In the early days of Dialectical Behavior Therapy (DBT), the treatment focused primarily on the person suffering from Borderline Personality Disorder (BPD). It is now recognized that family members and loved ones also need to participate in the BPD recovery process using DBT skills.
Family members often cope with “unrelenting crisis” and “inhibited grieving” as a result of the person with BPD’s behavior, said Shari Manning, Ph.D., founder and chief executive officer of Treatment Implementation Collaborative. Both can be better handled by family members and loved ones using some of the skills learned in Dialectical Behavior Therapy.
In this article, we will look at what “unrelenting crisis” is and how you can be proactive about ending the cycle. A follow-up article will explore “inhibited grieving.”
What Is ‘Unrelenting Crisis’?
“Unrelenting crisis” occurs when a person with BPD is dysregulated, engages in impulsive or destructive behaviors, and causes a chain resulting in further crises. When a person with BPD engages in impulsive behaviors or displays hyperemotionality, it is their way of alleviating intolerable emotions.
This is usually because the person with BPD has inadequate problem-solving skills and can’t see any other means of dealing with the problem. Nevertheless, dysregulated behaviors often cause a snowball effect that leads to further conflict and difficult situations that can affect the health and happiness of the entire family unit.
Through DBT, patients learn to slow down when their emotions get the best of them and bring themselves back into the present moment so that an alternate reaction to the situation can be explored.
DBT Skills for Family Members
When a person with Borderline Personality Disorder is demonstrating highly emotional behavior, it can cause loved ones to have their own elevated emotional responses that contribute to further conflict. Manning described methods family members can use to diffuse tension and bring the focus to solving problems rather than exacerbating them.
First and foremost, families must wait until the person with BPD is able to reorient their attention enough to engage in a productive conversation. This may mean giving them some distance and space to bring themselves into a state where discussion can take place.
Manning explained that with an open mind and non-judgmental tone, you can approach problem-solving in a way that is non-threatening to the person with BPD. She suggests allowing the person to fully explain the problem in their own terms and then brainstorm about potential solutions without necessarily evaluating those solutions in the moment.
In addition to fully and openly exploring potential solutions to the problem with the person with BPD, you can have them partake in a discussion of what could possibly interfere with or stop them from implementing the solution. You can ask what additional problems may arise and help them evaluate the outcome of the problem-solving action after the fact.
In this way, we encourage our loved ones with BPD to participate in problem-solving and hope that it assists them in developing the skills they need to do so on their own. DBT therapy is reinforced in the home and family members are brought into the process.
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