Reflective Listening + Validation

Reflective Listening

The goals of reflective listening are several:

1. To facilitate the expression of someone else's feelings.
2. To enhance a speaker's problem-solving ability by helping them move through "stuck" feelings; and
3. To generate a feeling of warmth and understanding between listener and speaker.

The technique of reflective listening is deceptively simple to describe, and challenging to master. The listener must identify the primary feelings the speaker is having and then reflect back that understanding with an empathetic tone. For example:

Wife: If that neighbor parks in my space again I'm going to let all the air out of his tires!
Husband: Sounds like you're angry that he keeps taking your spot.
Wife: You bet I am. I've told him not to ten times! But I don't want to get him mad at us because I know what a jerk he can be.
Husband: You're afraid of what else he might do.

Reflective listening avoids the many pitfalls listeners tend to fall into: judging, minimizing or discounting feelings, giving advice, or not responding at all. One of the most common pitfalls is trying to help “solve the problem”. Speakers are often just looking for empathy, a chance to vent, and to clarify their own thinking.

They may consider it an insult to their intelligence for the listener to offer solutions. And if the solutions posed seem simple, the speaker may feel like her feelings are being judged as being irrational.

Reflective listening is not simply repeating or paraphrasing what a speaker has said. Most speakers don't question your comprehension of their words, but they need to know that you know how they feel.

Reflective Listening Is Not Always Enough

While reflective listening is arguably the single most important communication skill taught, sometimes the technique falls short of its goals. When the feelings expressed are quite strong, or the speaker carries some doubt or shame about their feelings, a neutral reflection by the listener can miss the mark, even if the feeling reflected is accurate and the tone is empathetic. For example:

Worker: I can't believe the secretary hasn't finished my report yet. What the hell is the matter with her?
Co-worker: You're angry that she's not done.
Worker: Angry? Oh no. I'm sure she's got her hands full like all of us. But damn it, I've got to present that report in half an hour!
Co-worker: You are afraid you won't have it in time.
Worker: No. It doesn't matter. I can present the bulk of it without having it in writing. ...Damn!

The worker in this example is embarrassed by his own feelings as they are reflected back to him, and he denies them. He is not convinced by the reflective listening that his anger and fear are understandable. An empathetic tone of voice is not always enough to communicate that someone's feelings are okay. The empathy in the tone, however, can be put into words. This is where the skill of validation comes in.

Validation Defined

Simply put, validation is the message, "Your feelings make sense. Not only do I hear you, but I understand why you feel the way you do. You are not bad or wrong or crazy for feeling the way you do."

This is a message people often need to hear, especially when they are rocked by strong feelings. No one is going to sound authentic, however, parroting these exact words. The art of validation is in tailoring the essence of this message to the specific feeling and situation the speaker is experiencing.

The Need For Validation

To understand why people need to be validated requires us to look at how often our feelings get shamed. As a society we have very few places where feelings are welcomed. We learn that strength means not crying, bravery means not feeling fear, and maturity means never being angry.

Showing strong emotion tends to make the people around you very uncomfortable. Usually, they will attempt to get you to stop as quickly as possible. They may try to convince you that your feelings are inappropriate. Or they may try to reassure you. Even if their intent is to help you feel better, often the message is that it's not okay to feel bad.

Consequently, we have all accumulated many messages that our feelings are wrong. We yearn, therefore, for acceptance of our feelings, especially when our feelings are strong. Whatever else someone may be saying when they vent their feelings, they are probably also implicitly asking, "Are my feelings okay?" Validation answers this indirectly asked question, and provides satisfaction for a profound, though often unconscious, need.

The "Natural" Validation

Validation comes naturally whenever a listener feels the same way as the speaker. If Tom describes his anger at the invasiveness of telephone marketing and Corrine hates telephone marketing too, then all she has to do is express her feelings and Tom will probably feel supported that his feelings are okay.

Often someone needing validation will tell their story over and over again to different people, unconsciously searching for someone who feels the same way they do. Natural validation works well and does not require any specific skills. It is limited, however, to situations where the speaker and the listener feel the same way.

The Skill of Validation

When you do not feel the same way as someone you are listening to does, you can still validate their feelings. Doing so requires that you identify in yourself "sub-feelings" or different parts of yourself. While you may have a primary or dominant feeling about something, you can often have sub-feelings that are quite different.

When a friend moves away, a person might say she feels sad. While sadness may be the largest single feeling she has, she may have sub-feelings as well. She might feel angry at the friend for leaving. She might feel relieved that the friend is finally going to do what he has been talking about for years. Or she might feel afraid that her friend may be making a mistake.

There is a common misconception that we only feel one thing at a time. This error can make it difficult for a person to articulate his feelings. As soon as a person identifies one feeling, he hears a nagging voice inside saying “Oh no you don’t, you feel just the opposite!” Trying to decide on a single feeling with which to represent oneself can result in a confusing inner conflict, causing a person to become tongue tied. By allowing for the existence of sub-feelings, even contradictory ones, we can identify and express a more thorough picture of how we feel.

Identifying sub-feelings can also help us validate someone whose predominant feeling is different than our own. Imagine someone describing to a friend how angry he is at the thief who just held up a store he was in:
"I was so angry I just wanted to follow the guy out and beat him up!"

Imagine that the listening friend, however, identifies how scared she would be in that situation. She can't imagine the desire to pursue the thief. The idea sounds quite stupid to her. She can still validate her friend's feeling, however, by identifying her own sub-feelings.

She might ask herself, "Have I ever felt angry enough to want to fight back against someone?". She may then remember wanting to slug a guy who harassed her with catcalls on the street the other day. Having contacted a similar anger within herself she can then validate her friend by saying something like:
"I can understand being angry enough to want to strike back".

This validation is likely to feel genuine to her friend because she was willing to feel a similar anger inside her-self before she said it. If she had just said, "You are angry about the hold-up," without identifying any sub-feelings of anger within herself, her response would likely seem mechanical and not very validating.

Some readers might fear that validating someone's anger will make them more likely to act it out. Quite the opposite is true. When someone's feelings are validated the urge to act them out actually lessens. The validation helps them let the feeling go and begin thinking more clearly about a wise course of action.
The art of validation, then, requires that you actually feel some aspect of the emotion the speaker is having.

Your feeling does not have to be the main response you would have to the situation they describe. It can be a sub-feeling, or it can be a feeling you would have in another situation that has some similar elements. What makes a validation authentic is your willingness to call up and experience a part of yourself that can connect with the emotion being described. When you speak from that willingness, your message that the emotion in question is understandable or okay will be truly validating.

Choosing Feelings?

Another roadblock to good validation is the fallacy that we "choose our feelings". Listeners can shame speakers with this misconception.

“So you are choosing to be upset with your husband. I guess that’s your right. How is it working for you?”


This approach may be well-meaning, but it is likely to be poorly received. The power of examining our choices is a valuable tool, but we must be clear about what we have choice over and what we do not.

Our feelings are bodily experiences that we perceive, rather than choose. The only direct choice we have over our feelings is whether to be aware of them or to repress them. Either choice may be appropriate, given the situation. Sometimes it is best to put your feelings aside and focus on a particular task. At other times, knowing how you feel is important so you can make good decisions, or so you can connect meaningfully with others.

There are choices we make, however, that affect our feelings indirectly. Our feelings spring from our needs, our experiences, and our interpretations of them. How we interpret events affects how we may feel about them. Our interpretations, and the beliefs upon which we base them, are subject to our choice. By changing the way we look at a situation we can change how we feel about it.

Unfortunately, many of the beliefs that underlie our interpretations of events are either not conscious, or resistant to change. The pessimist, for example, is unlikely to simply decide to suddenly believe that “things will all turn out okay”. Many past experiences have formed the basis for his pessimism. Perhaps, for instance, a pessimistic attitude was once an effective way to cope with a series of disappointments.

Changing one’s belief systems, therefore, can be a difficult process. First the underlying belief must be identified. Then, a more functional belief must be proposed, and finally, experiential evidence supporting the new belief must be accumulated. Only then do feelings begin to change.

Hence, it is unrealistic to expect someone to change their beliefs whenever challenged. Listeners who do this may appear callous and uncaring.

Feelings and Needs

Feelings are also a factor of whether a person’s needs are being met or not. Marshall Rosenberg, founder of Non-violent Communication, explains that good feelings are the response we experience when our needs are being met and uncomfortable feelings are the result of our needs going unmet.

Feelings that spring from unmet needs are often difficult to accept, particularly if one does not believe that the needs they have are legitimate. Whether they believe it or not, all people have needs for connection, autonomy, mastery, physical comfort, and meaning. An under-standing of these universal human needs can help people give themselves more permission to have their needs and the feelings generated when those needs go unmet. Such self-acceptance can help a person soothe themselves when they cannot find validation for their feelings from someone else.

Validating Feelings about You

One of the greatest challenges of good communication is validating the feelings someone has about you. When someone has a negative feeling toward us our first impulse is usually defensiveness. It makes sense that we would feel defensive because rarely do we do something with the intention of hurting someone else.

In order to respond to such feedback it is useful to make the distinction between the intention you had and the impact of your actions on someone else. Intent does not always equal impact. Only you know what your intention really was. Only others know what your impact on them really was.

Good communication can be defined as creating the impact that you intend. In order to communicate well, you have to be willing to listen to ways that your impact may have varied from your intent. Such feedback can help you make the proper correct-ions. Often, however, your first impulse may be to defend your-self.

Consider the following example:
Customer: Where's my car! I've got to go! It's supposed to be ready by now! It's been an hour!
Tire Salesperson: You have to give us some leeway on our estimated time for a job!

The customer here may feel that the salesperson is invalidating her feelings. If so, she may insist that her anger is justified and an argument may ensue.


Validating someone's feelings about you requires that you temporarily quell your impulse to explain yourself. Internally you may respect your intent and hold yourself blameless. Meanwhile, you focus your attention on what the other person felt and try to find something in your actions that could plausibly set off the feel-ings they describe. For example, our tire salesperson could say:

Tire Salesperson: Our estimate was off. I can see how that would be upsetting if you're in a hurry.

It is helpful to acknowledge what you did or said that sparked someone's feelings toward you. You do not, however, have to hold yourself accountable for the full intensity of their response. Your actions may have simply triggered strong feelings from their past. Pointing this out to someone, however, is likely to make them defensive unless you cop to your own involvement first. If you validate your contribution to their feelings they are often freed to look more closely at their own contribution.

After you have validated someone's feelings about you and allowed some time for those feelings to release, you can explain what your intention was without appearing defensive. Here are a few examples of the difference between defensiveness, reflective listening, and validation:

Example A:
Sister #1: Jackie! You pig! The pie is almost all gone!
Sister #2 (defensive): I didn't eat it all!
Sister #2 (reflective): You're angry about how much pie I ate.
Sister #2 (validating): Oh. I wasn't keeping track of how much I was eating. But if I had more than my share it makes sense that you'd be pissed.

Example B:
Child: This is a drag. You never take us anywhere fun.
Dad (defensive): What do you mean! What about last weekend!
Dad (reflective): You are bored with what we are doing.
Dad (validating): I can see how it might get pretty boring just hanging around here all day.

In both cases the validating response goes beyond the reflective response to include the message that the feelings expressed are understandable. The validating response thus addresses the unconscious question, "Are my feelings okay?" Because the need to be validated is so universal among people, those who gain proficiency at this skill can become very popular indeed.

18 Months vs. 15 Years...

I have written many posts describing a therapist who has treated several dozen BPD couples. He said that BPD relationships typically last 18 months or 15 years. They last 18 months, he explained, when the Non is healthy and has strong personal boundaries. In that case, the Non enjoys the 6 month passionate honeymoon and is willing to work for up to a year trying to reestablish the honeymoon. Then he bails.

The relationship last 15 years, he explains, when the Non has weak personal boundaries, being codependent. In that case, the Non never does leave. Instead, the BPD leaves him because each year she grows increasingly resentful that he did not fix her or make her happy. Moreover, as her body ages, she becomes increasingly fearful of abandonment.

--http://www.psychforums.com/borderline-personality/topic36357.html


word! This makes so much sense it hurts.

Nutrient-Dense Supplemental Foods

Egg yolks

Egg yolks are number one in my book. The way they blend effortlessly with other foods and even enrich them, and (if you get a really pastured one) provide unparalleled taste and mouthfeel when eaten straight out of the shell can’t be praised enough. The vitamin A, choline, folate, selenium, iodine, and omega-3 (again, if you get pastured) are rather nice, too. Eat egg yolks every day, just don’t smoke ‘em. Yes, that was a double reference to both the egg yolk/cigarette study and Dr. Dre.

Liver

Since every animal comes with but a single liver, it’s tough to get more than a few ounces if you’re sharing with everyone else in the group. Good thing liver is the most nutrient-dense food on the planet, so nutrient-dense that eating more than a half pound to a pound a week is probably overkill and will net you an excessive amount of certain nutrients.

Seaweed

Seaweed is green vegetation that’s been marinating in mineral-dense seawater for its entire life, and when you eat seaweed, you get the best source of iodine, plus magnesium, manganese, iron, and tons of other trace minerals that you might be (probably are) missing out on. Some of the healthiest traditional cultures consider seaweed a staple food, and essentially every group of coastal people utilized sea vegetables in their diets. Sprinkle kelp or dulse flakes on food, make broth using dried kombu, eat seaweed salad when you go out to eat sushi, roll up avocado and meat in nori wraps – the possibilites are many and delicious.

Turmeric

You might have read my old post on turmeric, thought, “Huh, interesting,” gone out for Indian that night, and never thought about it again. That’s a mistake, in my opinion, because turmeric is delicious and a true health food. It and its primary bioactive component – curcumin – have been shown to be anti-inflammatory, anti-lipid peroxidative, blood lipid-improving, and anti-carcinogenic in human studies. Contrary to popular belief, turmeric doesn’t just go with Indian food. I often sprinkle it liberally on my eggs, meat, and vegetables, and I even make a tea out of it. So no, you have no excuse not to use more turmeric more often. Add black pepper to increase the benefits.

Bone broth

It can feel like a chore to make, but it’s really not. Get bones, cover with water, heat, strain. It only seems like a big job. Once you get going, though, it’s easy enough. Make it a routine, to make it even easier and ensure that you have bone broth on hand at all times. Just be sure to clean those pots right away; dried, obliterated skeletal matrices are tough to scrub off of stainless steel pots. As for the benefits, bone broth is a good source of minerals and gelatin. If you’ve been pounding the muscle meat, balancing the amino acid methionine out with some glycine from gelatin is advised, since methionine metabolism depletes glycine. Gelatin also improves joint pain and sleep quality. I hate the former and love the latter, so I make and drink bone broth.

Bone marrow

Bone marrow is an interesting one. It’s plainly obvious why humans and their ancestors have been seeking it out for millions of years – it’s fatty, calorie-dense, and delicious – but its nutritional value beyond macronutrients is a bit more murky. In a previous post on bone marrow, I tried to divine the specifics and came to the shaky conclusion that since marrow is actively involved in bone and connective formation and resorption, we can effectively think of it as an organ and thus assume it to be nutrient-dense. I think that still holds. No, there are no studies or nutritional databases to confirm this, but I’m going to go out on a limb and propose we consider bone marrow to be an important supplemental food.

Shellfish

Over a year ago, I told you guys to start eating shellfish. Did you? Well, consider this another notification that shellfish, particularly oysters and mussels, should be a regular part of your diet. Why oysters? Just four medium sized Pacific oysters supply a smattering of B-vitamins (including over 1000% of daily B12), 1200 IU of vitamin A, a third of daily folate, almost 7 mg of vitamin E, 3 mg copper, 280% of daily selenium, and 33 mg zinc. That comes with 18 g protein, 4 g fat, 1.5 g omega-3, 0.1 g omega-6, and 9 grams of carbohydrates. Why mussels? They’re also rich in B-vitamins, selenium, zinc, and protein, but also come with good amounts of magnesium and manganese. Other shellfish are also good, but probably not as important as oysters and mussels.

Aged cheese

Gouda and pecorino romano are ideal choices. Gouda is the cheese with the highest vitamin K2 content, and the longer the cheese is aged (fermented), the more K2 it picks up. Pecorino romano, by definition, must come from raw sheep’s milk grazed on lush grasses, and it must be made the traditional way – from animal rennet. The result is a salty, sharp cheese with bite, CLA, and the ability to “cause favourable biochemical changes of atherosclerotic markers.”

Natto

I know, I know. It’s soy, a legume with significant levels of phytoestrogens, phytic acid, and trypsin inhibitors. It’s got a gross, slimy texture that may be outdone only by its interesting taste. It’s soy. By most accounts, people following a Primal lifestyle shouldn’t have anything to do with it. If you asked me a couple years ago, I may have said that. But natto is a special kind of soy. It’s fermented using a particular strain of bacterium called Bacillus subtilis natto. When steamed soybeans are inoculated with b. subtilis, they are transformed from a basic legume with few redeeming qualities into a powerful supplemental food imbued with high levels of vitamin K2, a nutrient important in bone mineralization, cancer prevention, and protection from heart disease. If you’re into those sorts of things, natto is the single best source of vitamin K2.

Tiny whole fish with heads and guts

Anytime you can eat the entire animal, you should. Heck, if they were able to genetically engineer bite-sized cows, I’d be all over that (assuming they were grass-fed, of course). Until then, tiny fish with heads and guts will do the trick. I’m talking sardines. I’m talking anchovies. I’m talking smelt. I’m talking any of the fish running between a half inch and six inches long. Any longer and the guts will begin to stand out in your mouth. But if you keep to that sweet spot, you’ll get the brains, the glands (all of them), the organs, the bones, the fermenting algae, krill, and assorted sundry microscopic marine goodies tiny fish like to eat, in addition to the omega-3s and protein, without adverse flavors. Oh, and because they’re tiny and low on the food chain, tiny fish will be largely free of the heavy metals other, larger fish tend to accumulate.

Red palm oil

For the PBer who fears almonds and other nuts and seeds for the omega-6 content, vitamin E is scarce in the diet. Some would argue that vitamin E is only there to prevent oxidation of omega-6 present in foods, and there’s something to that. But still: dietary, full-spectrum vitamin E is a powerful antioxidant, and red palm oil is the richest source of the full-spectrum variety. It’s also a good source of CoQ10, another powerful nutrient. Oh, and it tastes good (once you get used to the unique flavor). Go for African palm oil instead of Southeast Asian, because the former isn’t produced on the backs of dead orangutans.

Brazil nuts

Selenium, selenium, selenium. This essential little mineral is woefully absent from most people’s diets, and it’s a shame: selenium is vital for thyroid hormone production, the manufacture of endogenous antioxidants, and sex hormone production. Brazil nuts are the best source of selenium. Many of the previously listed foods are going to get you plenty of selenium, but brazil nuts are nice to keep around for those days when you haven’t been eating your lamb kidneys, mussels, and anchovies. Just pop two or three brazil nuts and you’ll have more than a day’s worth heading straight to your gastrointestinal tract. Easy peasy. Go for the ones in their shells if you can, since those are going to be fresher than the shelled nuts.
Speaking of brazil nuts, I’ve always wondered whether to capitalize the “b” or not. Any thoughts?

Purple/blue foods (sweet potatoes, berries, vegetables)

As I’ve said before, bright colors in plants often indicate the presence of potent polyphenols – bioactive compounds found in plants. No bioactive color has been more studied and lauded than the blue/purple anthocyanins, which are linked to anti-inflammatory, anti-atherosclerotic, and anti-carcinogenic effects and can pretty much be found in any blue or purple fruit, vegetable, or tuber. So, Okinawan sweet potatoes are great sources. Blueberries, raspberries, currants, purple grapes, and blackberries are great. Red lettuce, radicchio, and purple cabbage, cauliflower, kale, tomatoes, and carrots are also rich with anthocyanins. If it’s purple or blue and edible, it’s probably worth eating.

Fermented food

Since modern medicine is steadily unearthing new connections between the gut microbiome and a host of health and disease states, we know we should pay attention to our gut flora. I can’t tell you to go eat dirt and stamp around barefooted in parasite-ridden water (even though both may theoretically have their benefits), but I can tell you to eat a mix of fermented foods. You’ve got your yogurts, your kefirs, your sauerkrauts, your kimchis, your (aforementioned) nattos, your beet kvasses, your kombuchas. Benefits include more numerous and more bioavailable nutrients, new nutrients, new genetic material for your gut flora to acquire, and membership into a tens of thousands of years-old fermented food appreciation Meetup group with billions of members from every culture that came before us. In other words, gut flora is important, everyone who’s anyone regularly ate fermented food, and you should too.

Read more: http://www.marksdailyapple.com/are-you-eating-these-important-supplemental-foods/#ixzz2Hd6BFn00

Vitamin D

“Vitamin D may affect the function of dopamine and norepinephrine, which are monoamine neurotransmitters that are likely involved in depression. Furthermore, vitamin D may modulate the relation between depression and inflammation.” (vitamin-d, 2011)

 “Our results support an inverse association of vitamin D intake from foods and the occurrence of depressive symptoms..." (vitamin-d, 2011)

 In other words, this means the higher vitamin D intake from food the less depression. This is a good reason to eat ocean-caught salmon and fresh tuna (also known as brain food) two or three time a week. (vitamin-d, 2011)

My experience as a psychiatrist is that people who work outside seldom get depressed and some of this is from vitamin D, some from exposure of bright light to the retina of the eye and perhaps some is the endorphin effect of UVB on the skin. In other words, keep up both things you are doing, including getting out in the sun, every day if you can. (mailbag, 2011)

 A lifetime history of depression may be a risk factor for later development of Alzheimer's disease. Depression may increase the risk of mild cognitive impairment that turns into Alzheimer's. Patients with Alzheimer’s and depression have more pronounced hallmarks of the Alzheimer’s brain than patients with Alzheimer’s who are not depressed. Studies indicate vitamin D deficiency may also be a risk factor in Alzheimer’s. (mental health, 2011)

This correlation scares the crap out of me.  A lifetime of depression... and in the end, degeneration.

I cannot explain how serious my depression and related issues (anxiety, suicidal thoughts, OCD) have become this last year.  A lifetime of depression coupled with an amazing number of life stressors have left me mentally drained.  I feel better when I get out in the sun, either working or exercising.  I take a daily Vit D supplement, 2,500 IUD, and if I have skipped a day or feel at all under the weather, I take a second at bedtime with 400 mg of Magnesium Citrate.

Sources:

vitamin-d, 2011, from: http://blog.vitamindcouncil.org/2011/10/04/vitamin-d-in-diet-and-depression/

mailbag, 2011, from: http://blog.vitamindcouncil.org/2011/09/24/mailbag-vitamin-d-sun-exposure-and-depression/

mental health, 2011, from: http://www.vitamindcouncil.org/health-conditions/mental-health-and-learning-disorders/depression/

Hip Strength

7 Step Hip Strengthening Routine

1. Lateral Leg Raises: lie on your right side with a theraband around your ankles.  Lift your left leg to about 45 degrees in a controlled manner, then lower.  I do 30 reps per side.
2. Clam Shells: lie on your right side with your knees together and a theraband around your lower thighs.  Your thighs should be about 45 degrees from your body and your knees bent at 90 degrees.  Open your legs like a clam shell but don’t move your pelvis – the motion should not rock your torso or pelvic girdle.  Keep it slow and controlled.  I do 30 reps on each leg.
3. Hip Thrusts: lie on your back with your weight on your upper back your feet.  Your legs will be bent at the knee.  Lift one leg so your weight is all on one leg and your back.  Lower your butt almost to the ground and thrust upward by activating your glutes.  This exercise is great for glute strength and hip stability.  I do 25 reps on each leg.
4. Side-Steps / Shuffle: with a theraband around your ankles and knees slightly bent, take ten steps laterally.  The band should be tight enough so it provides constant resistance during all steps.  Still facing the same direction, take another 10 steps back to your starting position.  That is one set.  I like to do 5 sets.  This exercise will look like a slow-motion version of a basketball “defense” drill.
5. Pistol Squats: These are simply one-legged squats.  The key to a successful pistol squat is to not lean forward, keep the motion slow and controlled, and make sure your knee does not collapse inward.
6. Hip Hikes: Stand on your right foot.  With your pelvis in a neutral position, drop the left side so it is several inches below the right side of your pelvic bone.  Activate your right hip muscle and lift your left side back to its neutral position.  I do 20 reps per side.
7. Iron Cross: This dynamic stretch will help you feel loose after the previous strength exercises. Lie on your back with your arms out to your sides and swing your right leg over your torso and up to your left hand. Repeat with your left leg and do 20 reps in total.

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I have discovered a weakness in my running more than 5k... my hips.  Inevitably, one of my hips will start to ache and while I can usually finish my run, the hip hurts so much for the next few days that it sucks to walk.  I have discovered a few stretches that help, post-workout, but I think I would be best served attempting to strengthen all of the myriad muscles that control the "2nd most badly designed joint" in the human body. 

Helping Someone With BPD

1. Assess: ask what has happened.
2. Listen actively; don’t contradict, judge, or say your loved one is overreacting.
3. Validate: find something in what happened that makes sense and is understandable, that you can relate to; say what that is.
4. Ask if you can help, not to solve the problem but to get through the moment.
5. If your loved one says no, give him or her space and remember the emotions of emotionally vulnerable people last longer. 

 Areas of Dysregulation

• Emotional dysregulation — extreme emotional responses, especially with shame, sadness and anger.
• Behavioral dysregulation — impulsive behaviors like suicide, self-harm, alcohol/drugs, binging/purging, gambling, shoplifting, etc.
• Interpersonal dysregulation — relationships that are chaotic, fearfulness of losing relationships coupled with extreme behaviors to keep the relationship
• Self-dysregulation — not knowing who a person is, what their role is, being unclear on values, goals, sexuality
• Cognitive dysregulation — problems with attentional control, dissociation, sometimes even brief episodes of paranoia

Validation

Validation is a way of acknowledging some small piece of what the person says as understandable, sensible, “valid.” An important piece of validation that people miss is that we don’t validate the invalid. For example, if your loved one is 5’7,” weighs 80 pounds and says “I’m fat,” you wouldn’t validate that by saying, “Yes, you are fat.” That would be validating the invalid.

You can validate some part of what she is saying by saying “I know you feel fat (or bloated, or full)”, whatever is appropriate to the context of what she is saying. Try to find some small kernel of validity. Remember that tone and manner can be invalidating when words are validating. “I know you FEEL fat” can be invalidating because it communicates that the feeling is wrong.