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Mental Health

Book Reviews

Stephanie Wilson

Reprinted from "Borderline Personality Disorder" issue of Visions Journal, 2011, 7 (1), p. 26

The Borderline Personality Disorder Survival Guide: Everything You Need to Know About Living With BPD

By Alexander L. Chapman, PhD, and Kim L. Gratz, PhD. Oakland, CA: New Harbinger Publications, 2007. 238 pp.

Alexander Chapman is an assistant professor at Simon Fraser University, a registered psychologist and founder of the DBT Centre of Vancouver. He is also the guest editor for this issue of Visions. Kim Gratz is a research assistant professor at the University of Maryland and director of personality disorders division at the Center for Addictions, Personality and Emotional Research.

In the introduction to The Borderline Personality Disorder Survival Guide: Everything You Need to Know About Living With BPD, Chapman and Gratz pose an important question: “What took so long?” That is, why did it take so long to recognize BPD? And why do so many people living with BPD not have any supports? Fortunately, Chapman and Gratz also have some answers.

The Borderline Personality Disorder Survival Guide is, first and foremost, a practical day-to-day guide for people living with BPD and their loved ones. It’s divided into two parts: “What is Borderline Personality Disorder?” and “How Do I Get Help for BPD?” In part one, the authors explain BPD, using stories to describe symptoms. They counter myths about BPD, such as “BPD is a life sentence” and “BPD is untreatable,” and they describe research into the causes of BPD. Next, they discuss the course of BPD and briefly describe other mental health problems that may go along with BPD, such as post-traumatic stress or substance use disorders.

In part two, Chapman and Gratz guide readers through finding answers to the most important question: How do I find help? The authors explain how to find accurate information on BPD and describe dialectical behaviour therapy, mentalization-based therapy and medication. Finally, they offer tips on coping with suicidal thoughts and intense or overwhelming emotions.

The information is offered as a practical, step-by-step map. Chapman and Gratz provide the background information, such as how a treatment works and what to expect from treatment providers. And they outline specific actions to take, including how to find a treatment provider and where to get recommendations for treatment. Part two also includes quick and easy-to-reference guides to help readers navigate the treatment system, such as important questions to ask a treatment provider and important questions to ask about medication. There are activities to help readers think through treatment options and charts for monitoring symptoms.

The Borderline Personality Disorder Survival Guide is an accessible and easy-to-use handbook for living well with BPD. It is written in plain language and clearly defines steps and strategies for recovery. It is based on current research and best evidence, but the authors are conscious that the purpose of the book is to provide a resource that anyone can use. They don’t overwhelm readers with data; instead, they offer concise, relevant information and describe how it applies to the real world.

Throughout the book, Chapman and Gratz emphasize hope and reiterate that recovery is absolutely achievable. The Borderline Personality Disorder Survival Guide is an important tool that empowers readers to learn more and take action.

Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change

By Valerie Porr, MA. New York: Oxford University Press, 2010. 396 pp.

After learning that a loved one was living with borderline personality disorder, Valerie Porr founded the Treatment and Research Advancements National Association for Personality Disorder (TARA APD). Based on her own experiences and the experiences of the family members she encountered through her advocacy work, Porr realized that families didn’t have access to practical skills for rebuilding relationships with loved ones. In response, she developed a family-based skills course for TARA. Overcoming Borderline Personality Disorder: A Family Guide to Healing and Change is based on this hands-on experience, as well as current research on personality disorders, dialectical behaviour therapy and mentalization-based therapy.

Porr encourages readers to deeply and compassionately challenge their preconceived ideas of borderline personality disorder. She also encourages readers to apply the book’s exercises, based in dialectical behaviour therapy (DBT) and mentalization-based therapy, to their own relationships. The exercises help family members to cope with difficult feelings around a loved one’s diagnosis (e.g., grief, loss or hopelessness) and behaviours (e.g., avoiding conflict or attempting to overly control a loved one), and to build healthy, respectful relationships. In essence, Porr guides readers to hope.

Porr proposes that families need to change before a loved one living with borderline personality can change. This doesn’t mean that family members have done anything wrong or have ‘caused’ BPD, but it does recognize that families play a key role in building relationship skills. It is evident that tough love—such as setting strict rules or refusing to help a loved one—doesn’t help to build relationships, particularly when a loved one is living with BPD. Porr writes, “How can someone ever trust a parent who refuses to help her, throws her out, has her arrested, or locks her away in an institution, all in the name of love?”

Working through the book, readers learn about the therapeutic skills, what responses may be unhelpful, and how to apply these new skills in their relationships. The following are skills that readers explore:

  • Validation—Family members learn that validating their loved one means acknowledging their loved one’s experiences. By accurately reflecting their loved one’s perspective without judgment—and avoiding unhelpful responses, like jumping to conclusions—family members can rebuild trust and rebuild relationships.

  • Radical acceptance—Readers learn to accept and tolerate the complete reality of their loved one’s life in the present moment.

  • Mentalization—Readers to look at a loved one’s reactions from a different perspective.

When family members adopt and model helpful behaviours, they may also help their loved one practise these skills on their own recovery journey.

Overcoming Borderline Personality Disorder requires the reader to engage and actively participate. Porr uses stories, scenarios and checklists to help readers understand the exercises and, importantly, to help readers understand the purpose and meaning behind the exercises so they can readily apply them to their own situations. However, the amount of information Porr provides may feel daunting to people who are not familiar with borderline personality disorder or cognitive therapies. It may be helpful to work through one chapter at a time, rather than tackle the entire book at once.

There are few resources aimed specifically at family and loved ones. But unlike other publications, this isn’t a step-by-step guide to avoid “triggering” a loved one’s BPD behaviours. This is a guide for assessing a difficult situation and making proactive changes. The love and hope in Porr’s words shine through every facet of her approach.

 
About the author
Stephanie is the Editorial Coordinator for Visions.

 

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