Find Help. Find Hope. A Publ icat ion of NAMI Tri -County I l l inois

P.O. Box 10167 Peor ia , IL 61612 309 693-0541 www.namitr i -countyi l l inois .org

Helping to meet the needs of people with severe and persistent mental illness and their families in Peoria, Tazewell, and Woodford Counties in Central Illinois

April—May 2017

Twenty years after he became an orphan at age 6, film maker Dinesh Sabu documents his journey to India and across the U.S. to piece together the story of his immigrant parents’ lives and deaths. A silenced family history of mental illness and the reali-ties of schizophrenia and suicide are his family legacy. Dinesh hopes to raise awareness, host discussions and encourage story telling, and he looks to the future.

See Unbroken Glass on Thursday, April 6 at 7 p.m. ICC North, Arbor Hall Auditorium, Room A111

Mr. Sabu will be with us for Q & A

Brought to you by NAMI Tri-County Illinois, an affiliate of the National Alliance on Mental Illness.

Free of charge

The Unbroken Glass Project

Unbroken Glass is a documentary about filmmaker Dinesh Sabu's journey to under-stand his parents, who died 20 years ago when he was six years old. Traveling to India, Lousiana, California, and New Mexico, Dinesh pieces together the story of his mother's schizophrenia and how his family dealt with it in an age and culture where mental illness

Dwarka and Susheela Sabu lived complicated lives bridging two countries and cultures. Unbroken Glass is more than a story about immigrants or mental illness, it is a

More than a linear narrative of their lives, Unbroken Glass is an impressionistic portrait of who Dinesh's parents were—immigrants, family members, complex peo-ple subject to social forces. It weaves togeth-er his journey of discovery with cinema-verity scenes of his family dealing with still-raw emotions and consequences of his parents lives and deaths.

According to the National Institute of Mental Health, roughly 1% of the US population is affected by schizophrenia, and there is a proven genetic component to the illness. Some research has pointed to a link between "acculturative stress," the kind of stress im-migrants experience adjusting to a new life, and the onset of mental illness. Dinesh hopes that telling this story will raise awareness about schizophrenia and empower families of the mentally ill to share their stories.

April—May 2017 Family Forum Page 2

Educational Opportunities

NAMI Family to Family Class Current class began March 27, 2017

Parents, spouses, friends, or adult children of people with mental illnesses are invited to participate in the next 12-week

There is no charge for this NAMI signature program. Partici-pants will learn valuable information to help them understand and support an ill relative while maintaining their own wellbe-ing. Please call Kim at 309 645-1683 for information or to register for the March class.

NAMI Peer to Peer Class Please call to register for the next class

The next class will be held when there are sufficient num-bers to offer it. Please call Dean at 840-0915 or Larry at 745-8359 to register. To take the 10-week class, you must be 18 or older, have a psychiatric diagnosis, and have someone with whom you can talk about any issues/problems the classes unearth. The classes teach information about the various men-tal illnesses, tell how different medications function, help you create a relapse prevention plan, and start you toward creating an advance medical directive. The class will be facilitated by Dean and Larry. There is no charge for this NAMI signature program.

NAMI Basics Education Program Current class began March 28, 2017

This course is for parents and caregivers of children and ado-lescents with mental illness. Basics is taught by parents who have lived similar experiences with their own kids and have received training to teach the course. The class covers the biol-ogy of mental illness, treatment, school interventions, and the latest research as well as the trauma of brain disorders for the child and the family. If you are interested in this class, please call Beth at 251-5830. There is no charge for this NAMI signature program but registration is required.

Also, check out www.NAMI.org "Basics" video on You Tube for further description of the course.

Inside this issue Unbroken Glass Documentary ......................... 1

Educational Opportunities ................................ 2

President’s Letter .............................................. 3

Education Meetings .......................................... 3

Speaker Biographies ......................................... 4

COGs & Educational Oportunities ................... 4

Narcissism Questionnaire ................................. 5

Important Contact Information ........................ 5

Book Review & Suggestions ............................ 6

NAMI Board, Phone Numbers ........................ 6

Calendar ............................................................ 7

.......................................... 8-10

11

Membership Form ............................................ 12

Volunteers

Needed!

Possible jobs:

Participate in the Community Outreach Group (COGs) regularly or occasionally. This group does planning and implementation of fundraisers and other activities

Drop off NAMI brochures at doctor and therapist offices—requires day availability

Help with set up of activities; example: Hog roast/picnic on August 5; organize games and/or entertainment for the event

Attend support group meetings; consider be-coming trained to be a support group leader

Help with newsletter by doing research or writing book reviews and/or articles; consider the edit-ing position

Please call 309 691-5830 to discuss

what you would like to do.

April—May 2017 Family Forum Page 3

Letter from the President

To All our NAMI Friends:

Spring is here and in addition to this being the time for blooms and nesting birds, I’ve learned that this is the season of health fairs and other local programs for which we are often asked to present information on men-tal health. These are opportu-nities to speak up and we will.

“Telling Your Story” was the topic of our March Education Presentation. One of our

board members, Susan O’Neal, guided us in listening to sample stories, then introduced steps to creating our own stories in a “succinct and powerful” manner. She gave us an outline, time to write, and then the chance to present them. The result was powerful! Her audience thought well and then organized and related personal experiences with a purpose of enlightening and presenting a concern that remains. These stories could be used to influence a legislator or city official when they are establish-ing priorities or to share our experiences with others. Have you written your story? If you’d like to do that, I’d be happy to read it. Can I challenge you to a one-page version? Please address: 1. How does mental illness affect you or a family member? 2. What happened? 3. What helped? 4. What is the greatest challenge you or a loved one continues

to face?

You can email your story to me at belawren@comcast.net or send an anonymous copy to the NAMI address. Knowing your concerns will help me express our concerns.

Are you, too, eagerly watching what our legislators are prepar-ing as a replacement for the Affordable Care Act? The media coverage is large and changes daily. Legislators are debating and close to making decisions that will affect millions. I hope to see affordable and available health insurance coverage in our state and continued funding for necessary Medicaid services. Watch and speak up.

When I wrote for our last issue, I mentioned the loss of our COGs, our community outreach group. This group planned and carried out our social activities and fund raisers. We’re looking to bring that back with a group planning to meet in Metamora. I’m so glad! Thank you, Kim. See COGs is Active, p. 4.

Our April guest, Dinesh Sabu, will be coming to Peoria from Chicago to share his story of discovery of mental Illness via the documentary film he has made. Last October Dinesh showed his film at the NAMI Illinois Conference in Chicago. Come watch Unbroken Glass and meet this young man whose experi-ence left him and his siblings orphans at tender ages and in-spired his international journey of discovery. Let’s give him a warm welcome.

Looking forward to seeing you,

Beth Lawrence

Education Meetings First Thursday of most months

7:00—8:30 p.m.

April 6, 2017 View the documentary Unbroken Glass

(see page 1) Q & A Session: Dinesh Sabu

Location: ICC North, Arbor Hall Auditorium, Room A111

May 4, 2017 Topic: Personality Disorders

Speakers: Jay Rawal, M.D. and Amanda Vastag, M.D.

(see biography on p. 4)

Location: ICC North, Poplar Hall, Room 132

June 4, 2017 Topic: Panel Discussion on Dual Diagnosis

Location: ICC North, Poplar Hall, Room 132 (panelists to be announced in the June/July newsletter)

Thank You!

Monetary Donations Ken and Janet Schrock Durita Sendelbach

In Memory of Doris Jean Birchler Richard & Nancy Monroe

April—May 2017 Family Forum Page 4

May Education Meeting May 4, 2017

Personality Disorders Speakers—

Jay Rawal graduated with his B.A. in Political Science and Economics from Ramapo College of New Jersey. In December of 2013, he graduated with his medical doctorate from the Uni-versity of Medicine and Health Sciences. He speaks English, Gujarati, Hindi, Urdu and some Spanish.

Amanda Vastag, our Chief Resident, is from Skokie, Illinois, and attended Ross University School of Medicine. Years of classical ballet training have prepared Amanda well for walk-ing the hospital halls in her fashionable high heels and for de-partmental dance-offs.

We look forward to an interesting presentation made under-standable and useful as these doctors have done in the past.

NAMI 2017 National Convention will feature:

• Attendee visit to Capitol Hill to advocate for mental health.

• Top-notch researchers and clinicians providing information and tools to advance and sustain recovery from mental illness.

• People living with a mental illness and their families providing their own important perspectives on recovery.

• The country’s keenest minds and savviest policymakers offering strategies and tactics to effectively advocate for changing the mental health system in our nation.

• Abundant networking opportunities so we can learn from each other about how we can improve the lives of all people living with mental illness and their families.

• Inspiration, innovation and an exhilarating four days in Washing-ton, DC.

For more information or to register:

http://www.nami.org/Convention

COGs is Active Again! One of NAMI Tri-County Illinois’ board members and Family to Family teachers, Kim Modglin, has offered to organize and

lead our Community Outreach Group (COGs). This group or-ganizes volunteers who do planning and implementation of

fundraisers and other activities. They have helped with our Trivia Nights, Hog Roasts, Mental Health Miles, Mental Illness

Awareness Week Dinners, etc. They also organize volunteers to replenish brochures in professional offices in Peoria and sur-rounding areas. At this time, they are especially looking for

people to brainstorm fundraising ideas.

The people who are involved with COGs offer to help our or-ganization in any way they can. Would you like to be part of

this group? Their meetings will be on the third Tuesday of each month at 7:30 p.m. and they will meet at McDonald’s in

Metamora. Contact Kim at 309 645-1683 or kimbermodg-lin66@yahoo.com if you wish to participate, or just show up on April 18. The most helpful are those who can come to meetings

consistently.

Volunteers are essential to any well-run

organization; thank you for your help.

Helpful Classes for you to Attend You may still participate if you sign up ASAP

or by April 3

NAMI Family to Family Class Current class began March 27, 2017

Call Kim at 309 645-1683

NAMI Basics Education Program

Current class began March 28, 2017

Call Beth at 309 251-5830

See more information about these classes on page 2 or on our website, namitri-countyillinois.org

April—May 2017 Family Forum Page 5

Important Contact Information

Local NAMI Information 309 693-0541

www.namitri-countyillinois.org

NAMI IL – State Headquarters 1-800 346-4572

http://namiillinois.org

National NAMI Helpline 1-800 950-6264 http://nami.org

Hult Center for Healthy Living 309 692-6650

www.hulthealthy.org Heartland Community Health Clinic

309 680-7600

UnityPoint Health—Methodist Community Behavioral Health

309.672.4103

Children’s Home 309 685-1047

National Suicide Hotline 24-Hour Hotline

1-800 273-TALK

American Foundation for Suicide Prevention

212 363-3500

Survivors of Suicide 309 697-3342 309 208-3027

Police – all counties Emergency Response Service:

Peoria County Woodford & Tazewell County

911

309 671-8084 309 347-1148

Human Service Center Tazwood Center for Wellness

309 671-8000 309 347-5579

VA Suicide Hotline 1-800 273-8255

Narcissism Questionnaire

The following are questions from the book You Might Be a Narcis-sist If… by Dr. Paul Meier and others. We can ask these questions of ourselves (and others) in order to check for accidental, uncon-scious narcissistic traits, in order that we can become more loving and experience more love, joy, and meaning in our lives by operating on truth rather than lies we may have been taught by our parents or others in our childhood (or by others in our adulthood):

1. Do I have a humble heart? Do I realize I'm not perfect and have both strengths as well as weaknesses—and don't feel overly threatened to acknowledge either of them?

2. Do I have empathy for others? Can I put myself in their shoes and imagine how my behavior has impacted them? For example, do I slow down my driving when passen-gers say they are frightened?

3. Can I admit when I'm wrong? Can I apologize with a caring heart, and do I seek to make things right to help repair the rift in the relationship? (It takes a humble heart to be able to do this.)

4. Do I think I deserve special favors and preferential treatment and should be treated as having special status? For example, do I ask for things that aren't on the restaurant menu or talk to the server in a haugh-ty tone of voice that makes him feel inferior to me?

5. Do I tend to think in terms that categorize people in my head as superi-or or inferior to myself, rather than believe we are all equal?

6. Do I tend to talk about others behind their backs in a tone of voice or in a manner that puts them down or makes them seem inferior?

7. Am I able to share my strengths and weaknesses with others, or do I tend to brag about my accomplishments, but hide my weaknesses?

8. Am I shocked or do I become angry when others have an opinion that is different from my own?

9. Do I try to exert extensive control over my family members so they dress or act in certain ways so they don't tarnish my image to others? For example, do I try to get my kids to pursue sports or careers that I want them to do rather than honor what they want?

10. Do I often feel envious of others or believe they are envious of me? 11. Do I take advantage of others or use others to achieve my own ends

without enough regard for their feelings or needs? 12. Do I believe I am special or unique and can only be understood by oth-

ers who also are special or unique? 13. Do I expect others to automatically comply with my wishes, and do I

become shocked and outraged when they don't? 14. Do I feel an increase in my self-worth when I associate with others who

possess beauty, wealth, high status, or power? 15. Do I tend to need excessive admiration from others, and do I seek this

attention from others—even in subtle ways? For example, do I talk to strangers in a restaurant to get their attention?

16. Do I get energized by thoughts of myself possessing more intelligence, attractiveness, wealth, status, or power than others?

17. Do I take pride in being able to do things without the help of others, and do I believe that to need others or need help from others makes a person weak or pathetic?

18. Do I feel safest psychologically when I feel alone? 19. Do I feel threatened psychologically when I feel I am becoming at-

tached to and emotionally dependent upon another person? 20. Do I verbally attack or withdraw from a person who has pointed out my

failure, and do I devalue them (put them down) as a way to inflate my own self-worth?

21. When I experience failure (as all people do), do I either become grandi-ose in my head (wherein I increase my self-worth by believing I never fail), or do experience strong feelings of self-loathing or self-contempt because of my failure or mistake (self-devaluation) and feel shame, humiliation, rage, inferiority, or emptiness?

Crisis Intervention Resources Youth: CARES (Crisis and Referral Entry Services);

1-800 345-9049 CARES is Statewide and will assess eligibility for SASS (Screening and Assessment Referral Services)

24-hour crisis lines: Nat’l Suicide Lifeline: 1-800 273-8255 Peoria County ERS: 309 671-8084 Tazewell & Woodford Counties: 309 347-1148

Dial 2-1-1 for a non-emergency number that connects people with essential community information and services: food, shelter, counseling, mental health, employment, elderly, children & families

If the individual is at risk: Contact the police department for an initial response. The police will contact ERS when the situation is secure.

If individual safety is not a concern: Contact ERS at 309 671-8084 ~ TTY Line: 309 671-3566. You will be asked for some brief information to assist our response.

Medical Detox: 309 689-3080

To Keith and Beth Lawrence in the death of Keith’s fa-ther in Massachusetts in February. Our thoughts and pray-ers are with you and your family. To long-time NAMI member and regular attendee of our meetings, Sam Wheeler in the death of his wife in March. Our thoughts and prayers are with you and your sons dur-ing this time.

April—May 2017 Family Forum Page 6

Book Review

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

Valerie Porr knows the helpless feeling that comes from receiving the news that a loved one has been diagnosed with Borderline Personality Disorder (BPD). That is

why she wrote her book, Overcoming Borderline Personal-ity Disorder: A Family Guide for Healing and Change, which this reviewer has recommended to clients as an ex-cellent resource for persons and families affected by the distress associated with Borderline Personality Disorder.

Ms. Porr admits there is no simple explanation for how BPD operates. To help us imagine the symptoms of a per-son with BPD, she asks us to imagine that a juggler is toss-ing nine balls, each ball a different color, to describe nine different problems a person with BPD may be experiencing at any time.

A blue ball stands for impulse control dysregulation, the tendency to act quickly without thinking which results in a

person with BPD overreacting to non-threatening situations and getting into trou-ble. A red ball stands for mood dysregulation, describing how the brain of a person with BPD is vulnerable to increased arousal and a sense of heightened shame. A purple ball stands for sensitivity dysregulation with increased sensitivities to touch, sound, smells and sight, as if one is having an allergic reaction to any stimuli. A green ball is for cognitive dysregulation, processing information in a way that leads to relational misunderstandings. A yellow ball stands for emotion processing dysregulation, the sense of having a consistent negative emotional bias to infor-mation and emotion. An orange ball is for sleep dysregulation, possibly from a sense of a constant state of fear. A black ball is for pain dysregulation, whether in actual experience or perceived, that can lead to a tendency to self-injure. A white ball is for memory problems. A pink ball is for anxiety, having persistent feelings of being out of control.

Ms. Porr asks us to imagine a juggler cycling through these “colored balls” in dif-ferent rhythms and speeds, to illustrate how dysregulation exposes a person with BPD to constant distress and uncertainty. With this and other descriptions, she helps us to empathize with the struggles of a person experiencing BPD.

In regards to a person with BPD receiving professional help, Porr describes current therapies that are recommended for the treatment of Borderline Personality Disor-der, including Cognitive Behavioral Therapy and Dialectical Behavior Therapy. Porr recommends these therapies for persons with BPD and encourages family members to learn and apply those treatments also in order to improve family func-tions and relationships.

Porr extensively writes in her book about the need for family to reach out with understanding to a loved one suffering with BPD. She compares the experience of a person with BPD to being in solitary confinement with unmet emotional needs. In an especially helpful section Porr describes the use of validation to communi-cate sympathy, compassion and empathy to a loved one with BPD. She recom-mends validation as a way to show unconditional acceptance and provides exam-ples of what validation could look like in relationship to a person with BPD.

In regards to personal care for oneself Porr describes the practice of mindfulness to maintain both personal well-being and relational effectiveness. Porr also suggests that relationships strained by dynamics of BPD may be helped by mentalization-based therapy as a way to communicate with others while having the ability to see another person’s perspective of a situation while being aware of your own perspec-tive of the same situation.

In the final section Porr brings it all together with a variety of suggestions integrat-

ing the skills described in the book for acceptance and change. A great deal of help

for families is available in Porr’s book Overcoming Borderline Personality Disor-

der or by looking at her website www.tara4bpd.org.

Additional books that might be helpful when dealing with

Personality Disorders

N A M I Tri-County Illinois (309) 693-0541

Officers President ............................. Beth Lawrence Vice President ............................................. Secretary ................................. Roger Geiss Treasurer ................................. Roger Mohn Past President .................... Suzanne Spears Editor .................................... Lila Gammon

Directors Becky Dorman Larry Fordham Dianne Geiss John Mayfield Kimberly Modglin Susan O’Neal Craig Stanford Clark Wade

Family Support Group Facilitators Lila Gammon Gay Knapp Marjorie Schwebel Suzanne Spears

Larry Fordham Dean Harris Lori Knapp Eymarde Lawler

John Mayfield

Family to Family Class Instructors Brenda Bleichner Dianne Geiss Roger Geiss Angie Lamb Bill Lamb Bruce Leman Lisa Marie McKeown Kim Modglin Roger Mohn Lindsey Naffziger Susan O’Neal Dennis Staggs Jean Wallace

Peer to Peer Class Instructors Dean Harris Larry Fordham

Becky Dorman Beth Lawrence Pat Lindberg Pat Sefried

For any subject matter of interest or suggestions, please call Beth 309 691-5830 or

Lila 309 648-5420

April—May 2017 Family Forum Page 7

NAMI TRI-COUNTY ILLINOIS CALENDAR OF EVENTS

April & May 2017

~~Illinois Central College North, 5407 N. University, Peoria~~ Education Meetings, Poplar Hall, Room 132

Support Groups, Poplar Hall: Family—Room 132; Connections—Room 131

April Tuesday, April 4, 7:00 p.m.

Monthly Education Meeting, ICC North, Arbor Hall, Arbor Auditorium, Room A111. View documentary Unbroken Glass and ask questions of the film maker, Dinesh Sabu. See more details on page 1

Tuesday, April 18, 7:30 p.m. COGS meeting, Metamora McDonald’s. For more information contact Kim, 309 645-1683 or kimbermodglin66@yahoo.com

Tuesday, April 18, 7:00 p.m.

April 20 7:00–8:30 p.m. Monthly Support Groups, ICC North, Poplar Hall

Family and friends of people with brain disorders, Room 132. For further information call Sue, 309 360-1143. Connections—individuals participating in recovery, Room 131. For further information call John 309 472-5907.

Thursday, April 27,

May Tuesday, May 2, 7:00 p.m.

Thursday, May 4, 7:00 8:30 p.m. Education Meeting, ICC North, Poplar Hall, Rm. 132, Speakers: Jay Rawal, M.D. & Amanda Vastag, M.D. Topic: Personality Disorders

Thursday, May 11, 6:30–8:30 p.m.

Tuesday, May 16, 7:30 p.m. COGS meeting, Metamora McDonald’s. For more information contact Kim, 309 645-1683 or kimber-modglin66@yahoo.com

Tuesday, May 16, 7:00 p.m.

May 18 7:00–8:30 p.m. Monthly Support Groups, ICC North, Poplar Hall

Family and friends of people with brain disorders, Room 132. For further information call Sue, 309 360-1143.

Connections—individuals participating in recovery, Room 131. For further information call John 309 472-5907.

Thursday, May 25,

Looking Ahead:

The Mental Health Mile which is annually on the last Saturday of June has been suspended for this year. August 5—Picnic/hog roast in Detweiller Park; more details in future newsletters

Brighter Days Ahead 513 NE Madison Peoria, Illinois 309 222-2012

“Brighter Days Ahead” offers a positive and uplifting environment for people 18 years of age or older who have experienced a mental illness. Its purpose is for members to have a safe place where they can socialize, receive support, and be part of fun, recovery-oriented activities while envi-sioning the brighter days ahead.

Hours of Operation Monday - Saturday from 9 a.m.–5 p.m. Sunday from 12 noon–5 p.m.

If you have any additional questions, we would be happy to talk either by phone 309 222-2012 or at recoverycenter@fayettecompanies.org

Survivors of Suicide - Peoria http://www.afsp.org/coping-with-suicide/find-support/find-a-support-group/illinois/survivors-of-suicide-peoria Contact: Rev. Eimo Hinrichs or Mrs. Pat Hinrichs, 309 697-3342 or Sylvia Murphy, 309 208-3027 Meeting Place: Chapel at Proctor Hospital, 5409 North Knoxville Ave., Peoria, IL 61614 Meeting Day(s)/Meeting Time: 1st and 3rd Tuesday, 7:00 p.m. Facilitated by: Peer/Professional Charge: None

April—May 2017 Family Forum Page 8

Editor’s note: All articles on this topic were researched and submitted by Kevin Siscoe, D.Min., LCPC, CSAT, CMAT who works with The Antioch Group. His help is deeply appreciated.

Borderline Personality Disorder

Definition Borderline personality disorder (BPD) is a serious mental

disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depres-sion, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety

, suicidal thinking and behaviors, and suicide.

While mental health experts now generally agree that the label "borderline personality disorder" is very misleading, a more accurate term does not exist yet.

Signs and Symptoms People with BPD may experience extreme mood swings

and can display uncertainty about who they are. As a result, their interests and values can change rapidly.

Other symptoms include:

• Frantic efforts to avoid real or imagined abandonment

• A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)

• Distorted and unstable self-image or sense of self

• Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating

• Recurring suicidal behaviors or threats or self-harming behav-ior, such as cutting

• Intense and highly changeable moods, with each episode lasting from a few hours to a few days

• Chronic feelings of emptiness

• Inappropriate, intense anger or problems controlling anger

• Having stress-related paranoid thoughts

• Having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or los-ing touch with reality Seemingly ordinary events may trigger symptoms. For ex-

ample, people with BPD may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Stud-ies show that people with this disorder may see anger in an

Some of these signs and symptoms may be experienced by people with other mental health problems—and even by people without mental illness—and do not necessarily mean that they have BPD. It is important that a qualified and licensed mental health professional conduct a thorough assessment to determine whether or not a diagnosis of BPD or other mental disorder is

Tests and Diagnosis Unfortunately, BPD is often underdiagnosed or misdiag-

nosed. A licensed mental health professional experienced in diagnosing and treating mental disorders—such as a psychia-trist, psychologist, or clinical social worker—can diagnose BPD based on a thorough interview

The licensed mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with BPD, making it difficult to distinguish BPD from other mental illnesses. For example, a person may describe feel-ings of depression but may not bring other symptoms to the mental health professional's attention.

Research funded by National Institute for Mental Health (NIMH) is underway to look for ways to improve diagnosis of and treatments for BPD, and to understand the various compo-nents of BPD and other personality disorders such as impul-sivity, relationship problems, and emotional instability.

Risk Factors The causes of BPD are not yet clear, but research suggests

that genetic, brain, environmental and social factors are likely to be involved.

• Genetics. BPD is about five times more likely to occur if a person has a close family member (first-degree biological rela-tives) with the disorder.

• Environmental and Social Factors. Many people with BPD report experiencing traumatic life events, such as abuse or aban-donment during childhood. Others may have been exposed to unstable relationships and hostile conflicts. However, some people with BPD do not have a history of trauma. And, many people with a history of traumatic life events do not have BPD.

• Brain Factors. Studies show that people with BPD have struc-tural and functional changes in the brain, especially in the areas that control impulses and emotional regulation. However, some people with similar changes in the brain do not have BPD. More research is needed to understand the relationship between brain structure and function and BPD.

Research on BPD is focused on examining biological and environmental risk factors, with special attention on whether early symptoms may emerge at a younger age than previously thought. Scientists are also studying ways to identify the disor-der earlier in adolescents.

Treatments and Therapies BPD has historically been viewed as difficult to treat. How-

ever, with newer and proper treatment, many people with BPD experience fewer or less severe symptoms and an improved quality of life. Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with BPD and their loved ones to be patient and to receive appropriate support during treatment. People with BPD can recover. If

(BPD Cont. on page 9)

Personal ity Disorders

April—May 2017 Family Forum Page 9

selves. This approach is based on the idea that BPD stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress.

• Systems Training for Emotional Predictability and Prob-lem Solving (STEPPS) is a type of group therapy that aims to educate family members, significant others, and health care professionals about BPD and gives them guidance on how to interact consistently with the person with the disor-der using the STEPPS approach and terminology. STEPPS is designed to supplement other treatments the patient may be Families of people with BPD may also benefit from thera-

py. The challenges of dealing with a loved one with BPD on a daily basis can be very stressful, and family members may un-knowingly act in ways that worsen their relative's symptoms. Some therapies include family members in treatment sessions. These types of programs help families develop skills to better understand and support a relative with BPD. Other therapies focus on the needs of family members and help them under-stand the obstacles and strategies for caring for a loved one with BPD. Although more research is needed to determine the effec-tiveness of family therapy in BPD, studies on other mental dis-orders suggest that including family members can help in a per-son's treatment.

Other types of psychotherapy may be helpful for some peo-ple with BPD. Therapists often adapt psychotherapy to better meet a person's needs. Therapists may also switch from one type of psychotherapy to another, mix techniques from different therapies, or use a combination of psychotherapies.

Medications Medications should not be used as the primary treatment

for BPD as the benefits are unclear. However, in some cases, a mental health professional may recommend medications to treat specific symptoms, such as mood swings, depression, or other disorders that may occur with BPD. Treatment with

Because of the high risk of suicide among people with BPD, health care providers should exercise caution when pre-scribing medications that may be lethal in the event of an over-dose.

Certain medications can cause different side effects in dif-ferent people. Talk to your doctor about what to expect from a particular medication.

Other Treatments Some people with BPD experience severe symptoms and

require intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emer-gency care. Although in rare cases, some people who develop this disorder may improve without any treatment, most people benefit from and improve their quality of life by seeking treat-ment.

Finding Help More information about finding a health care provider or

treatment for mental disorders in general is available at the website for the National Institute for Mental Health.

(BPD cont. on page 10)

Personal ity Disorders

conditions and are less likely to make healthy lifestyle choices. BPD is also associated with a high rate of self-harm and suicid-al behavior.

If you are thinking about harming yourself or attempting suicide, tell someone who can help right away. Call your li-censed mental health professional if you are already working with one. If you are not already working with a licensed mental health professional, call your personal physician or go to the nearest hospital emergency room.

If a loved one is considering suicide, do not leave him or her alone. Try to get your loved one to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Remove any access he or she may have to firearms or other potential tools for suicide, including medications, sharp edges such as knives, ropes, or belts.

If you or a loved one are in crisis: Call the toll-free Nation-al Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is availa-ble to anyone. All calls are confidential.

The treatments described below are just some of the op-tions that may be available to a person with BPD. However, the research on treatments is still in very early stages. More re-search is needed to determine the effectiveness of these treat-ments, who may benefit the most, and how best to deliver treat-ments.

Psychotherapy Psychotherapy (or “talk therapy”) is the main treatment for

people with BPD. Current research suggests psychotherapy can relieve some symptoms, but further studies are needed to better understand how well psychotherapy works.

Psychotherapy can be provided one-on-one between the therapist and the patient or in a group setting. Therapist-led group sessions may help teach people with BPD how to interact with others and how to express themselves effectively. It is important that people in therapy get along with and trust their therapist. The very nature of BPD can make it difficult for peo-ple with this disorder to maintain a comfortable and trusting bond with their therapist.

Types of psychotherapy used to treat BPD include:

• Cognitive Behavioral Therapy (CBT): CBT can help peo-ple with BPD identify and change core beliefs and/or behav-iors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.

• Dialectical Behavior Therapy (DBT): This type of therapy utilizes the concept of mindfulness, or being aware of and attentive to the current situation and moods. DBT also teach-es skills to control intense emotions, reduce self-destructive behaviors, and improve relationships. DBT differs from CBT in that it integrates traditional CBT elements with mindfulness, acceptance, and techniques to improve a per-son’s ability to tolerate stress and control his or her emo-tions. DBT recognizes the dialectical tension between the need for acceptance and the need for change.

• Schema-Focused Therapy: This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view them-

(BPD Cont. from page 8)

April—May 2017 Family Forum Page 10

Personal ity Disorders

How can I help a friend or relative who has BPD? If you know someone who has BPD, it affects you too. The

first and most important thing you can do is help your friend or relative get the right diagnosis and treatment. You may need to make an appointment and go with your friend or relative to see the doctor. Encourage him or her to stay in treatment or to seek different treatment if symptoms do not appear to improve with the current treatment.

To help a friend or relative you can:

• Offer emotional support, understanding, patience, and encour-agement—change can be difficult and frightening to people with BPD, but it is possible for them to get better over time.

• Learn about mental disorders, including BPD, so you can un-derstand what your friend or relative is experiencing.

• With written permission from your friend or loved one, talk with his or her therapist to learn about therapies that may in-v

• Seek counseling from your own therapist about helping a loved one with BPD. It should not be the same therapist that your loved one with BPD is seeing.

Never ignore comments about someone's intent or plan to harm himself or herself or someone else. Report such com-ments to the person's therapist or doctor. In urgent or potential-ly life-threatening situations, you may need to call the police or dial 911.

How can I help myself if I have BPD? Although it may take some time, you can get better with treat-ment. To help yourself:

• Talk to your doctor about treatment options and stick with treatment.

• Try to maintain a stable schedule of meals and sleep times.

• Engage in mild activity or exercise to help reduce stress.

• Set realistic goals for yourself.

• Break up large tasks into small ones, set some priorities, and do what you can, as you can.

• Try to spend time with other people and confide in a trusted friend or family member.

• Tell others about events or situations that may trigger symp-toms.

• Expect your symptoms to improve gradually over time, not immediately. Be patient.

• Identify and seek out comforting situations, places, and people.

• Continue to educate yourself about this disorder.

• Don’t drink alcohol or use illicit drugs – they will likely make things worse

Signs of a Personality Disorder

There are 10 distinct personality disorders that are clustered into three different groups. The conditions in need of mental health treatment are outlined as follows in the DSM-IV: Cluster A—Odd or eccentric behavior.:

• Paranoid personality disorder

• Schizoid personality disorder

• Schizotypal personality disorder

(BPD Cont. from page 9) Cluster B—Dramatic, emotional or erratic behavior:

• Antisocial personality disorder

• Borderline personality disorder

• Histrionic personality disorder

• Narcissistic personality disorder Cluster C—Anxious or fearful behavior:

• Avoidant personality disorder

• Dependent personality disorder

• Obsessive-compulsive personality disorder

• Antisocial Personality Disorder—With antisocial person-ality disorder, which occurs in one percent of American adults, signs include impulsive behavior, an inability to con-form to social rules and an inability to show compassion for the feelings of others.

• Avoidant Personality Disorder—With avoidant personali-ty disorder, individuals often shy away from social situa-tions. When they do find themselves in an environment sur-rounded by others, they may feel inadequate and sensitive to judgment. This type of personality disorder occurs in 5.2 percent of individuals over the age of 18.

• Borderline Personality Disorder—Borderline personality disorder happens to 1.6% of American adults and can in-volve issues with self-image, impulsivity and problems with interpersonal relationships.

• Schizoid Personality Disorder—This type of personality dis-order causes people to appear introverted and withdrawn.

• Paranoid Personality Disorder—Signs of this personality disorder include feeling like the actions of others are threaten-ing or demeaning.

• Obsessive Compulsive Personality Disorder—Signs of this personality disorder include intensive organization habits with an inability to adapt to routine changes.

• Schizotypal Personality Disorder—Signs of this personality disorder include dressing unusually, behaving over the top in social situations and talking to oneself.

• Narcissistic Personality Disorder—Signs of this personality disorder involve a belief of enhanced importance and a desire for attention from everyone.

• Dependent Personality Disorder—Signs of this personality disorder include submissive behavior and a reliance upon others to the point where there is a fear of functioning without help.

April—May 2017 Family Forum Page 11

Guidel ines for Interact ions with Antisoc ial Indiv iduals

Guidelines for Interacting with High-Conflict People with Antisocial Personality

Disorder

1. Do not label the person with Antisocial Personality Dis-order. Labeling backfires. Instead, concentrate on ways to better manage the relationship. Since the high conflict per-son struggles with connection, you will need to be the one who listens and shows empathy and respect. Doing this will lower the person's defenses, making room for the be-ginning of trust. Labeling or pointing out the person's faults escalates rage and irrationality.

2. Try to stay calm. When emotions intensify, say something like, "We can revisit this when we are both calmer." The person in the conflict can own his or her part of the prob-lem, rather than singling out the high conflict person for being so unreasonable. Don't engage in blame or it will become a contest. Begin a conflict by saying something like, "I understand your frustrations. I am paying attention to what you say. Let's see if we can come up with a solu-tion." Or respond by saying, "You may be right "or "Tell me more about that.” This eliminates pushback and keeps the emotion level down.

3. Assess your safety. If there are dangerous behaviors like domestic violence or criminal acts, you need to make sure you are safe and appropriate controls are in place.

4. Relate to the person around tasks that need to be done or possible solutions rather than reacting to his or her symptoms. Symptoms distract from the issue at hand, so keep the issue front and center. Focus only on behavior. Think like a detective, “Just the facts.”

5. Choose your battles. Since most high conflict people love the battle, minimize your contact with that person when you can. When you do engage, resist the urge to defend yourself, which only ends in more conflict.

6. Set a structure for conflict discussion and talk about expectations. Establish fair fighting rules, such as no yell-ing, name-calling, interrupting, etc. It may help to meet in a public place and or take a mediator.

7. Set boundaries. If a boundary is violated, be firm. Tell the person what the expectation is and what is needed to con-tinue the conversation. Although you may want to, do not ignore the person. Ignoring usually sets the person up for even more anger because it triggers feelings of emotional neglect and abandonment. It is better to revisit the rules of engagement.

8. Disengage from the drama and manage your own thoughts and feelings. When someone starts accusing you, disengage and realize this will go nowhere. Take a timeout or concentrate on your reaction only.

9. Forgive readily. Chances are you will be treated unfairly. No matter what, you need to forgive and then be cautious with your trust. Holding on to unforgiveness hurts you, even when reconciliation is not possible.

10. Do reality testing. You cannot challenge a person's per-ception directly because the conflict will escalate, emotions

will take over, and nothing will get solved. However, you can ask questions in a more indirect way. Say something like, "Sometimes people get really angry at others when they are hurt and want to make them pay. Do you know what I mean?" This is indirect, but will keep the conversa-tion going and help you discern whether the person is in-tentionally trying to deceive you to get what he or she wants, or whether there really is a distortion in his or her thinking. Chances are that everything a person says is not a lie or exaggeration. Parts may be true.

11. Be patient. Working on conflict with a difficult person takes time and patience. Change is often slow but can hap-pen with commitment to the process and desire to work on the relationship. The person has to experience approaches and see that working through issues can be done and ac-complishes more than acting in extreme ways.

12. Talk about the elements of a healthy relationship. Healthy relationships have similar characteristics – respect for one another, support, empathy, sharing thoughts and feelings without fear of negativity, mutual trust, honesty, and fidelity. In healthy relationships, people like to spend time together and try to be fair and grow in connection and intimacy over time. Healthy relationships are not character-ized by blaming, criticizing, idealizing, projecting, raging, embarrassing, demeaning, yelling, lying, and always being right. Helping the person see that certain behaviors make a person more interpersonally effective is one goal.

13. Try psychotherapy. The most effective psychotherapy is called dialectical behavior therapy (DBT). This therapy helps people learn to calm down and soothe them-selves, tolerate distress, develop coping skills, and learn how to be more inter-personally effective. With slow and steady help, peo-ple with personality disor-ders can learn to be more effective in dealing with conflict in relationships, but it may take a personal men-tal health therapist to move them forward. Be willing to include yourself in treat-ment so you can work to-gether on finding ways to effectively deal with conflict. Don't bring up the idea of treatment in the middle of a fight. Wait until things are calm and then suggest help for the two of you in order to work together.

www.nami.org/—National Alliance on Mental Illness nimh.nih.gov/—National Institute on Mental Health

mentalhealthtreatment.net—Mental Health Treatment articles www.tara4bpd.org—Treatment And Research Advancements

for Borderline Personality Disorder samhsa.gov—substance abuse & mental health services admin-

istration psychcentral.com—getting help for a variety of mental illnesses Choicesinrecovery.com—guides for recovery strategies

April—May 2017 Family Forum Page 12

We provide education, support groups, and advocacy for families, friends, and individuals with mental illness in Peo-ria, Tazewell, and Woodford Counties.

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NAMI Tri-County Illinois Membership Form

An affiliate of the National Alliance on Mental Illness

Membership dues also include membership in NAMI and NAMI Illinois

General Membership $35

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Open Door Membership $3

You may join on line rather than by sending in this form:

http://nami.org

NAMI Tri-County Illinois P.O. Box 10167 Peoria, IL 61612 309 693-0541 www.namitr i -county i l l ino is .org

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