7 Steps to Managing a BPD Episode: Step by Step

Summary

In this video, Dr. Fox offers guidance on managing a Borderline Personality Disorder (BPD) episode, emphasizing the importance of establishing trust and patience in the relationship with the affected individual. Key steps include focusing the person on the present, encouraging slow, deep breathing, reassuring them of support, and addressing the triggering incident once calm. Dr. Fox stresses the necessity of clear, concrete problem-solving and consistent follow-through to maintain a reliable connection with the person experiencing the BPD episode.

Takeaways

• 🤔 Recognize a BPD episode as a time when the person is highly agitated and at risk of self-harm or acting out.
• 🔒 Importance of having a trusted, patient, and caring relationship with the person to effectively manage their BPD episode.
• 👂 Listen to how you are perceived; if seen negatively, it may hinder your ability to calm the person down.
• 🌀 Focus on getting the person to concentrate on the present moment and not on future worries or past issues.
• 👃 Encourage slow and deep breathing from the stomach to help regulate their intense emotional state.
• 💬 Speak calmly and avoid reacting to any negative comments to maintain a peaceful presence.
• 👍 Reassure the person that things will be okay and that you are there to help, reinforcing your role as a supportive figure.
• 🔍 Once calm, ask the person to explain what triggered the episode without delving into broader issues.
• 🛠 After calming down, focus on problem-solving the specific trigger of the BPD episode, avoiding general issues.
• 📋 Make clear, concrete, and achievable suggestions for how to address the trigger, and ensure you follow through on them.
• 🤝 Emphasize the importance of consistency in actions and words to build trust and reliability in the relationship with the person with BPD.

Q & A

What is a BPD episode?

A BPD episode refers to a period of intense emotional distress experienced by someone with Borderline Personality Disorder (BPD), characterized by heightened agitation, potential self-harm, and acting out behaviors.

Why is the perception of the person managing the BPD episode important?

The perception of the person managing the BPD episode is crucial because if they are seen as trusted, patient, and caring, they are more likely to be able to calm the person down and effectively manage the episode.

What should be the initial focus during a BPD episode?

The initial focus should be on getting the person to focus on the present moment and the person managing the episode, rather than on worries about the future or past events.

How can breathing exercises help during a BPD episode?

Breathing exercises, specifically slow and deep breaths using the stomach, can help slow down the person's intense breathing and calm them down during a BPD episode.

What is the role of the person managing the BPD episode in terms of communication?

The person managing the BPD episode should communicate in a calm voice, avoid reacting to provocations, and remain present and focused on the person experiencing the episode.

Why is reassurance important during a BPD episode?

Reassurance is important to help the person feel safe and supported, knowing that someone is there to help them through the episode.

When should the person managing the BPD episode ask about the triggering incident?

The triggering incident should be discussed once the person has calmed down a bit and is no longer in the middle of the episode, allowing for a more rational discussion.

What is the key to effective problem-solving during a BPD episode?

Effective problem-solving involves focusing on the specific trigger of the BPD episode and avoiding general issues, ensuring that the discussion remains relevant and manageable.

How should suggestions for help be presented during a BPD episode?

Suggestions for help should be clear, concrete, and achievable, ensuring that they are realistic and can be followed through on.

Why is consistency in actions important when managing a BPD episode?

Consistency in actions is crucial because it builds trust and reliability. Actions should align with what is said to avoid misunderstandings and to maintain a stable relationship with the person with BPD.

Outlines

00:00

🤔 Managing BPD Episodes: Trust and Care

Dr. Fox discusses managing Borderline Personality Disorder (BPD) episodes, particularly when the individual is experiencing a 'Florida reaction,' characterized by intense agitation and potential self-harm. The video emphasizes the importance of the relationship between the caregiver and the person with BPD, stressing the need for trust, patience, and care. If perceived negatively, the ability to calm the individual and manage the episode decreases. The first step is to establish a trusting, patient, and caring presence to help focus the person on the present moment.

🧘 Calming Techniques for BPD Episodes

The video script outlines practical steps for managing BPD episodes, starting with getting the individual to focus on the present and matching their breathing with slow, deep breaths. It's crucial to maintain a calm voice and not react to provocations, such as name-calling. The goal is to slow down the person's intense breathing and create a sense of calmness through synchronized breathing exercises.

👍 Reassurance and Problem-Solving in BPD Management

After achieving a calm breathing pattern, the script advises reassuring the individual that help is available and that the situation will improve. It's essential to be seen as trustworthy and caring, which can facilitate a more significant calming effect. Once the person is somewhat calm, the caregiver should encourage them to discuss the triggering incident. However, the focus should remain on the specific trigger, avoiding broader issues, and then work together to find a solution.

🔨 Follow Through on Promises for BPD Support

The final part of the script stresses the importance of following through on any promises made to the individual with BPD. It's critical to base the relationship on actions, not just words or aspirations. Clear, concrete, and achievable suggestions should be made, and it's imperative to ensure that whatever is suggested is actually carried out. This consistency helps build trust and reinforces the effectiveness of the support provided.

Keywords

💡BPD

BPD stands for Borderline Personality Disorder, a mental health condition characterized by unstable moods, behavior, and relationships. In the video, managing a BPD episode is the central theme, emphasizing the importance of understanding and responding to the emotional needs of someone with BPD.

💡Episode

In the context of mental health, an 'episode' refers to a period of heightened symptoms or a crisis. The video discusses managing a BPD episode, which is a critical moment when the person with BPD is highly agitated and potentially at risk of self-harm.

💡Florida reaction

This term is not a standard psychological term but seems to be used in the video to describe an intense emotional reaction. It suggests a state of being very upset and agitated, which is a key aspect of a BPD episode that needs to be managed.

💡Trusted

Being 'trusted' is crucial in the context of managing a BPD episode. The video emphasizes that the person with BPD needs to perceive the caregiver or helper as someone they can rely on, which is essential for effective communication and support during a crisis.

💡Patient

Patience is a key attribute for those managing a BPD episode. The video suggests that being patient with the person experiencing the episode can help in calming them down and facilitating a more constructive interaction.

💡Caring

Caring is highlighted as an essential quality in the video. It implies showing empathy and concern for the person with BPD, which can help in establishing a supportive relationship and managing the episode effectively.

💡Breathing

The video emphasizes the importance of breathing exercises during a BPD episode. Slow, deep breaths are recommended to help the person regain calm and focus, which is a practical technique to manage heightened emotions.

💡Present

Focusing on the present is a strategy discussed in the video for managing a BPD episode. It involves bringing the person's attention to the current moment, away from worries about the future or past, which can help in reducing anxiety and agitation.

💡Triggering incident

In the context of BPD, a 'triggering incident' is an event or situation that initiates or exacerbates an emotional episode. The video advises focusing on understanding and addressing this specific incident rather than broader issues.

💡Problem-solving

Problem-solving is a method mentioned in the video for dealing with the triggering incident of a BPD episode. It involves working with the person to find a solution to the specific issue that caused the episode, rather than generalizing the problem.

💡Follow through

The video stresses the importance of following through on promises and suggestions made during a BPD episode. This builds trust and reliability, which are crucial for maintaining a supportive relationship with the person with BPD.

Highlights

Managing a BPD episode involves helping someone who is highly agitated and at risk of self-harm.

The person managing the episode needs to be seen as trusted, patient, caring, not aggressive or neglectful.

Focus on building a strong relationship to increase the chances of calming the person down.

Get the person to focus on the present moment, not on worries about the future.

Encourage slow, deep breathing from the stomach to help calm the person.

Speak calmly and avoid reacting to any negative comments from the person.

Reassure the person that everything will be okay and you are there to help.

Once breathing has calmed, ask the person to explain what triggered the episode.

Stay focused on the triggering incident and avoid discussing broader issues.

Work together with the person to problem-solve the specific trigger of the BPD episode.

Make clear, concrete, and achievable suggestions for how to address the trigger.

Ensure any suggestions made are followed through on to maintain trust.

Consistency in actions is key - what you say is what you do, not based on hope or aspirations.

These steps aim to provide practical guidance for managing BPD episodes effectively.

The importance of a calm and supportive approach cannot be overstated.

Breathing exercises are a critical component in helping to de-escalate the situation.

The video concludes with well wishes and an encouragement to take care.

Transcripts

hi so it's dr fox and in this video

we're going to talk about managing a bpd

episode

and

what's important is that bpd episode is

when that person

is really having what is called a

florida reaction so they're very upset

highly agitated maybe they're not

listening they're screaming potentially

increasing the probability of self-harm

or acting out or anything like that so i

want to quickly give you some tips some

steps that you can do

to help manage that bpd episode first

you got to know that you're relying on

your relationship with that person ask

yourself are you trusted are you patient

are you caring or are you seen as

aggressive neglectful and uncaring and

that's really important doesn't mean

that that's what you are but if that's

how you're perceived

that the more negatively you are

perceived the lower the probability that

you are going to be able to

calm that person down and manage that

bpd episode now the first thing that i

want you to do is right if you're that

person who's seen as trusted patient and

caring i want you to get that person to

focus on you in the present a lot of

times they're worried about a lot of

things that are not directly related to

the moment right they're worried about

things that might happen in the future

or what you're going to do not what

you've done or what you're going to do

you have to get them present focused

then ask them to breathe with you as you

take slow and deep breaths with your

stomach not your chest

see it's all right we're going to be

fine just breathe with me

breathing is so critical in these

situations and a lot of times these

folks are breathing really heavily

really intensely you want to try to slow

that down okay you want to you

want to breathe calmly and at an even

pace also make sure that you're speaking

in a calm voice

don't be reactive even if they're

calling you names stuff like that don't

be reactive right just be present try to

get them to breathe next right you want

to reassure them that it's going to be

okay that you're there to help

and hopefully again this goes back to

that step number one which is hopefully

you're seeing as trusted patient and

caring that is so critical

now once that breathing has calmed a

little bit you want to ask them to

explain the triggering incident if you

see that the respiration is rising go

back to breathing and focusing on you

right you want to try to get them

refocused still talk about the

triggering event once they're calmed

down not while they're in the middle of

that episode once they're slowly coming

out of it once they're slowly calming

down

now what you want to do is you want to

problem solve the trigger only do not

stray into larger more general issues

stay focused on whatever started or set

off that bpd episode that's so important

then describe how you're going to help

them together you and that person what

you can do to help if you can all right

that's important and try to make

suggestions that are clear concrete and

reachable also be sure that whatever you

suggest you follow through on it is so

important so many relationships with

individuals with dpd has to be based on

what you say is what you do cannot be

based on conjecture cannot be based on

hope cannot be based on aspirations it

is clear what i say is what i'm going to

do i hope you found these steps helpful

and i wish you all the best and please

take care thank you bye-bye