.
not uncommon to feel anger, rage, resentment, and hostility toward these identified others,
as well as love, caring, and desire for them. These conflicting emotions create confusion,
which we know is a key part of how your BPD keeps itself in place.
Tony reflected on his early experiences and related core content to pinpoint his identified
others.
My early experience: Mom paid more attention to her boyfriends and alcohol than she did
to me. She always ignored me and neglected me when her boyfriends wanted some-
thing, and they always wanted something. She didn’t come to my baseball games or
college graduation. She didn’t even help me pick out a college because she wanted to get
drunk and be with them instead.
It may look like Tony only had one early experience, but it’s something that happened
over and over while he was growing up. This is typical of the early experiences that create our
core content. Tony could’ve listed other significant life experiences involving past girlfriends,
coaches, friends, coworkers, and others who helped create his BPD, but he chose the person
he felt was most influential.
Tony carries this early experience and these core content areas (worthlessness and feeling
invisible) with him, and they influence his negative beliefs, behaviors, and patterns. They
cause him to fear doing things differently; encourage his belief in a negative, harmful, and
hurtful present and future; and are the foundation of the destructive wish he has to fulfill the
expectation of failure and neglect he learned from his mother to gain her attention, love,
approval, forgiveness, respect, and admiration. After identifying this early experience and the
related core content, Tony was able to name his identified other: his mom. Now it’s your turn.
This exercise is meant to help you recognize the identified others who are connected to
your early experiences and related core content. You’ll first describe a memorable early expe-
rience with as much detail as you feel comfortable providing. The experience should be some-
thing you went through or witnessed while you were growing up that has stuck with you and
affects how you see the world. Then, you’ll identify the associated core content, and, finally,
the person, or people—your identified others—who were important parts of the experience.
Perhaps these identified others caused the experience, made the experience worse, or influ-
enced how you felt about the experience. If you find yourself stuck or in need of assistance,
don’t forget the HELP steps from the book’s introduction. Use extra paper if you need to, or
you can download a copy of this worksheet at http://www.newharbinger.com/42730.
Growing Beyond Destructive Fears, Beliefs, and Wishes 183
My early experience:
Core content:
My identified others:
My early experience:
Core content:
My identified others:
My early experience:
Core content:
My identified others:
184 The Borderline Personality Disorder Workbook
Now that you’ve linked early experiences, core content, and identified others, let’s take
the next step and reveal the related destructive fears, beliefs, and wishes.
My early experience: Mom paid more attention to her boyfriends and alcohol than she did
to me. She always ignored me and neglected me when her boyfriends wanted some-
thing, and they always wanted something. She didn’t come to my baseball games or
college graduation. She didn’t even help me pick out a college because she wanted to get
drunk and be with them instead.
This experience led to my core content of worthlessness and feeling invisible, which causes
me to fear that no one will notice me or recognize all that I have done and achieved. I will
be worthless and invisible to the world.
These fears cause me to believe that no one cares about me, that I am second to everyone
else. People in my life always choose someone else over me. I’m unable to achieve what I
need to achieve but I don’t know what that is, so I just float through my life.
These beliefs cause me to wish that all of her men would leave her and take everything she
has, causing her to suffer enough to recognize that I am here and have value, purpose,
and gifts.
Tony’s responses really brought his fears, beliefs, and wishes to light, which helped him
address them and control them better. Tony’s revenge-like fantasy for his mom is not an
uncommon wish, and you may have similar wishes for your identified others as well. Many
people want to inflict pain or exact revenge upon their identified others or punish or torture
Growing Beyond Destructive Fears, Beliefs, and Wishes 185
them in some manner. It’s normal to have these thoughts and feelings, but it’s important to
get these out of the dark and into the light, where you can determine how they impact you
and your behavior.
It’s your turn to uncover your destructive fears, beliefs, and wishes and the influence they
have on you. Consider these exploration prompts as you identify them:
Fears
• I am afraid that my identified others will…
Beliefs
• When I think about my identified others and how they think of me, I believe they…
Wishes
Remember, do the best you can and don’t rush this exercise. There are no right or wrong
answers. Don’t forget the HELP steps, if you need them. Use extra paper if you need to, or you
can download a copy of this worksheet at http://www.newharbinger.com/42730.
My identified others:
My early experience:
186 The Borderline Personality Disorder Workbook
By uncovering your destructive fears, beliefs, and wishes you’re now ready to go forward
and challenge them by exploring their place in your past, present, and future.
My identified others, early experiences, and core content helped create my destructive fears,
beliefs, and wishes by making me feel like I had no choice but to follow the path of my
BPD, which led me to hurt myself, others, and opportunities I had. I lived my life based
on the fear of not being good enough, on the belief I would lose everything, and with the
wish that my BPD would get me all the love and caring I always wanted, but it didn’t.
My destructive fears, beliefs, and wishes hold me back by causing me to believe my mother,
which drives overwhelming, yet familiar and comfortable, uneasiness, fear, confusion,
Growing Beyond Destructive Fears, Beliefs, and Wishes 187
and conflict that push me to drink, cheat on my girlfriend, and destroy all I have built
for myself.
My destructive fears, beliefs, and wishes cause me to inflict self-damage by defaulting to the
negative beliefs, behaviors, and patterns of drinking and sleeping around, chasing
women to get some, or any, sense of being recognized. I push my ability and determi-
nation to the side and wallow in my pain and wait for someone to save me from my
worthlessness and feelings of being invisible, but only negative people come into my
life, and they don’t really want to save me. Instead they just amplify my mother’s
thoughts about me, and my feelings of being alone, sad, and worthless. I am a master
at self-destruction.
Without my destructive fears, beliefs, and wishes, I see my life being more honest. I see myself
being able to recognize both the good and the bad in the people in my life, and that the
things people say and do don’t have to impact me, if I don’t want them to. I’m able to
understand my emotions better and to control myself without feeling pushed or manip-
ulated by my identified other—my mother. I’m in control.
My life is good right now because I have a relationship with someone I can feel close to and
I know she respects me. I know my boundaries with her and she knows her boundaries
with me. I can feel appreciated at my job when I do a good job and get things right, and
this causes me to have an awesome day.
Without my destructive fears, beliefs, and wishes, I’m able to be myself, see my life without
my BPD lens—that it has possibilities—and control myself by using my mindfulness
skills. I can control my button responses and triggers because I’m not stuck in my old
cycle of patterns and self-hatred.
Now that you’ve seen Tony’s responses, take some time and answer the prompts on your
own.
My identified others, early experiences, and core content helped create my destructive fears,
Positive core content is powerful. It can help you replace your destructive fears, beliefs,
and wishes with healthy hopes, beliefs, and wishes. Take a few moments to complete the
prompts below.
Reminding yourself of this positive content routinely can strengthen your confidence in
a future full of both short-term and long-term rewards, as well as stability inside yourself and
with others.
192 The Borderline Personality Disorder Workbook
1.
2.
3.
1.
2.
3.
Now that you’re growing beyond your destructive fears, beliefs, and wishes with healthy
hopes, beliefs, and wishes, it’s time to address the defense mechanisms that have been holding
you back.
CHAPTER 18
In this chapter you’re going to identify the unhealthy defense mechanisms that keep your
BPD in place and replace them with healthy and adaptive defense mechanisms to enhance
your ability to cope with and respond to difficult people and situations more effectively.
Acting out This involves acting on impulse to avoid a feeling, belief, thought, or
image rather than waiting for a more appropriate time to deal with it.
By acting out, you avoid the frustration and anxiety of postponing a
particular behavior. For example, Betty pushed her coworker when she
felt disrespected at work.
Denial This involves rejecting the reality of a feeling, belief, thought, or image.
Denial prevents you from recognizing negative or uncomfortable
information about yourself, others, or situations. For example, Betty
denied that cutting herself caused people who cared about her to worry.
Projection This involves thinking someone else has your feelings, beliefs, thoughts,
or images. For example, Betty hated her boss, but that feeling was
overwhelming for her, so she believed her boss hated her instead.
Defense Mechanisms and Healthy Coping and Responding 195
Repression This involves pushing distressing feelings, impulses, ideas, or wishes out
of awareness. For example, Betty can’t remember when her dad left her
family because the memory is too painful.
Splitting self and This involves seeing yourself, or others, as all good or all bad as
others opposed to a mixture of positive and negative attributes. The shifts can
be rapid and intense. For example, Betty thought her friend Tammy was
a terrible person because she forgot to call her before she went out one
night.
As you went through the list, did some of these unhealthy defense mechanisms seem like
your go-to responses or coping strategies? Can you think of certain people with whom you use
unhealthy defense mechanisms, or situations in which you employ them? Before we explore
these important questions further, let’s examine Betty’s defense mechanisms (in parentheses)
in the following example.
The argument began after Betty arrived home late, having worked a fourteen-hour shift at
the hospital. Her boyfriend, Michael, calmly and clearly asked her, “What happened at
work? How come you’re late?”
Betty was tired and felt attacked. She thought Michael was accusing her of being
dishonest and unfaithful, and she said, “I’m tired and I don’t have to justify myself to you!
You’re not my daddy! Who do you think you are?” (Acting out, projection, rationalization,
splitting self and others)
Michael raised his voice and said, “Here we go again, causing problems when there
aren’t any! Just shut it down already!” The argument grew in intensity from there.
Betty yelled back, “You shit-heel! You don’t know a thing about what I go through each
day, and you just don’t care!” (Acting out, rationalization, splitting self and others)
Michael’s guard went up, and he yelled, “Why are you jumping all over me! I didn’t
even do anything wrong!” He continued cussing and refused to admit he’d made a mistake.
Betty responded with her default negative response pattern involving yelling, cussing,
name-calling, refusing to apologize, and seeing only one side of the story (acting out, denial,
projection, rationalization, splitting self and others). Betty grew more upset and threw books
at him, followed by the TV remote (acting out). She started to think that Michael was
going to rush out of the house and leave her forever, and a feeling of emptiness began to
196 The Borderline Personality Disorder Workbook
build inside of her. The argument continued until Betty ran into the bathroom and cut
herself (acting out), while Michael beat on the door for her to come out.
Betty didn’t use all nine unhealthy defense mechanisms, and you may not either. She
tended to engage in acting out, denial, projection, rationalization, and splitting self and
others. The defense mechanisms you use may depend on the person you’re with and the situ-
ation you’re in. Before we identify your unhealthy defense mechanisms, let’s go over healthy
defense mechanisms, so you can be sure you’re exploring every angle.
Anticipation This involves planning for future stress, fear, and discomfort and
exploring a desired outcome and the probability of success or failure.
For example, Betty noticed that nurse’s shifts were getting cut at the
hospital. Seeing the trend in cutbacks, with the knowledge that she had
been one of the most recent nurses hired, she began to search for jobs
so she’d be aware of her options if the hospital let her go, or if her
hours were cut.
Sublimation This involves being capable of meeting goals by using skills to reduce
stress rather than increasing it or blocking it out. Sublimation leads to
feelings of gratification. For example, Betty felt intense anger toward
her mother, friends, and boyfriends that she redirected into working
out.
Suppression This involves making the choice to avoid thinking about something
negative or delaying the impulse to respond. For example, Betty really
liked Michael and wanted to be in a relationship with him, but she
made the choice to take her time and get to know him first before
jumping in.
Were you able to identify the healthy defense mechanisms you use? Let’s turn again to
Betty’s argument with Michael, this time looking at it through the lens of healthy defense
mechanisms.
Betty came home from working a fourteen-hour shift at the hospital. She recognized that
she was tired because she’d stayed an extra two hours to deal with a patient emergency
(altruism). As she pulled into the driveway she took a deep breath and remembered that she
hadn’t called Michael, realizing that he was probably worried about her (anticipation,
self-discipline, suppression). She walked into the house and Michael calmly and clearly
asked, “What happened at work? How come you’re late?”
Betty took a deep breath, recognized his statement of concern and compassion,
remembered that she didn’t have to prove anything, pushed her guilt out of her mind, and
responded, “I’m sorry. I totally forgot to call you” (sublimation, suppression). “A patient had
a seizure, and a member of the treatment team had called in sick, so I stayed until we could
get the situation under control” (altruism, sublimation).
Michael paused for a moment, looking at her from the couch. “I know you work a lot
and that you give a lot to your job, but when you don’t call me I worry that you might be
hurt. Please try to call next time, and I’m glad you’re okay.”
198 The Borderline Personality Disorder Workbook
Betty was able to get a sense of fulfillment, pleasure, and self-control by effectively evalu-
ating and processing her feelings, thoughts, and experiences using anticipation, self-disci-
pline, sublimation, and suppression. She used healthy defense mechanisms to achieve a
positive outcome and to strengthen her relationship with someone she cared about very
much.
Let’s now take a look at the healthy and unhealthy defense mechanisms you use. In the
spaces below, list those you’ve identified from the lists.
Don’t worry if you use more unhealthy defense mechanisms than healthy ones. The
objective is to recognize the ones you tend to use in response to yourself, others, and situa-
tions, topics we’ll explore next.
I tend to use (defense mechanism) acting out with my friends, Robert, mom, and people I
work with because I want to control the situation or I just can’t wait any longer for them
to do what I want them to do. I use acting out to make sure that I’m noticed, so I won’t
disappear and vanish into nothingness. Acting out gives me a rush, making me feel
like I’m alive and present, because when things get too slow I get scared that people won’t
like me because I’m boring and dull. I use acting out when I get “itchy,” when I’m alone,
or when I’m feeling abandoned and empty.
I tend to use (defense mechanism) suppression with Michael and doctors at work because
I’m better able to control myself and to build up my relationships with them. Michael is
patient and caring with me, when I let him be, and his kindness causes me to fear that
he’ll abandon me and I’ll be left with an empty hole inside. I’m determined to improve
this relationship, and suppression gives me the permission to decide what is best for me.
I can see the steps I need to take to help Michael, myself, and our relationship. I use sup-
pression with the doctors at the hospital when it seems like they’re talking down to me.
I consider this the best response and course of action, so I’m able to keep the job I love and
get to continue to take care of patients.
In both examples Betty identified the defense mechanism she used, the people she used
it with most often, the situations she used it in, and how she benefited from using it. This
information about herself gave her a greater understanding of her unhealthy and healthy
defense mechanisms, as well as more control of when, where, and with whom she used them.
Now it’s your turn to identify yours. Don’t rush through this exercise. If you need to take
a break, allow yourself that time away, and then return to the worksheet when you feel ready
to reengage. You can download a copy of it at http://www.newharbinger.com/42730.
Defense Mechanisms and Healthy Coping and Responding 201
You’ve gained a lot of valuable information about yourself, your unhealthy and healthy
defense mechanisms, and the situations and people that affect their use. Let’s dive a little
deeper into the topic, looking at how defense mechanisms keep your core content safe. This
exploration should help you see the benefits of using healthy defense mechanisms.
My core content of abandonment, integrity, and resolve was activated when I knew I was
late and hadn’t called Michael, and he asked me where I’d been.
I used the following defense mechanisms (circle all the ones you used).
Denial Anticipation
Devaluation/idealization Humor
Intellectualization Self-discipline
Projection Suppression
Rationalization
Repression
The outcome of the situation: Michael and I got into it. I started screaming, and he started
screaming. I cussed and threw things at him until I got so overwhelmed that I ran into
the bathroom and cut myself while Michael beat on the door for me to come out.
My core content of abandonment, integrity, and resolve was activated when I knew I was
late and hadn’t called Michael, and he asked me where I’d been.
204 The Borderline Personality Disorder Workbook
I used the following defense mechanisms (circle all the ones you used).
Denial Anticipation
Devaluation/idealization Humor
Intellectualization Self-discipline
Projection Suppression
Rationalization
Repression
The outcome of the situation: Michael and I didn’t fight and I felt even closer to him. I was
able to see his point of view and control my thoughts, feelings, and tendency to react
negatively. I controlled the situation and myself.
Identifying the connection between core content, activating event, defense mechanisms
used, and outcome really helped Betty see the benefit of using healthy defense mechanisms.
I encourage you to use the log for past, present, and possible future situations. You can down-
load a copy of this log in the summary for part 4 at http://www.newharbinger.com/42730.
Defense Mechanisms and Healthy Coping and Responding 205
My core content of
I used the following defense mechanisms (circle all the ones you used).
Denial Anticipation
Devaluation/idealization Humor
Intellectualization Self-discipline
Projection Suppression
Rationalization
Repression
As you move forward and pinpoint the events that activate your core content and the
positive outcomes from using healthy defense mechanisms instead of unhealthy ones, you’ll
loosen the grip of your BPD. The exercises in this chapter are to be done many times; the
process of doing them again and again will build your skill of choosing heathy defense mecha-
nisms over unhealthy ones. As with all the others in this workbook, this skill is like roller
skating: the more you do it, the better you’ll get at it, until choosing healthy defense mecha-
nisms becomes an automatic adaptive and healthy response pattern.
1.
2.
3.
1.
2.
3.
Defense Mechanisms and Healthy Coping and Responding 207
In the next chapter we’re going to examine your internal love/hate conflict, so you can
reduce the conflict and confusion you experience related to how you see yourself, feel about
yourself, and think about yourself.
CHAPTER 19
Your internal love/hate conflict is an inner battle between kindness and hatred, compassion
and loathing, and the care and contempt you feel for yourself, the world, and those around
you, including people who’ve hurt you and those who love you. The internal love/hate con-
flict creates confusion that breeds uncertainty and self-hatred and encourages negative beliefs,
behaviors, and patterns. This confusion encompasses thoughts and images; things you say to
yourself; how you see yourself; and how you see your past, present, and future. How you
respond to this confusion can have a tremendous impact on your life.
In this chapter we’re going to explore your internal love/hate conflict. The knowledge
and skills you’ll gain will lessen your confusion and conflict and strengthen your self-love, so
that you can continue on this journey of growing beyond your BPD. The content in this
chapter may bring up many issues about your past and feelings that you’ve not yet explored or
haven’t explored in a while. Don’t forget to use the HELP steps, if you need them.
I’m seeing myself differently. I just keep hurting myself and others.
Tony’s confusion fed his internal love/hate conflict, making it harder for him to engage
in adaptive and healthy beliefs, behaviors, and patterns. Having awareness of this helped him
reduce the confusion and conflict he’d been struggling with for so many years.
Let’s start you on the path to reducing your struggle with your love/hate conflict. Be as
honest as you can and make sure you’re accessing your authentic view (chapter 16) and your
adaptive and healthy hopes, beliefs, and wishes (chapter 17).
Now that you’ve defined what makes up your internal love/hate conflict, the next step is
to replace the confusion with strategies that build self-love and weaken self-hate.
Self-Hate Self-Love
Self-Hate Self-Love
Examining self-hate and self-love strategies can bring up a lot of thoughts, feelings, and
memories. Don’t be hard on yourself if you tend to use more self-hate strategies. You learned
these while growing up, as your core content and BPD were developing. Take a moment to
explore the thoughts, feelings, and memories that are linked to your internal love/hate con-
flict using the space below. This exercise can help you see the impact this conflict has on you
and your world, giving you the understanding to help you overcome self-hate and build
self-love.
Making the connection between your core content and your self-hate and self-love strate-
gies is a big step, but there’s one more step to take: pulling it all together. Before you do this,
let’s look at an example of Tony’s.
Preventing patience
Practicing patience
Core content: Worthlessness, feeling
invisible
216 The Borderline Personality Disorder Workbook
Tony determined that his core content of “worthlessness” and “feeling invisible” was
linked to the strategy of “preventing patience.” The intense emotions he had related to this
content, such as believing he’d never be valued, caused him to react immediately in situa-
tions. He engaged in default negative beliefs, behaviors, and patterns, such as calling his
girlfriends over and over again until they answered (a form of the “preventing patience” strat-
egy), which pushed them away. He’d then use this as evidence of his worthlessness, leading
to feelings of self-hate. Once Tony had explored how his core content influenced the self-hate
strategy he often used, he identified ways he could respond differently.
My core content of worthlessness and feeling invisible is linked to the self-hate strategy of
preventing patience.
How my core content influences my use of this strategy: I become impatient when I feel forced
to respond right away, like I can’t wait. When Pam doesn’t answer my call, I feel invis-
ible and worthless. I feel like I’m going to lose control of the situation and myself, and
other people will control me.
I will do it differently by using the strategy of practicing patience: When I feel the urge to
respond immediately, that is my core content of worthlessness and feeling invisible
talking. I hear my mom in my head telling me negative things, but I control who I
listen to and what I do. I will take deep breaths, reexamine the situation, weigh the pros
and cons, and think about what it is I want in the end. I’ll determine what will help me
and what won’t hurt me.
Tony was able to see what drove him to use self-hate strategies. Once he had this aware-
ness, he was able to clearly identify techniques that promoted self-love. You can as well. Using
the following worksheet, identify the core content areas that are associated with the self-hate
strategies you use, describe how your core content influences the strategies you use, and then
describe how you’ll do it differently using a self-love strategy instead. You’ll see that I’ve
included a prompt for every self-love and self-hate strategy. This is purposeful. Even if you’re
not using a particular self-hate strategy, I’d like you to try to imagine yourself using the
counter self-love strategy in some situation in life. So please try not to leave any of the self-
love strategies blank. You can download a copy of this worksheet in the summary for part 4
at http://www.newharbinger.com/42730.
Conquering the Internal Love/Hate Conflict 217
This exercise has hopefully helped you to see ways to add self-love strategies to your life.
Doing so will lessen the conflict you feel and reduce the confusion that is inherent to BPD,
which has had you in its grip for too long. The more you practice self-love strategies, the more
powerful and helpful they’ll become.
1.
2.
3.
222 The Borderline Personality Disorder Workbook
1.
2.
3.
Having an awareness of your internal love/hate conflict will empower you to better
control its content and how you see yourself, others, and situations in life. All of the skills
you’ve learned in this book have prepared you to give up your old ways and embrace the new
ones—the subject of the next chapter.
CHAPTER 20
In this workbook so far, you’ve examined and learned strategies for controlling how your core
content affects your life and how you see yourself, others, and situations. This process has
helped you develop and strengthen methods for moving beyond your BPD. This chapter is
going to continue that trend. You’re going to learn more strategies for letting go of the old
ways while embracing the adaptive and healthy patterns that encourage growth, build empow-
erment, and strengthen the control you have over your life, especially when your core content
is activated.
My old ways led me to be suspicious, upset, and angry when things did not go as I
expected them to or felt they should. This caused my core content to explode. I would feel
a sense of abandonment and emptiness, like I had lost my integrity and resolve and
that there was nothing I could do about it, except to respond in a desperate way before I
drowned in my emotions. My old ways destroyed my relationships, while clouding how
I saw myself and the people in my life. I cut myself and slept with different people,
trying to make myself feel better, but none of it worked. This cycle wouldn’t stop, and
I was in an emotional tornado that was ripping through my life.
224 The Borderline Personality Disorder Workbook
My new ways allow me to breathe. I now know what my buttons, triggers, and beliefs,
behaviors, and patterns are. When I feel abandoned and empty, I can explore these feel-
ings, control them, and change them—clearly seeing how my life really is and that my
wishes and fears don’t have to control me and confuse me. I can use healthy defenses
and build healthy relationships with myself and other people. These are filled with love
and connection that allow me to grow. From this growth I’ve been able to paint a picture
of a future that I never thought was possible, but it is, and I own it. And I feel wrapped
in integrity and resolve to achieve good things in my life.
Betty was able to see where she was “then” without attacking herself, and she was able to
use it to see where she is now. She sees her life filled with potential and hope, and she recog-
nizes that by using adaptive and healthy beliefs, behaviors, and patterns she has more control
over herself and the way she sees others and life’s situations.
Now it’s your turn to explore your old and new ways. In the spaces below, describe your
old and new ways as you see them today and how they impact how you view yourself, others,
and situations. Be as detailed as you can, and try not to hold back. Don’t judge yourself for
where you were. Use where you are to encourage and empower yourself for the future.
My old ways
My new ways
Letting Go and Moving On with the New You 225
Writing out your old and new ways helps reinforce and clarify your resolve to grow beyond
your BPD using adaptive and healthy beliefs, behaviors, and patterns. It can also help you to
reinterpret your core content and what it means when it shows up in your life.
When I receive signals from my core content, I use these adaptive and healthy beliefs, behaviors,
and patterns:
Hopefully answering these questions has offered you greater clarity about your core
content, allowing you to embrace it and use it to your advantage. That is personal power and
control. As you go forward and grow, it’s important to be aware of the tendency to regress, to
go back to those old ways. To resist this temptation, it’s helpful to identify what might cause
you to revert back to negative and unhealthy beliefs, behaviors, and patterns.
They trigger my core content and seem to be empowered by my struggles and pain. My
ex used to call me names, and my mother still doesn’t seem to want to be a part of my
life. She wasn’t very nice to me the few times we spoke recently.
I can distance myself from them. I can spend less time with them, or no time. If I’m
around them and my core content is sending signals to me, I can use adaptive and
healthy response patterns to control or leave the situation.
I can be honest and open with them about my feelings and struggles. I can continue to
use healthy and adaptive response patterns to strengthen our relationships.
I’ll continue to use my venting journal to self-soothe, and I’ll use adaptive and healthy
beliefs, behaviors, and patterns when I’m triggered and my emotional buttons are
pushed. I’m dedicated to practicing my skills, building my empowerment, and encour-
aging and allowing these positive people to be in my life and close to me.
You’ve made many of the same gains that Betty has. Using the spaces below, explore who
and what move you forward or might hold you back. Be as descriptive as you can, and take
your time as you examine these different areas of yourself and your world. This is a great
activity to do many times throughout the year, as your world will change, and the people in
it may change as well. You can download a copy of this worksheet at http://www
.newharbinger.com/42730.
228 The Borderline Personality Disorder Workbook
Empowering Yourself
Empowerment is a very big part of continuing to grow beyond your BPD and resisting regres-
sion. In this exercise you’re going to identify words of empowerment and then use them to
develop empowerment statements, which can help you maintain your successes and build
upon them.
Go through the list of words of empowerment below and circle the ones that describe you
now that you’re growing beyond your BPD and have greater personal control thanks to your
adaptive and healthy beliefs, behaviors, and patterns. They should make you feel stronger,
confident, and more in control of your life. If there are words you’re not familiar with, don’t
worry about it. Take a few moments to look them up. This will build your empowerment
vocabulary, helping you to refine and expand your sense of how accomplished, captivating,
generous, soothing, resolute, and pleasant you are. If you feel the list is missing some empow-
erment words, write them in.
After you’ve circled the words that describe you, complete the empowerment statements
that follow. Do your best to make them as specific to you and your world as you can, and try
to use more than one word of empowerment to complete each statement. Have fun with this
exercise! Allow yourself to get absorbed by your amazing growth, determination, and psycho-
logical health. You can download a blank copy of this worksheet in the summary for part 4
at http://www.newharbinger.com/42730, so you can review and revise your statements again
and again as you grow beyond your BPD.
230 The Borderline Personality Disorder Workbook
Resilient Vigorous
Resolute Visionary
Soothed Worthwhile
Strong Worthy
Thriving Zealous
Transforming
Unlimited
Empowerment Statements
I am (add word or words of empowerment)
because I
because I
because I
232 The Borderline Personality Disorder Workbook
because I
You can use the results of this exercise to make an audio or video recording of yourself
saying your empowerment statements, or you can include them in your venting journal. If one
of your empowerment statements stands out, take a picture of it with your phone and save it,
or maybe decorate it with an app to personalize it. Make this statement a part of who you are
today, to take with you as you continue to grow. This is definitely not a “one and done” exer-
cise, but something you can continue to use to build on your success and to encourage your-
self to continue to achieve wonderful things.
You’ve grown beyond your old negative beliefs, behaviors, and patterns, and you’ve devel-
oped new ways of seeing yourself and the world. Your adaptive and healthy skills have opened
up a world of new and exciting opportunities. You’re in control, and you make the decisions
that influence how you live life, not your BPD.
1.
2.
3.
Letting Go and Moving On with the New You 233
1.
2.
3.
In the next, and last, part of the workbook, we’ll explore strategies for maintaining your
gains and continuing to move forward beyond your BPD. Before you move on to part 5, I
recommend that you go through the summary for part 4 that’s available for download at
http://www.newharbinger.com/42730. This summary pulls together the concepts, activities,
and exercises from part 4, and it will strengthen what you’ve learned in order to keep those
old negative beliefs, behaviors, and patterns out of your life.
PART 5
You’ve made incredible gains with your BPD! You’re now able to better control what once
pulled you down and held you back. This last part of the workbook is going to help you main-
tain your gains and avoid falling back into those discarded BPD beliefs, behaviors, and
patterns.
In the previous chapter I introduced the concept of regression, which happens when a
person falls back into those old beliefs, behaviors, and patterns of BPD. Stress is one of the
major causes for people to regress, and it can wear away at a person’s self-acceptance, which is
a recognition of personal strengths and weaknesses; an acknowledgement of skills, talents,
and worth; and a love for yourself despite flaws and past behaviors and actions. There’s no
way to have a stress-free life, but you can control the impact stress has on you and your
world—and on your self-acceptance—by understanding it and developing skills to cope with
it. You’ve already learned many skills in this workbook that will help you combat and reduce
the impact of stress, so in this chapter we’re going to examine the different types of stress and
focus on strengthening and maintaining your self-acceptance.
Types of Stress
We’re going to review five types of stress, each of which has its own unique presence and
impact on you and your self-acceptance. These types of stress can occur together, in various
forms, and in varying amounts.
238 The Borderline Personality Disorder Workbook
Time limited This is the most common form of This type of stress is the least
stress. It occurs for a limited time, likely to cause you to regress or to
but the stress can be intense. The wear away your self-acceptance.
stress only lasts as long as the You can use this stress to build
stressor is present. Examples your self-acceptance by
include being stuck in traffic or acknowledging your strength and
having a one-time argument with skills when you overcome and
your significant other or child. manage it.
Time-limited stress can be
motivational; for example, you
might experience stress about an
upcoming job interview or date,
so you prepare for it in order to
give a good first impression.
Environmental This type of stress occurs naturally Environmental stress will most
in your environment. Examples likely have little negative impact
include an annoying noise on your self-acceptance because
outside that you can’t stop, a you know you didn’t create the
rainy day when you wanted to be stressor. However, you do
outside, or a crowded movie determine how you handle the
theater on the opening day of a stress. Handling it with adaptive
movie you want to see. and healthy patterns reinforces
self-acceptance.
Blended These are stressful events that As the pressure of blended stress
happen one after the other. For increases, it can impact self-
example, let’s say you’re in a car acceptance by causing you to
accident, then you’re late to pick regress to old BPD patterns.
your child up from school, and Using adaptive and healthy
then you miss a phone interview patterns and managing each
for an upcoming job. stressor as it arises can help you
avoid this.
Maintaining Your Gains 239
Continuous This is stress that continues for an This type of stress can have the
extended period of time. greatest negative impact on
Examples include living in psychological and physical health
poverty, living with untreated and self-acceptance. It feels like a
medical or psychological issues wearing away of your adaptive
(such as BPD), or being in an and healthy patterns. When
unhappy marriage, job, or career. continuous stress occurs, it’s time
to review the skills you’ve learned,
as well as the summaries of this
book, to maintain and reinforce
your gains and to make the
changes you need to make.
(The summaries are available for
download at http://www
.newharbinger.com/42730.)
Historical This is stress that happened a This stress once haunted you and
long time ago but still causes you kept your self-acceptance at a
concern. Examples include child distance. It may take random jabs
abuse, the death of a loved one, at your self-acceptance, but
or being abandoned by parent. you’re probably too strong for it
to impact you much, now that
you’ve mastered your core
content and response patterns.
Keep using your adaptive and
healthy patterns and you’ll limit
the destructive effects of this
stress type.
Now that we’ve defined the five types of stress, how they can impact self-acceptance, and
ways to combat them, you’re ready to identify the types of stress you experience or you feel
you’re likely to experience. Let’s take a look at Tony’s types of stress first.
240 The Borderline Personality Disorder Workbook
1. At work my computer password expired and I had to wait for the IT person to give
me another one.
2. I dropped my cell phone and the screen cracked, so I had to go to the store and
replace it.
3. I had to pick up my girlfriend Julie from work, but I had to get gas, so I was late.
1. My mom didn’t give me the attention I wanted, and she neglected me.
2. I didn’t follow through with baseball, and I was really good at it.
Once Tony received his new password, exchanged his cell phone, and picked up Julie, his
time-limited stress was relieved. These experiences did not negatively impact his self-accep-
tance; in fact, they bolstered it because he handled them well, with confidence and self-
control. His historical stress still causes him concern, but these individual stressors, which are
also part of his core content, don’t have the same impact they once did. The stress he feels
from these is much lower than the time-limited stress he felt, because the historical stress is
something that’s been present for a long time, and he’s dealt with it and adapted to it, limiting
its impact.
Now it’s your turn to identify and describe your stress. In the spaces below, describe the
different types of stress you experience. As you’re identifying them, consider where the stress
is coming from, the impact it has on you, and who may be causing or contributing to it. Be
as descriptive as you can, and if you don’t have three examples for each type of stress, that’s
fine. If you have more than three, you can download a copy of this worksheet in the summary
for part 5 at http://www.newharbinger.com/42730. The goal is to increase your awareness of
which types of stress are present, or likely to be present, in your life.
Maintaining Your Gains 241
1.
2.
3.
1.
2.
3.
1.
2.
242 The Borderline Personality Disorder Workbook
3.
1.
2.
3.
1.
2.
3.
Identifying your types of stress will help you pinpoint where it’s coming from, its impact
on you, and who may be causing or contributing to it. This important information can help
you prepare for when it arises, reduce its impact before it can overwhelm you, and lessen the
likelihood of you regressing back to old beliefs, behaviors, and patterns.
Maintaining Your Gains 243
I think about
I think about
1.
2.
3.
Maintaining Your Gains 245
1.
2.
3.
Identifying the types of stress you experience and how they impact your thoughts, feel-
ings, and behaviors empowers you to have greater control over how you experience and
respond to them. Controlling how you handle stress will help you sustain your level of self-
acceptance and clearly see your personal strengths and weaknesses; recognize your skills,
talents, and worth; and accept yourself despite your flaws and past behaviors and actions.
This is acceptance of who you are beyond the grip of your BPD.
CHAPTER 22
This may be the end of the workbook, but it’s not the end of your journey growing beyond
your BPD. You now have the knowledge to embrace your empowerment; the skills to go
forward without being held back; and adaptive and healthy beliefs, behaviors, and patterns to
maintain your gains.
Before I sign off, please take a moment and identify what you learned and what you’ll be
taking with you as you continue to grow beyond your BPD. It’s a way of looking back before
moving forward.
In part 3, I learned that to change my BPD patterns and behaviors I need to:
To resist regressing, managing stress and sustaining your gains and self-acceptance is going to
be important as you move forward. To help strengthen what you’ve learned, there’s a summary
available for download at http://www.newharbinger.com/42730. This summary pulls together
the concepts, activities, and exercises from part 5 of the workbook, so I highly recommend
that you take the time to go through it.
Life Beyond Your BPD 249
When I conclude treatment with one of my clients, I like to give them a transitional object,
something that provides psychological comfort. For a child, it can be a security blanket, or for
an adult it can be a family heirloom or object of great importance that makes them feel safe
and secure.
As I finished writing this workbook, I was thinking about what I could give you. What’s
your transitional object? Then it hit me! This workbook, with all your writings and truths, is
your transitional object. It’s as much a part of you as the knowledge, perceptions, and skills
you’re taking with you. Take this workbook and put it somewhere you can see it. Going
forward, let it remind you of where you are and what you’ve accomplished. Remember, if you
find yourself challenged down the road, open it up and use it to get back on track.
You have my fullest respect and admiration for all you’ve accomplished.
Respectfully,
Daniel J. Fox
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256 The Borderline Personality Disorder Workbook
This is important: if this book isn’t enough, and you need the help of a skilled
therapist, use the following resources to find a clinician trained in the evidence-
based protocols appropriate for your problem. And if you need more support—a
community that understands what you’re going through and can show you ways to
cope—resources for that are provided below, as well.
Real help is available for the problems you have been struggling with. The skills
you can learn from evidence-based therapies will change your life.
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SELF-HELP A N E W H A R B I N G E R S E L F - H E L P W O R K B O O K
AN INDIVIDUALIZED APPROACH TO
MANAGING YOUR BPD SYMPTOMS
THE
The
Borderline
Rather than a one-size-fits-all treatment, this comprehensive workbook meets you where you are on
your therapeutic journey. You’ll find an integrated, evidence-based approach grounded in dialectical
behavior therapy (DBT), acceptance and commitment therapy (ACT), cognitive behavioral
Workbook
therapy (CBT), and interpersonal therapy to help you manage your specific symptoms. You’ll also
gain a greater understanding of your BPD, uncover your emotional triggers, and discover your own
personal motivators for positive change.
Your BPD doesn’t have to define you. With this compassionate and practical guide, you’ll be ready to
face your BPD head-on, and take those important first steps toward lasting wellness.
AN INTEGR ATIVE PROGR AM TO
“A must-have for those who want to understand, treat, and recover
UNDER STAND AND MANAGE YOUR BPD
from borderline personality. Enthusiastically recommended!”
—LANE PEDERSON, P sy D, author of
The Expanded Dialectical Behavior Therapy Skills Training Manual
DANIEL J. FOX, PhD, is a licensed psychologist in Texas, an international speaker, and » Balance Emotions » Improve Relationships
award-winning author. He has been specializing in the treatment and assessment of individuals
» Challenge Negative Beliefs » Grow Beyond Your BPD
with personality disorders for over fifteen years.
» Reclaim Your life
FOX
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