Customer Reviews

The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells

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Very few books can actually change your life. Randi Kreger has written two. "Stop Walking on Eggshells" (SWOE) changed my life and the lives of many others. "The Essential Family Guide" now offers the tools to family members and professionals to help deal with BPD with great efficiency and effectiveness.

"The Essential Family Guide" hits the nail directly on the head and drives it home. Where SWOE left off, the Family Guide picks up. It is critical reading for everyone - including counselors, psychologists, and legal professionals - living with or dealing with someone with Borderline Personality Disorder (a "BPD").

After reading through the first few chapters, I realized that "The Essential Family Guide" is the next step in my own recovery in dealing with my BPD ex-spouse and in caring for my children exposed to this disorder. If you are coping with a BPD - personally or professionally - you must read the Essential Family Guide.

I think of and hear from others out there dealing with the craziness of a BPD in their lives and searching for understanding. If I can convince one person to read The Family Guide and get the benefit that I have received from Randi's books, then I will have done a good thing.

My wife, I suspect, has BPD, and I read Randi's book, "Stop Walking on Eggshells", about a year and a half ago. I then participated in Randi's on-line support groups, and generally attempted to follow some of the advice in that book and on that site, without much success, frankly. This new book is helping me much more in understanding and empathizing with my wife, but I still think it doesn't quite get what is the most effective means for interacting with a borderline.

It's hard for me to explain the overarching problem I see with the book so I'll focus on one example. "Power tool #5: reinforcing right behavior" makes the point that, when a BP's traditional behavior does not get the reward they seek, they frantically repeat the behavior in an effort to get the reward (which Randi refers to as an *extinction burst*). My impression is that, for Randi, the "reward" is that the non complies with the borderline's desires, or accepts the abuse, or gets attention, and so on.

Rather than a focus on what is the actual emotion that the borderline is trying to communicate (albeit very ineffectively--that is why they call this a disorder, and specifically a disorder of emotion regulation), Randi is focused in this section on the behavior that one might want to stop, using "limits." She provides several examples of borderline behavior that one might want to stop, such as them calling you at work many times a day, or saying hurtful things to you. She describes "setting a limit" for each (for the first, explaining that you can take a maximum of 3 calls per day from the BP aside from emergency calls, for the second explaining to your BP that the conversation is uncomfortable and that "I'm going to my room. If and when you are ready to treat me with respect, let me know and we can talk").

Randi is clearly a strong believer that the loved one of a borderline can effectively extinguish problematic behaviors by either not rewarding them or even providing negative reinforcement for them, and she is influenced by and references Susan Pryor's "Don't shoot the dog," a book that I enjoyed immensely. She says that it may take a long time for the BP to get past the extinction burst phase, but once they do, the behavior is extinguished.

I have 3 issues with this approach.

1) Randi defines "setting a limit" as engaging in a behavior that is completely under one's own control (ie not answering the phone, or leaving the room for the above examples) but quickly ties this together with using this "limit" as positive or negative reinforcement (and clearly not punishment--she describes negative reinforcement correctly) to elicit behavioral change in the borderline.

This has helped clarify for me how Randi thinks about limits and boundaries, and explains why there is so much confusion about what these actually are. For Randi, I think, a limit is about our own behavior, but it is also intended to act as a positive or (more often) negative reinforcer of the BP's behavior. No wonder people are often confused about who a limit actually is supposed to apply to.

Boundaries are a standard tool used by folks at Randi's internet support group. They are meant to apply to the behavior of our own selves. Sometimes, however, people assume that the borderline is "supposed" to not "cross" these boundaries, which has never made sense to me since boundaries are supposed to apply to ourselves, not others. But I guess they are really talking about limits, which, again, seem to be similar to boundaries but are used as reinforcement tools to elicit change in other people's behavior. So I think it would be very helpful to clarify the difference between boundaries, limits, reinforcement strategies, etc--these all tend to get jumbled togather in a confusing way both in the book and on the internet support groups created by Randi.

2) People who follow this advice without paying heed to validation FIRST may (or may not, as I talk about below) eventually extinguish behaviors that they don't like, but I believe that they'll also likely end up with a borderline who feels deep-seated anger and shame, and who will find new ineffective behavioral outlets for this anger and shame. Randi does talk about the importance of validation (she appears to prefer the term "empathic acknowledging") and she even emphasizes that it is important to do so BEFORE and WHILE "setting limits" (something she didn't do in "Stop walking on eggshells"), but she doesn't integrate the tools. Her examples illustrate one "power tool" at a time.

For example, the example about the BP saying abusive things to her mother makes it look as if simple negative reinforcement (leaving the room) results, after "many years and lots of practice", in a BP that has learned to recognize that they're about to be emotionally dysregulated and trying their best to control their behavior, and apologizing in advance for anything hurtful they might say or do. She seems to imply that this is the expected end result of simple limit-setting, unless you accidentally intermittently reinforce the wrong behavior (which will result in a very intense reappearance of the behavior, because intermittent reinforcement is the most satisfying reward of all--think of gambling as an example, or the rat frantically pressing the lever: if you reward only intermittently, the behavior will be more intense).

The argument seems to be that, sure, things are going to become hellish for a long time as a result, but if you consistently implement the limits then, one day, things will improve. If things DON'T improve, then it's probably because you didn't consistently implement the limits (and thus provided intermittent reinforcement). This is risky, in my opinion, even WITH the use of validation. Such thinking can almost become like religious belief--you might never see the positive results but still be undeterred and believe that it is the correct process. This belief in the power of limit-setting as a means to extinguish BP behaviors that we don't like (using negative reinforcement) is almost untestable once you throw in the caveats that things will likely get worse before they get better, that it might take years to see results, and intermittent reinforcement might muck up the whole process.

Even if one does use validation, using negative reinforcement to elicit behavioral change is very risky, in my opinion, for somebody with an emotional disorder. Negative reinforcement can result in unpleasant feelings in anybody; for borderlines, you can multiply this by at least a hundred, I think. Positive reinforcement is great--it results in behavioral change AND helps people feel good. But negative reinforcement is risky. It may have its place as a tool, but I don't think it's a wise *first* approach for effecting behavioral change with borderlines. I do strongly believe that boundaries are sometimes needed to protect loved ones, but I think that these should not be confused with tools for eliciting behavioral change in a borderline. In other words, boundaries should not be used habitually as reinforcement tools, in my opinion. One has to be very careful in order to do this in a way that does not seem invalidating and judgmental to the very sensitive and very shame-filled borderline mind, and personally I doubt that it's possible. My impression is that those who treat Randi's books as the "bibles of BPD" consistently try this repeatedly and consistently fail to pull off "limit-setting" successfully, because they tend to not understand, empathize with, or validate the underlying emotional content, and because negative reinforcement by its very nature uses an unpleasant stimulus to effect behavioral change.

Meanwhile, you have a borderline whose feelings get more and more intense due to their frustration at not being heard and understood that it's their *feelings* that they are trying to communicate using their behaviors (albeit not very effectively). This brings me to my 3rd issue.

3) I don't believe that the "reward" that a borderline is seeking is simply to be able to get away with yelling at you, calling you names, being able to call you on the phone repeatedly, and so on. The "reward" is not that the loved one complies with the borderline's desires, or accepts abuse, or gives up control of their life, or whatever.

This is a quote from another internet support group that approaches the same issue differently:

"When someone with BPD talks to you, asks you to do something, or asks you to help, or when they behave in a certain fashion, they are really trying to communicate their feelings about things. They might not even really know that this is the motivation for action, because it is so built into their lives. It is conditioned. When a borderline does not get the desired result from the interaction (that is, the feeling is not properly acknowledged and validated, etc.), then the next step is to escalate. It's as if a rat has been pushing a button for a while and gotten fed, and suddenly, the button doesn't work. The rat will frantically push the button, over-and-over, until the rat's brain gets re-trained that the button doesn't work anymore. There is a period of confusion in the rat's brain, when their emotional expectations are not met by conditioned behavior. They try and escalate the behavior to see if the expectation can get met."

The expectation that they are looking to get met is that their feelings are understood. The author of this quote is Bon Dobbs, who writes a blog and runs a list for those with loved ones with BPD www.anythingtostopthepain.com). Bon encourages loved ones to see past the behavior and to understand what emotional content the borderline is trying to communicate. BPD is a disorder of emotional regulation; the behaviors are simply a manifestation of this. That is why it is so important to validate the emotions of a borderline.

I thought nothing could ever top the first book Randi Kreger co-wrote ("Stop Walking on Eggshells") but her newest book does it---I wish I could give ten stars instead of five. This seemingly simple book is one of the top five most useful books I've ever read in my life---I've already reread it twice, and will be reading it again in the years to come to help keep me in the right mental place. If you want to not only understand emotionally troubled people, but also do something concrete to help yourself, push the button and order this book right now.

There are so many powerful and easy-to-use tools provided in this book that it's tough to figure out which ones to mention in this review. They all give concrete answers to the seemingly unanswerable question that always arises whenever you're faced by a troubled personality--what do you do about it?

For example, I've always heard that you need to "set firm limits" with people who would overstep your boundaries. But personally, I never really quite understood what the word "limits" actually meant, and I certainly didn't know how to set them. Nothing I ever read on the topic helped much, because what little I found was so vague.

But Randi gives example after concrete example of what limit setting actually means in a variety of situations, emphasizing throughout that it's important to understand your own greater sense of what's fair and right for yourself as well as for others. Her chapter on uncovering what keeps you feeling "stuck" provides a terrific explanation of a problem in relationships with people who are troubled. In the chapter on communication, Randi describes precisely how to communicate and actually be heard.

And the good news is that it IS possible to get your troubled person to make changes---Randi tells precisely how to do it, even while you are improving your own health and life.

If you are dealing with a person who is making your life miserable and who leaves you constantly feeling as if you are walking on eggshells, you need this extraordinary book.

Now in 2008, Randi Kreger has another blockbuster book to add to her wonderful treasure trove of resources.

*The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells* is stimulating, challenging, educating and thought-provoking. It is an essential book for both the practioner, family member, students of mental health, psychology and Borderline Personality Disorder.

Everyone interested in mental health with some personal experiences of BPD will love this book.

This book is absolutely superb. It has a stimulating collection of essays that taken together really open up the subject of Borderline Personality Disorder.

*The Essential Family Guide to Borderline Personality Disorder* is full of information on how to find a therapist, insurance concerns,and different types of treatments and therapies.

The second part of the book is about the Power Tools for the non BP to get a grasp on how to set limits, boundaries, take care of themselves and to be heard by the borderline by using great communication skills and reinforcing the right behaviors.

Most 'family guides' focus on a broad spectrum or general overview and very little of the personality disorders. *The Essential Family Guide to Borderline Personality Disorder* is a family guide that specifically focuses on Borderline Personality Disorder for the non and what to do about the disorder and what steps to take.

This is an excellent book. It deserves more than five stars. It is well worth reading by those seriously interested in Borderline Personality Disorder. It's a scholarly academic text that is well supported by recent research and literature in the field, but remains easy to read and understand, given the complexity of the material it covers.

*The Essential Family Guide to Borderline Personality Disorder* is very well-researched with contact information, references, resources, up-to-date brain research, genetics, biological approaches and the role of the pharmaceutical industry, together with well-represented and refreshing analysis of psychological and social approaches.

Rita Closson, M.A. Social Psychologist
Kansas City, Missouri

Book Review of "The Essential Guide to BPD...New Tools and Techniques to Stop Walking on Eggshells"
Written by Randi Kreger (co-author of Stop Walking On Eggshells; author of Stop Walking On Eggshells Workbook)

Being a long time parent and advocate of people wo have BPD, I had planned on just skimming this book, thinking I've read so many books on BPD I don't need to read this one front to back. It didn't happen, I read the book word for word all the way through, including re-reading parts to help it settle in all the way.

The first half of the book gives an exceptional description of BPD, including what it is like from the inside of a person with BPD. The second half is stocked full of different ways to deal with BPD behavior to help, not only to prevent the behavior, but helping those of us who love someone with BPD. Also the approaches are done in a way to actually help our loved ones with BPD learn ways to behave in a more appropriate way. It offers help for the family as a whole!

Randi has put in the book some of the latest information about BPD and unlike other books on BPD, I never felt defensive while reading it.....no blaming the parents or insisting everyone with BPD was abused or traumatized. Very up-to-date stuff in this book and written in a way that us "everyday" people can understand.

While reading it, different members of our online parent group came to mind many times, thinking I need to tell this one this and that one that and I began highlighting the book. Eventually I realized that there were more highlighted areas than non-highlighted areas, which means it really is important to read the whole book and not just a snip here and there.

If you cannot purchase the book please request your library get one, after you read it, just think of others who will benefit from it! There isn't much out there for us families and she has definitely been a leader in getting books out there to help us.

Very friendly, welcoming, and easy to read, yet at the same time jammed with new and helpful information and guidance, much of which is available nowhere else. This is one of the best-written nonfiction books I've read--and, for people who are close to anyone with BPD, one of the most helpful and valuable. (Kreger's first book, Stop Walking on Eggshells, is equally good.)

Randi's new book, The Essential Family Guide to Borderline Personality Disorder, reflects changing opinions about BPD, and includes hopeful information about recovery and improving relationships. I am happy to see Randi's inclusion of many dialectics including loving someone and taking care of yourself. She appropriately quotes Viktor Frankl: "When we are no longer able to change a situation...we are challenged to change ourselves."

This book is not written for those with the diagnosis, but for those who interact with individuals with Borderline Personality Disorder. I can not imagine a more thorough condensation of current research on the disorder, communication skills, problem solving and self care. Her writing style is understandable and the arrangement of content is highly practical.

While I would not recommend this book to those in early or even mid-recovery from BPD, I highly recommend this book to those anywhere on the spectrum of recently coming to terms with their Borderline relationship all the way to seasoned veterans of understanding recovery.

I'd like to offer a heart-felt thank-you to Randi and the numerous contributors to this book!

Tami Green
[...]

If you have a spouse or significant other whose behaviour is both abusive and beyond comprehension, then you need to read this book. This book will give you the info you need to survive and go on, either with that person or without.

It's not just a book. I sincerely believe this is literally a masterpiece. For such an INSIDIOUS disorder to be so well understood and mapped out so thoroughly takes immense professionalism and selfless dedication. The author's methodology of using internet support groups to augment an already thorough understanding of BPD is unprecedented and of historical significance. Then to be able to structure all that information into a purely objective, usable, quality document is just ... what? ... Precious. Precious as life itself because it gives hope to so many (men, women, children and my God, the ever precious Family). I don't know the author at all. I am just impressed with this state-of-the-art contribution to society.

Side note: I highly recommend highlighting the BP's behavioral symptoms in yellow and the corrective behaviors/actions in green. This makes it into a good operator's manual.

I wish there was a better way to get the word out that this book is hands down a MUST read for anyone who has been impacted by someone they care about living with a personality disorder. I am a clinical social worker and I recommend this book whenever possible-- to the families of my clients, when I am giving presentations or teaching students. Although the book is specifically written for how to cope, understand and interact with someone living with BPD, Kreger offers some great suggestions for anyone in need of support for how to interact with a person having problems with interpersonal relationships and managing emotions.

You can read the first chapter "Welcome to Oz" in it's entirety on Google Books. However, there are two chapters I continually find to be the most helpful. Chapter 3: "Making sense of your relationship" is excellent. It offers insight for the reader to better understand how BPD features challenge a relationship. Kreger describes easy to understand concepts such as childlike characteristics, low emotional intelligence, rejection sensitivity and impulsive aggression. I also highly recommend Chapter 9: "Communicate to be heard," which educates the reader on BPD communication deficits and how to create a "climate of cooperation" with the person living with BPD. Kreger walks you through step by step how to verbally acknowledge what the other person is feeling. She offers specific words that can be used with the person such as "I want to hear about it, but it's hard for me when things get too emotional. I want to give you my full attention and that's too hard for me to do right now. Let me have a little while to calm down and then we can talk" Kreger's writing style is accessible and easy to follow. There are case examples in the book, but they are not too overpowering. The book is packed with useful information that will hit home for many readers.