Our relationships are among the most important aspects of our lives, but most of us are never directly taught how to improve them.

We learn by watching others and by trial and error. If you were exposed to people with poor social skills, especially early in life, you may have picked up some bad relationship habits. A good way to pick up positive relationship skills is to spend time with happy couples whose relationships you admire. Learning their positive relationship skills can greatly enhance your own relationships. Communications, empathy, and setting boundaries exemplify good relationship skills.

Communication 101
Communication is one of the most difficult, most sophisticated tasks in which we humans engage. To add complexity: We cannot not communicate. If you are in proximity to another person, you are communicating. Communication is more than just words. In addition to what we say, how we say it can make or break relationships-so can what we do and how we carry ourselves. Not saying something can be just as powerful a communication as saying something.

Communication 101: Being Assertive
Assertiveness means expressing your true feelings, wants, or desires whiele bridging the middle ground between being too passive, too aggressive, or passive-agressive. Common examplesof these approaches abound in everyday commerce. Let's say you ordered a medium-done steak in a restaurant, but it arrives well-done. A passive response would be to force a smile and say to the water, "It's delicious." A too agressive response would be to sulk, making everyone at the table miserable. In contrast, an assertive response would be to request politely that your original order be filled.

Being appropriately assertive in relationships is trickier. Let's say someone hurt your feelings by forgetting your birthday. A passive response would be to feel sorry for yourself. An aggressive response? Sarcasm or hostility expressed verbally or behaviorally. A passive-aggressive response means hostile action against someone by not doing something, such as giving the person the "silent treatment" and not communicating when they try to apologize.

Assertiveness is based on a few fundamental principles. One is healthy entitlement. You have certain basic rights, and you should be prepared to enact them. Psychologist Manuel Smith calls it your fundamental assertive right: "You have the right to judge your own behaviour, thoughts and emotions, and to take responsibility for their initiation and consequences upon yourself."

Exercising your fundamental assertive right, however, entails being aware of your needs, moods, thoughts, and feelings, and taking responsibility for expressing them in a constructive manner. The mindfulness section of this chapter can be extremely helpful in that regard.

"Assertive behaviour promotes equality in human relationships, enabling us to act in our won best interests, to stand up for ourselves without undue anxiety, to express one's feelings comfortably, to exercise personal rights, without denying the rights of others. Assertiveness means being clear and straightforward.

Communication 201: Close relationships
Communication in close relationships can be complex. Intricate patterns of communicating evolve over time. Since so many phrases are ambiguous, one of our best guides is knowing the person. When your loving husband says, "I think your dynamite," he probably means he thinks you're terrific, not that you have a hot temper. Even in close relationships-perhaps especially in close relationships-miscommunications occur.

The best way to address communications problems is with a sentence formula:

When you say or do X to me,

in situation Y

I feel Z

For example: When you forget to say anything to be on my birthday, I feel hurt. By saying "I feel" rather than "You make me feel," you provoke less defensiveness. You are owning your part of the interaction. You are not implying, "You are a terrible person for making me feel bad." You are saying, "I feel bad." The implied message is: "Since you are about me, my feeling bad is something we need to work on. since I am a worthwhile person, it is not okay for you to say things I experience as hurtful. This is a problem we need to resolve."

Your feelings are what they are, and they are okay. They are your radar, your most sensitive indicators of your thought processes, your ways of viewing the world, your values, and your involvement in a relationship. When we don't express out feelings verbally, we must either suppress them or act them out. One reason very young children have more tantrums than adults do is that they lack alternative ways of expressing their feelings.

Similarly, with adults, if we can say, "I feel angry and dissapointed." we are less likely to act it out by screaming. Talking things out, when possible, is almost always the best solution, as it carries little downside and tends to pave the way for better conflict resolution next time around.

Giving criticism is also an art. Sometimes, in order for a relationship to work, we need to tell others we don't like how they are doing things. But how we say it affects how well out message is received. In any communication, especially when you criticize, start out by empathizing. Imagine what it would feel like to be the other person. How will it feel for her to hear what you are about to say? How would you feel? If she disappointed you, perhaps you can give her credit for her efforts. Start your message with something positive, if you can.

Compare these 2 statements:

"I have it when you're late. I don't even want to go now!"

"I'm sure you were trying to get everything perfect for our date. When you're late, though, I feel tense and pressured. It's more important to me that you're on time."

By recognizing that the person has good intentions or is under pressure, you can go a long way toward making a criticism easier to swallow and enhancing your chances of gaining compliance. Please do not misconstrue this as saying things you don't mean in order to get the other person to do what you want. Any "empathizing" that is not genuine is likely to backfire and make things worse.

Mindfulness refers to being fully present in the moment, fully aware of one's thoughts, feelings, and circumstances. The idea of mindfulness is well developed in the Buddhist vipassana meditation tradition, which is approximately 2,500 years old.

By meditating-being fully present in the moment with minimal distractions-one is able to clear away distractions and see the process of one's own thoughts more clearly. Mindfulness is best begun by sitting in silence or by such movements as yoga, tai chi, or walking. The test, however, is applying mindfulness to your daily life in the real world.

A story: A belligerent samurai, an old Japanese tale goes, once challenged a Zen master to explain the concept of heaven and hell. But the monk replied with scorn, "You're nothing but a lout- I can't waste my time with the likes of you!"

His very honour attacked, the samurai flew into a rage, and, pulling his sword from his scabbard, yelled, "I could kill you for your impertinence."

"That," the monk calmly replied, "is hell."

Startled at seeing the truth in what the master pointed out about the fury that had him in its grip, the samurai calmed down, sheathed his sword, and bowed, thanking the monk for his insight.

"And that," said the monk, "is heaven."

The sudden awakening of the samurai to his own agitated state illustrated the crucial difference between being caught up in a feeling and becoming aware that you are being swept up by it. Socrates' injunction "Know thyself" speaks to this keystone of emotional intelligence: awareness of one's own feelings, as they occur.

The samurai tale illustrates mindfulness, the difference between feeling angry and being aware you feel angry.

"There is a difference between watching the rushing water of the river from the embankment and trying to swim in the river."

We can gain insight from taking note of rushing emotions, without diving in and drowning in them. Mindfulness is transcendence. By rising above and transcending emotions, we gain a clearer perception of the situation and ourselves, leading to a more accurate vision of reality. Instead of viewing events as simply happening to us, we can see the role of each person, including ourselves, in events. Mindfulness is a skill best learned through daily practice.

Mindfulness is a full awareness of the present moment, accompanied by a feeling of being "centered" and "grounded." In a moment of mindfulness, all is in flow, and the universe seems simple. It is as if the clutter has been swept away, allowing you to see unimpeded. Living in the moment has tangible benefits.

As Joe, a former mindfulness student said, "When I look at just this moment, it's never that bad." Joe often felt overwhelmed by the demands of running his own business. But by staying present in the moment, he felt clear and focused and could see daily demands as manageable. Instead of feeling rattled by events, Joe learned to take events in stride.

Although living in the moment may seem similar to being impulsive, it is actually its opposite. Impulsivity involves reflexive action.

Paths to Mindfulness
There are several ways to become mindful. One way is to practice meditation. Before discussing various methods of meditation, let's dispel some of the myths about meditation. The biggest myth is that meditation is a direct path to peace and tranquility and that such serenity occurs quickly. Many of my meditation students express frustration that they are "not doing it right" or "can't get into it." Meditation is a learned skill, presumably as difficult as learning to play a musical instrument, yet no one would expect to sit down at a piano after taking a few lessons and perform a concerto. Nonetheless, many people have expectations of instant "success" with meditation. It is important to let go ot expectations and judgments, including judgments about how "well" one is meditating.

To become more balanced in everyday life, it is best to encounter the same struggles in your meditation practice that you encounter in real life. For example, if you have difficulty coping with boredom-a problem for many- the way in which you transcend boredom during your meditation is the way you can transcend boredom in daily life.

One of the paradoxes of meditation is that progress is best made in the absence of striving. Striving for the goals of tranquility, inner peace, or even relaxation hinders the ability to mediate properly. In order to meditate, just follow the most mundane of instructions. If you are doing a breath-watching meditation and you are paying attention to your breath, then you are doing it right. If you are doing a thought-watching meditation and you are paying attention to your thoughts-without "forcing" your thoughts in any particular direction-then you are doing it right, even if you are feeling anxious, frustrated, or angry because of a situation in your life. Roll out the welcome mat for those feelings. Rather than saying to yourself, "I must be doing this wrong because I'm not relaxed," ask yourself what this experience means to you. Allow the experience to be your teacher, your mentor and your own private Zen master.

BPD Notes: New Hope for People with Borderline Personality Disorder

BPD involves massive mood fluctuations, intense relationships, desperation, and insecurity.

Books:
I Hate You - Don't Leave Me
Stop Walking on Eggshells
Boundaries: Where You End and I Begin by Anne Katherine
The Healing Power of Humour by Allen Klein
Cutting: Understanding and Overcoming Self Mutilation by Steven Levenkron

BPD Symptoms:
Depression, moodiness, anger, disorganization, anxiety, low self-esteem, rage, feeling life is pointless, feeling unworthy or unlovable. Having no clear sense of identity. Feeling inadequate and impulsive, self-destructive behaviour and suicidal thoughts. Being overly dependant and feeling abandoned and unloved.

5 or more of the following 9 symptoms may indicate BPD:

1. Makes desperate attempts to avoid abandonment.
2. Unstable and intense relationships, idealizing then devaluing your partner.
3. Sense of self chronically unstable.
4. Impulsive (overspending, overeating, acting out sexually, abusing drugs).
5. Attempted suicide and/or self injury.
6. Highly unstable moods (depressed, irritable, or anxious).
7. Feel empty most of the time.
8. Easily provoked to anger.
9. Under stress can become paranoid or experience dissociative symptoms.

* Hypersensitivity as a child
* Adults who do not know how to comfort themselves
* Rarely feels empty in the company of others
* Takes relationships too fast
* Needs constant reassurance (of love, devotion, and loyalty)
* Sees everything as black and white, good and evil, right and wrong
* Internalizes feelings of others
* Needs to develop problem solving methods, embrace life, and remove incentives for suicidal behaviour

Joy - why does it not remain?
Pain and depression engulf me
In their icy grip
I long for the light-heartedness I enjoyed
Brief as it was
Why does the heaviness and discontentment have to return - again,
once more?
Inside I scream in anguish
Do they see it in my eyes, hear it in my voice?
And if they do, do they care?
I want it to go away, all the torment, aching and misery
I reach out for help, but they don't understand.

Empty
thoughts stopped.
Dreams ended.
Nowhere to go
from here.
Can't make something out of emptiness
except maybe a hole
to toss pent up feelings into.
But I have no feelings anymore.
Can't think of anything
at all.

* Emptiness leads to impulsive behaviour to escape

Anger - Individuals with BPD can be provoked to a fit of rage over things that seem trivial to others. They can react with a level of anger that, to most everyone else, is inappropriate to the situation.
- Tend to hold onto they're feelings of being upset long after the event or threat has passed.

Causes of anger issues: Born with fiery temperament, had poor soothing from others as a child, or had poor role models for modulation of emotions.

Paranoid or Dissociative Symptoms: Dissociation is an adaptive response by people experiencing something overwhelming that they are powerless to change.

"Numb"
Sometimes I forget I'm here,
listening to your filthy words.
Sometimes I forget
you're screaming
So loudly, it makes my ears ring...
But sometimes I remember,
and it hurts
again.

* Thinks people are out to get them
* Loss of awareness, time, location, or identity
* Nervous breakdown(s)
* Dissociation lasts for minutes, hours or less frequently a few days
* Often associated with abuse
* Dissociation can become a coping mechanism when abused
* Make act, think, or feel like a child but are expected to behave like adults
* Acts like a child to feel safe
* Stress causes dissociation
* "Spacing out" is considered a mild form of dissociation
* Called borderline because BPD patients test between neurotic and psychotic on psychiatric tests
* When a person with BPD sees something, he/she may not be able to select from what is important and what is unimportant (poor filtering)
*Difficulty with recall of complex material may make it difficult to learn from experiences. People with BPD often make the same mistakes over and over

Two Psychiatric Tests: MCMI - III and Minnesota Multiphasic Personality

Inventory

*Invalidation, someone tells you your feelings, thoughts, and perceptions aren't real or don't count
*Media has a profound impact on personality development. Heroes/role models have become increasingly violent, unstable, and overtly sexual
*TV teaches people to be impulsive, cynical, promiscuous, angry, and melodramatic

As more people explore values, practices and lifestyles that enhance inner peace, a sense of maturity and groundedness, a healthy self-image, and a purpose in life, we may begin enjoy better mental health. It's estimated that at least 2% of the general population has BPD. It's 2 to 3 times more common in women than men. For some BPD runs its course by middle age, others it lasts well into senior years. BPD is often misdiagnoses as many other disorders have some of the same characteristics. A personality disorder is an enduring pattern of inner experience and
behaviour that deviates markedly from the expectations of the individuals culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and tends to lead to distress or impairment.

Most psychological tests used by psychologists help to determine a diagnosis and evaluate areas of concern. a clients strengths and skills can also emerge through testing.

* Rorschach Test
* Thematic Apperception Test
* Stop drinking caffeine at night to help insomnia
* Approx. 2 years of therapy is needed for patients with BPD

A recent review found that psychotherapy resulted in large improvements in clinicians ratings of the client functioning, such as whether the client was suicidal, able to function at work, or was in touch with reality.

Psychotherapies:

Psychodynamic
Cognitive-Behavioural
Client-Centered
Family Systems
Group

Dialectical Behaviour Therapy Skills for BPD:

Core mindfulness Skills: Be present in the moment by staying calm, focused, and centered.

Interpersonal Effectiveness Skills: Maintain self-respect in relationships by obtaining what you want and need.

Emotional Regulation Skills: Reduce your emotional vulnerability by paying attention to bodily cues giving you signals about how you feel. Lead a healthy, balanced life.

Distress Tolerance Skills: Cope with life's crises through self-soothing techniques, such as imagery, relaxation, encouragement, and prayer. The basic premise of cognitive therapy is that the way we think powerfully shapes our feelings and behaviours.

* Dream analysis
* It is difficult to overstate how important family dynamics are in maintaining behaviour, beliefs, and feelings
* Suicide attempts are actions of desperation
* You must work to make yourself well
* Psychosis means a loss of contact with reality


For BPD, antipsychotics have demonstrated improvements not only in thought disorder symptoms but also improvements in mood, anger, anxiety, and somatic complaints. Atypical antipsychotics are more effective than older ones sometimes at reducing psychosis and improving functioning.
Neurological side effects with typical antipsychotics include Akinesia (difficulty moving), drowsiness, Parkinson like shaking, and motor restlessness. Side effects of long term use of antipsychotics can be very serious. If you have major depression along with BPD, tricyclics (TCA's) are effective with depressive symptoms. Situations showing encouraging results for using yoga and meditation techniques to help alleviate conditions with BPD. Autogenics training for
relaxation. Relaxation training can be effective for anxiety, post traumatic stress disorder, ADHD, stress, insomnia, headache, asthma, and hypertension.

* Psychodrama, dance and movement therapy, yoga and art therapy can be helpful for BPD patients
* Music Therapy
* Traditional Chinese Medicine (Acupuncture and herbs)
* Diet and exercise
* TCM's focus on balance provides a welcome perspective
* Vedic Medicine (Meditation, transcendental meditation, homeopathy)
* Do 30 minutes of exercise 3 times a week.
- Why exercise today? To reduce depression and increase my enery level
* Rate your Stamina (once a week on friday)
- 1: My energy level is very low.
- 7: I have all the energy I need.
* Check your weight (once a week on friday) and chart to see improvement
* Once you get into the habit of exercising, it can become self-rewarding and external motivations become unnecessary

Stress Reduction Basics:
1. Live mindfully
2. Balance your lifestyle with rest, exercise, nutrients, and activities.
3. Balance your relationships with communication. empathy, and boundary setting
4. De-escalate extreme emotions, such as anger, depression, and anxiety with calming responses
5. Engage in stress reduction techniques, such as humour, relaxation training, yoga, prayer or meditation
6. Engage in spiritually satisfying experiences regularly; nurture your soul
7. Avoid excessive use of alcohol, drugs, or food
8. Join a support group
9. Know your rights
10. Cope with any stigma you may feel about having BPD
11. Replace self-destructive and impulsive behaviour with positive and self-nurturing behaviours
12. Orchestrate therapists, doctors, helpers, and healers into a team that meets your needs

* Rage is hell, understanding is heaven
* Mindfulness is a full awareness of the present moment accompanied by a feeling of being centered and grounded
* Keep active to avoid depression
* You have the right to listen to other peoples without making them your problems