Borderline Personality Disorder (BPD) FACTS Families and Carers Training and Support Programme A short course for family members and friends of people who have BPD Module 1: Introduction to BPD Module 2: Mindfulness and Emotion Management Module 3: Mentalizing Module 4: Validation Module 5: Problem Solving Background reading Module 5: Problem Solving Feedback Feedback forms. Exercise 1: Problem Solving. Used during slide 4 Helps people to think about whether we are criticising, praising or using feedback when we talk to people. Exercise 2: Problem Behaviour. Used during slide 5 - Helps people to think about why people with BPD behave in the way that they do Homework: Scenarios Feedback Homework sheet: Problem Solving Worksheet Scenario suggestion form Feedback form 1 of 10
Module 5 Problem Solving Solving problems can only be done when a person is calm and can take a more objective view of the situation. Positive moods enhance our ability to be flexible in thinking about things and help us develop more ideas which lead to solutions. Tips: Try to remain calm and logical when approaching a problem. It is not possible to resolve a problem when you are over-emotional. Keep in mind that to solve a persistent problem between you and the person with BPD you might need to discuss it with a friend or someone you trust first. Attitude is the key. Embrace problems The more problems you solve, the greater your experience will be with problem solving. If you start feeling too emotional, for example upset or angry, take a break. Realize that every problem has a solution. If you feel like you can't do anything, stop thinking about what you can't do and start thinking about what you can do. There are four basic steps in problem solving: 1. Defining the problem 2. Generating potential solutions 3. Selecting and planning the solution 4. Implementing and monitoring the solution Be aware of the differences between praise, criticism and feedback. You will need to use these when working on problems with someone else. Beware of criticism! Praise: An expression of approval. Criticism: An expression of disapproval based on perceived mistakes or faults. Feedback: Information about a person s performance of a task used as a basis for improvement. Activity: How does it make you feel when you receive approval? How does it make you feel when others criticise you? Are you able to respond to feedback differently? Think about a time when you criticised someone else. What happened? How did that situation ultimately make you feel? 2 of 10
Step 1: Defining the problem We may think a problem is obvious, but this is not necessarily true. For example, we might think the person with BPD is untruthful and conclude that this is the main problem. However, it could be that they feel too much is expected of them and that they can t manage what is expected, and the only way to deal with the pressure is by being untruthful, for example saying they have done something when they haven t. So the main problem is actually your overestimation of their ability, rather than the lying. The problem can be more accurately defined by using mentalizing of self and other techniques (see Exercise 2). By doing this you will build up a picture of what might be happening to the person that makes them untruthful to you. It will allow you to focus on where the problem can be addressed is it in you or them? Is it between both of you? The challenge is to turn the problem into a manageable statement. For example, We cannot agree on Now that the problem is defined, analyse it; gather information surrounding the problem i.e. is there a reason for the behaviour? A lot of the time people get caught up in symptoms of a problem rather than working on the problem itself. They re affected by someone s attitude, anger or other emotions. It is important here to focus on looking for the real cause. Step 2: Generate potential solutions Begin to develop possible solutions, identifying every potential variation. There are no wrong answers, and no judgments should be made about others suggestions. Step 3: Select and plan the solution Select the best solution to fix the problem. This is a slow process of elimination. There may be some solutions that are immediately eliminated, and there might be some that you can join together. When you are down to one or two solutions, discuss them and come to a decision on the best solution for everyone; it could end up being a compromise but it must meet everyone s needs equally. Step 4: Implement the solution Write down steps that you will need to reach your goal. They should be clear for you and the other person and be measurable, allowing you to see whether they have been achieved. Then check on the progress and evaluate the outcome. Some problems will resolve more easily than others; sometimes it may not seem to be working and you may need to try and problem solve a number of times. Ask: Did we define the problem correctly? Could the problem be re-thought? Were my goals too complex or vague? Did I miss a better solution? Were we carrying out the solution we agreed? Do not blame each other for the lack of success. Problem solving was a joint venture and so it is a joint responsibility. Free online problem solving worksheet at: www.heretohelp.bc.ca/toolkits/problemsolving/index.php 3 of 10
Module 5: Exercise 1 (For use during slide 4) Problem Solving Read the following statements and decide whether you think each one is criticism, praise or feedback: 1. I told my daughter how much I appreciated her being back home at the time that we agreed. 2. Your room is such a mess. Are you sure you are not trying to annoy me and your mother? 3. I noticed that you ve been coming in late the last couple of nights. 4. How many times do I have to tell you not to leave your dirty cups in the sink? 5. You look great today. 6. It would be helpful for me if I could explain how I see things before you start asking questions. 7. I thought that the way you spoke to the rude shop assistant showed how well you have managed to develop the ability to avoid unnecessary argument. It was impressive. Now try to rephrase the way the above statements were made. How might rephrasing get a different response or reaction? 4 of 10
Module 5 Problem Solving: Exercise 2 (For use during Slide 5) Problem Solving: Problem Behaviour Think of some behaviour that your significant other/family member engages in. 1. Ask yourself why anyone would (insert problem behaviour). Write down as many reasons as you can think of around the box below. Draw an arrow from each one into the box. 2. Consider which of them may relate to the person with BPD; what goes on in his/her mind that could lead to being (problem behaviour)? Highlight these. 3. Consider your own actions that may contribute to the end result of being (problem behaviour) and write these down.. (Problem behaviour) 4. Write down answers to the question What does it matter that they (problem behaviour)? 5 of 10
Module 5 Problem Solving: Homework Problem Solving Worksheet Step 1: Define the problem Be specific, realistic and make it achievable. The problem I want to solve is: Step 2: Generate potential solutions Possible solutions Advantages Disadvantages Step 3: Select and plan solution Solution selected: 6 of 10
Step 4: Implement and review solution Steps that you need to take to reach your goal should be clear and measurable Step 1 Step 2 Step 3 Step 4 7 of 10
Check on progress and evaluate the outcome What happened? What went well? What did you and your significant other do well? What got in the way? Did we define the problem correctly? Could the problem be re-thought? Were my goals too complex or vague? Did I miss a better solution? Next steps: Free online problem solving worksheet at: www.heretohelp.bc.ca/toolkits/problemsolving/index.php 8 of 10
Suggestions for Scenarios for use in FACTS courses Borderline Personality Disorder (BPD) FACTS Families and Carers Training and Support Programme We are always looking for ideas for discussions or role-play to help explain the different skills in FACTS. Please give us any examples and suggest which skills might be helpful. With many thanks for your help. Scenario Which skill/s might have been useful? (Or leave it to us to decide how to use your suggestion). Scenario Which skill/s might have been useful? (Or leave it to us to decide how to use your suggestion). Please complete this form and leave it on your seat. Alternatively, email it to BPDHarrow2015@yahoo.co.uk. 9 of 10
Feedback Form Module 5 Problem Solving Borderline Personality Disorder (BPD) FACTS Families and Carers Training and Support Programme Thank you for joining us for FACTS. Please help us by completing the final feedback form. Please complete this form and leave it on your seat. Alternatively, email it to BPDHarrow2015@yahoo.co.uk. This information will help us to ensure the course is helpful to future participants. Question Please rate how useful the session was to you Please rate the session delivery Please rate the Slides/handouts How much of the material was familiar to you? Were the contents relevant to your life? How likely are you to recommend this course to a friend? Please circle below Poor Average Good Excellent Poor Average Good Excellent Poor Average Good Excellent None Some Most All None Some Most All Very Possibly Not at all likely General comments: (Please continue on the other side if you would like to). Was this session what you hoped for / expected? How could the session be improved? Other comments relating to this session or the course in general: Optional: Your name/ Phone number/ Email address 10 of 10