Some weeks ago, I mentioned that Stephen and I had decided to become leaders for a Family Connection program that had helped us understand and help a family member who struggled with Borderline Personality Disorder, also known as emotion dysregulation. Last weekend, we attended that training.
The first step, of course, is to understand the disorder, so that is where Dr. Alan Fruzetti, who developed the program with Dr. Perry Hoffman more than a decade ago, began. He explained that there are three factors in emotion dysregulation:
- Extreme sensitivity - hyper-aware of nuances; perceives criticism and rejection with any negative feedback. This is especially true if the feedback is given in public or in any situation that can feel humiliating or shameful.
- High reactivity - responds with very high arousal, sometimes physically. This reactivity can overwhelm social boundaries that would otherwise inhibit inappropriate behaviour like yelling, swearing, or lashing out.
- Slow return to "baseline" - takes a long time to calm down enough to have a "rational" conversation. While we all need time to calm down, someone with emotion dysregulation will remain in the hyper-aroused state for much longer. They may appear to be holding it together, but it will take just a minor incident to spring them back into that over-the-top state.
In fact, when we're feeling low, we want our loved one to be sensitive enough to notice our sighs and downturned eyes. Picture Mr. Rogers being sensitive to the mood of the child he's talking to; that is a valuable trait.
When we share really good news with a friend, we want someone who is reactive: we want their face to light up, we want them to jump with joy for us. Conversely, have you ever had an argument with someone who was completely non-responsive? It is bizarrely annoying.
It is the trifecta that creates the perfect storm. One of the parents at our program referred to it as "Sensitive Butterfly Disorder."
An imaginary scenario with Jennifer, who has emotion dysregulation.
Jennifer had trouble sleeping last night and then hit the snooze button on her alarm clock several times before finally dragging herself out of bed. Because she was running late, she skipped breakfast, and barely made the bus. She hadn't had time to do her hair or make-up so was feeling ugly and felt people looking at her sideways.You can imagine how families feel like they are constantly walking on eggshells. And you can imagine how exhausting and painful it is to live in Jennifer's mind.
Right now, her mood is well above baseline (not a good thing).
The bus was full so there was no seat for her, and she heard some teenagers laughing in her direction when she stumbled as the bus accelerated.
Now, she's roiling with feelings: frustration, embarrassment, fear of being late for class, hungry, tired, unattractive. But there is no time for her to acknowledge or deal with any of this.
She made it to class, but was late. The professor had just finished reminding people that their essays were due next class. He wanted Jennifer to know this as well so, when she walked in, he paused his lecture and reminded her as well. She felt this as a public humiliation and gave the professor a look that would have cracked granite. She had to sit near the front, but really wasn't paying much attention to the first part of the lecture and really had to fight the impulse to run out of the room.
Immediately after class, Jennifer went to grab a coffee and donut, but didn't have enough cash and the coffee shop didn't accept debit or credit, so she had to walk a few blocks out of her way. Then someone bumped her and spilled coffee down the front of her favourite jacket.
Her day continued like this. One thing after another kept her from finding a calm place in her inner storm. People kept saying and doing things that hurt her and kept her arousal level up near the ceiling. She kept a grip on herself (she did not flip the bird at that rude cashier, though she was severely tempted), but several times found herself on the verge of tears and increasingly angry.
She finally got home, really hoping for a hot meal and a peaceful place. She walked in the front door, dumped her backpack in the middle of the front hall and her mother called out (in what she intended to be a neutral voice) to Jennifer to please put her backpack where it belongs.
And that's when all hell breaks loose. Jennifer throws her gloves at her mother and swears. She storms to her bedroom, sobbing, and starts cutting on her legs, the one way she has found to release the pent-up agony. The mother is stunned, feels disrespected, and thinks, "Here we go again." The evening is ruined and could well end with a call to 9-1-1.
The Family Connections course takes us from coping with this kind of "drama" in an ad hoc manner to developing skills and understanding that help family members help their Jennifers find that place of calm in the storm.
It is powerful, and we really look forward to helping others the way we have been helped.