• It’s like waving a red rag to a bull
• The world is your oyster
• It makes the blood boil
• Feeling like being in quicksand
• Feels as if the life jacket is deflating
• There is a light at the end of the tunnel
• Going to pieces
• Struggling to keep my head above water
• Scared to death
• As white as a ghost
• A heart of gold
• Yo-yo feelings
• Feel like a square peg in a round hole
• Jumping the gun
• You can take a horse to water but you can’t make him drink
• The grass is always greener on the other side
• Like father like son, or like mother like daughter
• No use locking the stable door once the horse has bolted
• We all don’t sing from the same hymn sheet
• A heart of stone
• Life is not a bowl of cherries
• Every cloud has a silver lining
• A rolling stone gathers no moss
• All that glitters is not gold
• The grass isn’t always greener on the other side
• Don’t put all your eggs in one basket
• Never judge a book by it’s cover
• A bird in the hand is worth two in the bush
• A stitch in time saves nine
• Live every day as your last as one day it could be
• Never say never
• Read between the lines
• It’s not what you do but how you do it
• Grab the bull by the horns
• Rome wasn’t built in a day
• There are two sides to every story
• When one door closes another opens
• Let sleeping dogs lie
• A recipe for disaster
• Food for thought
• Fish out of water
• Plenty more fish in the sea
• Lightning never strikes in the same place twice
• Every dog has his day

If you can think of anything to add to this list then please send us an email to
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About our network

Our network is a national group of practitioners who are specialists or have a specialist interest in working with those diagnosed with personality disorder. Our Nationally available practitioners are available to work with you face to face, over the telephone or via the Internet and BPDWORLD’s secure server.

Benefits of Joining Our Network

1. Client referrals
2. Professional consult
3. Membership will boost your professional status
4. Personality disorder newsletters
5. Discounts on our future conferences
6. Information leaflets
7. Discounts on distance learning training courses
8. Discounts on Professional Liability Insurance

Requirements For Joining:

• You must be qualified to Diploma Level
• You must have Professional Liability Insurance
• Have had previous experience in working with a diagnosis of personality disorder

How it works

Joining our network is completely free. The only time you will incur a cost is for each and every initial assessment/appointment a client referred to you by us.

The client pays us for the first session and then every session after that your rates are paid to you.

It’s as simple as that. Receive no referrals pay nothing.

For more information on joining the network please call our information line number: 0844 445 0629

Join NOW!!

Online form

Managing Intense Emotions and Overcoming Self-Destructive Habits: A Self-Help Manual

By Lorraine Bell

Product Description

This self-help manual for those who meet the diagnosis of 'emotionally unstable' or 'borderline personality disorder'(BPD) outlines a brief intervention based on a model of treatment known to be effective for other conditions.

From the Back Cover

The treatment of personality disorder is a major concern facing current mental health services. Managing Intense Emotions and Overcoming Self-Destructive Habits is a self-help manual for people who would meet the diagnosis of 'emotionally unstable' or 'borderline personality disorder' (BPD), outlining a brief intervention which is based on a model of treatment known to be effective for other conditions, such as anxiety, depression and bulimia.

The manual describes the problem areas, the skills needed to overcome them and how these skills can be developed. Areas covered include:

• * the condition and controversy surrounding the diagnosis of BPD
• * drug and alcohol misuse
• * emotional dysregulation and the role of thinking habits and beliefs
• * depression and difficult mood states
• * childhood abuse and relationship difficulties.

It will be essential reading for people with BPD and professionals involved in their care - psychologists, psychiatric nurses, psychiatrists and occupational therapists.

Skills Training Manual for Treating Borderline Personality Disorder (Diagnosis & Treatment of Mental Disorders)
By Marsha Linehan

Product Description

This session-by-session treatment manual demonstrates how clinicians can teach patients four essential psychosocial skills: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance.

Review

'Marsha Linehan's tremendously in-depth and informative book and its companion skills-training manual offer a needed guide to the cognitive-behavioral treatment of borderline personality disorder... Her method has become so widely used by clinicians that the experts in psychosocial treatments consider it one of the best... Marsha Linehan's methods are highly eclectic because they are empirically based; they have been fashioned to fit what works best for borderline patients.' - Lester Luborsky, PhD

Borderline Personality Disorder Demystified: An Essential Guide for Understanding and Living with BPD (Demystified Series) [Illustrated] (Paperback)
By Robert Friedel

Product Description

Over six million Americans suffer from Borderline Personality Disorder (BPD), a chronic, disabling psychiatric condition that causes extreme instability in their emotional lives, behavior, and self-image, and severely impacts their family and friends. In Borderline Personality Disorder Demystified, Dr. Robert Friedel, a leading expert in BPD and a pioneer in its treatment, has turned his vast personal experience into a useful and supportive guide for everyone living with and seeking to understand this condition. Friedel helps readers grasp the etiology of Borderline Personality Disorder, the course it takes, the difficulties in diagnosing it, the types of treatment available, strategies for coping, and much more. Borderline Personality Disorder Demystified is an invaluable resource for everyone diagnosed with BPD, those who think they might have the illness, and friends and family who love and support them.

Reader review (Amazon website)

I thought this book was excellent and far exceeded my expectations!! I would recommend this as the only book you would need to read. It is very informative and I found it extremely easy to understand. It even explains whats happening in the brain (although a tad complicated - still worth reading) and stresses this disorder is as real as diabetes etc.

Excellent informative book!!!

Mentalization-based Treatment for Borderline Personality Disorder: A Practical Guide
By Anthony Bateman & Peter Fonagy

Reader Review (Amazon website)

FANTASTIC! THis morning my Amazon order plopped through my door.How Do Anthony Bateman and Peter Fonagy make their work very readable and understandable?

I am biased having had MBT treatment and having moved on in my life yet still stuck in many areas which they do talk about in the practical guide.

Currently I am woking as a service user consultant deivering PD training locally with a generic clinical team who have done the three day MBT training-I have to say that it makes a remarkable difference..

Mentalizing is far from easy but somuch better when you STOP andTHINK, also pushing that pause button and exploring what has happened......

This work is groundbreaking and inspiring.

As a BPD sufferer on a recovery journey I find this book heartwarming too.

BPD IS Treatable and Bateman and Fonagy show you how. The beauty of it is that MBT reaches the parts of you that others may not have reached before. The process of change is painful-MBT makes it a welcome change. FL.

Mentalization: Theoretical Considerations, Research Findings, and Clinical Implications (Psychoanalytic Inquiry Book)
By Fredric N. Busch (Editor)

From the Back Cover

Mentalization is the capacity to perceive and interpret behavior in terms of intentional mental states, to imagine what others are thinking and feeling, and is a concept that has taken the psychological and psychoanalytic worlds by storm. This collection of papers, carefully edited by Fredric Busch, clarifies its import as an essential perspective for understanding the human psyche and interpersonal relationships. The book is divided into theoretical, research and clinical papers, reflecting how the investigators thoughtfully and purposefully pursued each of these goals. Those involved in identifying mentalization have also made consistent efforts to measure and research the concept. Thus, in addition to expanding the theoretical bases and implications of mentalization and identifying clinically useful applications, the authors describe research that scientifically grounds the concept.

Review

"This fascinating and stimulating book focuses on a core aspect human mental capacity, how we perceive and understand ourselves and others, the understanding of which is of central importance to our work with every patient we treat. Dr. Busch has brought together an intellectual powerhouse team of authors, whose work spans the latest thinking about mentalization. The time spent with this work will be repaid over and over for clinicians at any stage of their careers."

- Allan Tasman, M.D., Professor and Chairman, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine

Changing Ideas About the Treatmentof Borderline Personality DisorderW. John Livesley Journal of Contemporary Psychotherapy, Vol. 34, No. 3, Fall 2004 ( C° 2004)

“The problems presented by the typical patient include symptoms, situational difficulties, maladaptive traits, maladaptive interpersonal relationships, dysfunctional self and interpersonal cognitions, and core self and interpersonal pathology. Few therapies incorporate interventions that cover this range. Most therapies are based on the assumption that there is a single core dysfunction underlying borderline problems”

“A potential problem with eclectic treatment is that therapists, faced with a complex array of problems and the pressure of the patient’s demands will continually switch intervention strategies leading to a confused and disorganized form of treatment. This eventuality may be avoided by addressing problems in a sequential manner.”

“It is not only ideas about treatment that are changing; major changes are also occurring in ideas about the etiology of borderline pathology. Until recently, both psychosocial and biological perspectives tended to assume that there was a major cause for the condition. Psychosocial models tended to stress the contribution of adversity, especially childhood sexual abuse and trauma, and biological models offered explanations in terms of a relationship with mood disorder or dysregulation of specific neurotransmitter systems. The origins of borderline problems, however, are more complex. Multiple lines of evidence indicate that borderline is a psychobiological entity that is influenced approximately equally by genetic and environmental factors.”

Borderline personality disorder: Psychosocial considerations and rehabilitation implications

Mary Hennesseya,∗ and Connie J. McReynoldsbaVocWorks, Inc., P.O. Box 534, Kent, OH, USAbDepartment of Educational Foundations and SpecialServices, Kent State University, Kent, OH, USA

“Psychotherapy plays a central role in the treatment of BPD. It is the cornerstone of treatment because it is a stable and consistent process, especially because the disorder itself is marked by instability and inconsistency”

In terms of structuring the therapeutic relationship, Johnson (1991) advanced an eight-point framework for professionals working with clients who have BPD. The tenants of this model are paraphrased below:

1. Practioner and client contacts should be structured, with clear rules regarding meeting times, fees, and procedures established at the outset of the initial meeting.
2. The practitioner must take an active role during the sessions to keep the client in reality and minimize transference distortions.
3. The practitioner must be able to endure the client’s potential verbal abuse without retreating or reciprocating.
4. The practitioner must continually remind the client of the harmful results of self-destructive behaviors such as substance abuse, binge eating, casual sex, and reckless driving. The focus needs to be placed on the results of the behaviors, not on the motives behind them.
5. The practitioner’s role is to help the client forge a connection between his or her actions and feelings when the client engages in self-destructive acts.
6. The practitioner must set limits on client behaviors that threaten the safety of any person interacting with the client. State mandatory reporting laws and ethical codes of the practitioner’s profession must be expressly followed.
7. The practitioner should present all interactions as occurring in the present, not the in client’s past.
8. The practitioner needs to monitor his or her reactions to the client as a means of avoiding acting out. The client with BPD can be frustrating and irritating to counsel, but these are the very symptoms that require the highest degree of patience and professionalism to treat effectively. 

Adapted from: H. Johnson, Borderline clients: practice implications of recent research, Social Work 36 (1991), 166–173.

Children At-Risk for BorderlinePersonality DisorderMarsha J. Harman

Adult patients who have been diagnosed with borderline personality disorder (BPD) have provided valuable information about events and family dynamics that are frequently associated with BPD. Clinicians who work with children are frequently aware of family or individual characteristics that may put a child at risk for developing BPD. Such situations frequently involve attachment issues with the child’s caregivers and can include sexual abuse, divorce, alcoholism/substance use, illness/ death, and neglect. Child characteristics such as learning difficulties and temperament may also predict BPD. Yet, many children are resilient and seemingly unaffected by these events or situations, especially when early intervention may prevent development of BPD.

Frequently, the characteristics associated with a specific personality disorder do not manifest themselves until later adolescence or young adulthood. Nevertheless, a growing number of articles discuss children with personality disorders. One, in fact, describes therapy with a four-year-old who was treated for BPD (Nilsson, 2000).

Personal Accounts: A "Classic" Case of Borderline Personality Disorder Lynn Williams

The first misconception most people have about borderline personality disorder is that its dramatic manifestations such as reckless or suicidal behavior are merely deliberate, manipulative attempts to get attention. That is not true. The distress is real

Sometimes it's difficult to remember when you're caring for someone else that you still have needs yourself as an individual.

Try to make time to yourself.

In your routine try to make some ‘you time’. It could be that you just have a nice cup of tea, going for a walk, or even have lunch out but important you do something to take care of yourself.

Try to keep up with your circle of friends, make time to socialising with them. It's just as important that you look after your own emotional health, as let's face it without it you will find it hard to support anyone else.

It's important you observe your own limits and the person you're caring for is aware of this. You can only do what you can do and try not to forget this.

Take care of the basics; make sure you're eating well, sleeping well, and taking regular exercise.

Listening

Listening is a vital skill when helping someone with BPD; it is more than simply hearing what they say – it also includes understanding what they have said in your own way. It is important to remember listening is an active process.

Good listening skills involve:

• Give the person your full attention
• Allow the person to finish what they are saying without interrupting
• Listen for the key points in what the person says
• Clarify things you are unsure of
• Feedback to the person to show you have understood

Validation

Validation is another important skill and consists of two parts. The first involves mindful listening and requires you to give the person your full and undivided attention and to show an interest in what the person has to say in the form of verbal and non-verbal cues (i.e. facial expression and gestures). The second part of validation involves reflecting and acknowledging what the person has told you. In your reflection, you should not simply repeat what the person has said in parrot fashion, but instead convey the essence of what the person has said.

As part of validation it is also important that you clarify and summarise. This is vital if there are areas which you did not understand so that you can ask the person to explain this again and for you to then summarise so the person can correct you on any areas you may have misunderstood.

You can also put problematic behaviour into a larger context to avoid such negative behaviours occurring again in the future. If the person were to describe an argument they had with their partner for which they feel responsible because they said something nasty, you may be able to validate it if their partner also said something nasty; you may do this by explaining that although they said something nasty, they did not storm out of the house, but instead stayed and calmed themselves down.

Alongside this you could also point out to the person that their reactions and emotions can be perfectly legitimate. If for example, the person had organised a family meal and no one came, you could normalise their upset by saying, “I understand you are upset that no one came to the meal, anyone would feel the same in that situation”.

In the following guidelines “regular and substantial” refers to at least 35 hours per week.

Mental Health Bill

Provides carers with the right to be consulted during an assessment.Does not provide carers with the right to be consulted by mental health tribunal at the time of discharge

Allows change of “nearest relative” provision in favour of a “nominated person”.

“Nearest relative” refers to the person who comes highest:

• Provides carers with the right to be consulted during an assessment.
• Does not provide carers with the right to be consulted by mental health tribunal at the time of discharge
• Allows change of “nearest relative” provision in favour of a “nominated person”.
  
  
  • “Nearest relative” refers to the person who comes highest:
    • Husband or wife
    • Eldest:
      • Child
      • parent
      • brother or sister
      • grandparent
      • uncle or aunt
      • nephew or niece
  • There are however some exceptions to this list.

The Mental Health Act (1983 – sections 26 – 30)

• A nearest relative or nominated person has the right to:
  • Request that an assessment be carried out by an approved social worker (ASW) if they feel that the person they are caring for requires this and they are unwilling to request care themselves.
  • Apply for compulsory admission which requires a written supporting statement from two doctors.  This can be reduced to one doctor in urgent circumstances.
  • Information and consultation before admission to hospital.  If the person being cared for is to be admitted under a section 2 (for an assessment), the carer must be informed of the action and their rights in regards to their powers of discharge.  If the person being cared for is admitted under a section 3 (for treatment), the carer must be informed and agreement sought.  If the carer does not agree to this action being taken, the person they care for cannot be detained.  The approved social worker may then however, apply to the county courts to request that you be replaced as the nearest relative.
  • Information and consultation after hospital admission and to be given certain information regarding:
    • Detention
    • Making an application to a mental health tribunal
    • Hospital discharge
    • Compulsory treatment
    • Mental Health Act Commission

The detained person can object to you being given this information

•  
  • Review detention if this is being reviewed by the hospital or a mental health review tribunal; in which carers have the right to state their views
  • Obtain discharge as long as the person is not subject to special restrictions or a hospital order.  This has to be done within three days after receipt of the carers letter
  • Apply to the mental health review tribunal
  • Be told when the person is to be discharged, unless the patient objects.

National Strategy for Carers

• Information – what carers can expect from services
• Support – carer involvement in planning and provision of services
• Care – to have their own needs met

Human Rights Act

• On behalf of a person being cared for, carers have the right to invoke Article 3 (the right not to be subjected to inhuman or degrading treatment or punishment) and Article 4 (the right to liberty and security of the person – although this can be overridden for persons of “unsound mind”)

Carers Services and Recognition Act (1995)

• Gives carers the power to request local authorities to carry out an assessment of their ability to provide care
  .
• This applies to those who provide, or intend to provide a regular and substantial amount of care.

Carers and Disabled Children’s Act (2000)

• Carer can ask for and receive an assessment of their own needs if the person they care for has refused an assessment or services.
• The local authority has the power, not a duty, to provide some services direct to carers.

Carers (Equal Opportunities) Act (2004)

• The local authority has a duty to:
• Inform carers of their rights to an assessment
• Consider the wishes of carers concerning:
  • Employment;
  • Training;
  • Education
  • Leisure activities

National Service Framework for Mental Health (2000)

• Those who provide ‘regular and substantial’ care should:
  
  
  • Have an assessment of their own caring, physical and mental health needs.  This should be conducted on an annual basis
  • Have their own written care plan which is given to them and implemented in discussion with them.

Carers Allowance

• Carer’s Allowance is a benefit for people over 16 who spend a regular and substantial amount of time caring for a disabled person. It is non-means tested or reliant on National Insurance record. There is however, an earnings limit if they are in paid employment
• The basic eligibility criteria for claiming carers allowance:
  In some circumstances a carer claiming Carer’s Allowance may reduce the means tested benefit of the person they are caring for.  It is therefore recommended to seek advice before claiming carers’ allowance.
  • aged 16 or over at date of claim…and
  • if in work, must not earn more than £90…and
  • not in full time education…and
  • care for a disabled person for at least 35 hours a week…and
  • the disabled person must receive Attendance Allowance or the high or middle rates of DLA Care Component…and
  • must not be ‘subject to immigration control’…and
  • must normally live in Britain and have been here for 26 out of previous 52 weeks
• Carers Allowance Unit: 01253 856123 or visit www.dwp.gov.uk
• Carers may also be entitled to reduced council tax and income support.  It is recommended that you seek advice regarding these before applying.

Financial Support

Carers Allowance

Carer’s Allowance is a benefit for people over 16 who spend a regular and substantial amount of time caring for a disabled person. It is non-means tested or reliant on National Insurance record. There is however, an earnings limit if they are in paid employment

The basic eligibility criteria for claiming carers allowance:

• Carer’s Allowance is a benefit for people over 16 who spend a regular and substantial amount of time caring for a disabled person. It is non-means tested or reliant on National Insurance record. There is however, an earnings limit if they are in paid employment
• The basic eligibility criteria for claiming carers allowance:
  In some circumstances a carer claiming Carer’s Allowance may reduce the means tested benefit of the person they are caring for.  It is therefore recommended to seek advice before claiming carers’ allowance.
  • aged 16 or over at date of claim…and
  • if in work, must not earn more than £90…and
  • not in full time education…and
  • care for a disabled person for at least 35 hours a week…and
  • the disabled person must receive Attendance Allowance or the high or middle rates of DLA Care Component…and
  • must not be ‘subject to immigration control’…and
  • must normally live in Britain and have been here for 26 out of previous 52 weeks
• Carers Allowance Unit: 01253 856123 or visit www.dwp.gov.uk
• Carers may also be entitled to reduced council tax and income support.  It is recommended that you seek advice regarding these before applying.

Crisis Loans

As the name suggests this is a type of loan from the benefit office which has to be repaid, the advantage is no interest will be incurred and repayments are usually very small and over a period of time.

For more information please visit Click Here

Emotional Support

Supporting someone with a personality disorder can be very emotionally demanding and therefore it is imperative that you look after yourself to enable you to care for your loved one. Most local charities will offer counselling services at either a reduced rate or completely free of charge. BPDWORLD also as a network of specialist therapists who worked throughout the UK. Click here

For those on benefits you may find This Website useful in finding counsellors willing to offer free counselling.

Crisis Support

Should the person you are caring for become a risk to themselves or others, you can ask for a mental health act assessment. Should the need arise you would need to contact your GP or local A&E department who would make the necessary arrangements.

Should you be concerned about the person you're caring for in a public place then you would need to call the police on there emergency number. Once they arrive they have the ability to detain someone for the purposes of assessment. This will be done at the police Station, which is considered a place of safety.

Should you feel the person you care for is at risk but would prefer not to go down the route of the mental health act assessment then there is the option of you contacting your local emergency duty team. This is run by this social services department in your area. You will need to contact them during office hours to obtain this number or contact directory enquiries.

One of most popular enquiries we receive from Parers of people with Personality Disorder is “How the do I get my loved one diagnosed?”

I'm afraid the short answer is you don't, you can't, or at least not without their cooperation. Should you have this, then the process is quite simple.

1. Go with the person you suspect of having a Personality Disorder to their GP.
2. Ask for a referral to a Psychiatrist. Should they be able to afford it, going to see a Private Psychiatrist is quite a lot quicker and costs in the region of £150.
3. Speak about your suspicion of Personality Disorder being the appropriate diagnosis.

Many people however, will not receive this cooperation and therefore must consider asking themselves “Why is it I want them to receive a diagnosis?”

Could it be that you are looking for a reason or excuse for their behaviour?

Even if they had the diagnosis would it excuse their behaviour?

What does it mean to you, if your loved one receives a diagnosis?

It is completely understandable for you to want an explanation as to why your life is more complex and chaotic due to this person behaving in a manner which may suggest they have a Personality Disorder. It may be more beneficial for you however, to encourage them to seek help for the problems they are experiencing, after all, Personality Disorder is just a label for a series of problems/symptoms.

Some may find it a little less frightening to receive care and treatment for specific problems they are experiencing rather than to receive a diagnosis that could affect their whole life including their work, travelling abroad, and future relationships. Remember you can't change another person, only yourself. Take steps to keep yourself safe by observing your own limits. There is only so much you can do, and you need to be clear, not only for your sake, but also that of the person you care for.

This course will teach you how to encourage and support the client to work through challenging issues towards self-empowerment, self-confidence and a happier, more productive and successful life.

The course covers the history, techniques and applications that go to make up the Life Coaching process, plus a guide to setting up a Professional Life Coaching Practice.

It also looks in some depth at specialist niche coaching including relationship, prosperity, career, spirituality, self-esteem and well-being formats and includes success tips from a successful Life Coach.

For more information or to order this course please visit Cambridge Open College