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Section 11
Coping Strategies in Responsive Treatments for Borderline Personality Disorder

Question 11 | Test | Table of Contents

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In the last section, we discussed the characteristics of assuming behavior in BPD clients. These characteristics include  ambiguous gestures; parataxic distortion; and warning signs.

In this section, we will present several coping strategies for BPD clients that utilize self-talk slogans.  We will categorize lists of self-talk slogans into stages of anger arousal. These stages are  reassurance; triggering; physiological tension; and digressing.

Four Stages of Anger Arousal

♦ Stage #1 - Reassurance
In my experience, the first stage of self-talk is the reassurance stage. This stage occurs when a BPD client senses a conflict is imminent, but has not yet begun. The purpose of the following slogans are to reassure the client that he or she is able to control his or her anger during the argument or discussion.

           1. "This may upset me, but I know how to deal with it."
           2. "I can make a plan to handle this."
           3. "There’s no need for argument. I can handle the situation without escalating.

You may also want to prepare your own list with your client based on the specific issues and motives behind his or her anger. For instance, Jerry was having trouble controlling her anger because she, in fact, did not feel in control of the situation.One of Jerry’s slogans was, "I am in total control of the situation. There is no need to get upset to control my surroundings." Slogans like these will prepare a BPD client so that he or she is not taken by surprise.

♦ Stage #2 - Triggering
The second stage of self talk is triggering.  As we discussed in section 9, trigger escalation is one of the main causes of conflict. These triggers are also related to the trigger thoughts discussed in sections 5 and 6, such as should trigger thoughts and blamers. You may want to refer back to those sections to better understand which trigger thoughts your client is experiencing.

The following slogans are categorized into the specific trigger thoughts that set off most BPD clients. You might review with your client just what attitudes and thoughts he or she experiences when angry to better suit the slogans. The following slogans are categorized by the trigger thoughts we discussed in sections 5 and 6.

-- Predetermined Rules
            "People do what they need to do, not what I think they should do."
            "I can’t expect people to act the way I want them to."

-- Conditional Assumption
            "When they disappoint me, it doesn’t mean that they don’t care."
            "His or her needs are as legitimate as mine."

-- Punishment Fallacy
            "I do not have the right to punish anybody on a whim."
            "Not everyone is subject to punishment.  I may be misinterpreting their actions."

-- Black-and-White Thinking
            "It is merely a problem that our needs conflict; he or she is not right and I am not wrong."
            "I make no judgments."

-- Mind-Reading
            "Assume nothing, check it out."
            "Assuming makes an ass out of you and me."

-- Labeling
            "No labels, be specific."

I have found that if BPD clients initiate these slogans in their everyday life, they are less likely to react to certain triggers and conflicts do not arise as often.  Think of your BPD client.  Could he or she benefit from these triggering slogans?

♦ Stage #3 - Physiological Tension
In addition to the reassurance and triggering stage, the next stage of anger is physiological tension. Everyone feels tense or a certain pain somewhere when their body is under extreme pressure. In some cases, this extra pain will actually worsen the BPD client’s agitation.In section 7, we presented some relaxation techniques that many clients find helpful to cope with physical tension, but many clients become so upset that they forget to take the time to relax their muscles. 

I find that the following slogans help to remind BPD clients to remember their relaxation techniques:

            1. "Take a deep breath and relax."
            2. "When my muscles get tight, it’s time to relax and slow things down."
            3. "It’s time to check my body for tension and relax what’s tight."

After they have completed saying these slogans, I ask my BPD clients to then complete their relaxation or breathing techniques that will relieve the physical tension.

♦ Stage #4 - Digressing
The fourth stage is digressing. Many times, BPD clients wish to bring up past grievances during an argument that does not relate to those specific issues. This will elevate the altercation as the client remembers the pain from the past experience. The following slogans are designed to keep the BPD client in section with the conversation so that he or she may communicate their feelings in a less personal or aggressive manner.

            1. "I’ll state my needs clearly and simply. What do I want here?"
            2. "Acknowledge his or her needs and concerns here."
            3. "Stick to the facts, no putdowns or attacks."

To control a BPD client’s anger, I have found that by communicating his or her needs simply and rationally, more is accomplished and quite often the client’s needs are met. This will, of course, help with healing further on down the line.

In this section, we presented several coping strategies for BPD clients that utilize self-talk slogans. We categorized lists of self-talk slogans into stages of anger arousal. These stages are  reassurance; triggering; physiological tension; and digressing.

In the next section, we will examine the various triggers of defensive anger in BPD clients. These triggers are criticism; fear of unworthiness; and helplessness.

Nisenbaum, R., Links, P. S., Eynan, R., & Heisel, M. J. (2010). Variability and predictors of negative mood intensity in patients with borderline personality disorder and recurrent suicidal behavior: Multilevel analyses applied to experience sampling methodology. Journal of Abnormal Psychology, 119(2), 433–439
Reviewed 2023

Peer-Reviewed Journal Article References:
Daros, A. R., Williams, G. E., Jung, S., Turabi, M., Uliaszek, A. A., & Ruocco, A. C. (2018). More is not always better: Strategies to regulate negative mood induction in women with borderline personality disorder and depressive and anxiety disorders. Personality Disorders: Theory, Research, and Treatment, 9(6), 530–542.

Kramer, U., Keller, S., Caspar, F., de Roten, Y., Despland, J.-N., & Kolly, S. (2017). Early change in coping strategies in responsive treatments for borderline personality disorder: A mediation analysis. Journal of Consulting and Clinical Psychology, 85(5), 530–535.

Vansteelandt, K., Houben, M., Claes, L., Berens, A., Sleuwaegen, E., & Kuppens, P. (2020). Self-criticism and dependency predict affective variability in borderline personality disorder: An ecological momentary assessment study. Personality Disorders: Theory, Research, and Treatment, 11(4), 270–279.

Vest, N. A., & Tragesser, S. (2020). Coping motives mediate the relationship between borderline personality features and alcohol, cannabis, and prescription opioid use disorder symptomatology in a substance use disorder treatment sample. Personality Disorders: Theory, Research, and Treatment, 11(3), 230–236. 

QUESTION 11
What are four stages of anger arousal that can be coped with using self-talk slogans? To select and enter your answer go to Test.

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