Personality Disorders & Relationships: The Tools You Need [MedCircle LIVE]

[Music] i'm very excited for this dr romney this was our first ever med circle live event and i love it see people joining us right now welcome and uh we we we posted one instagram post on our instagram and i thought you know 100 slots that's for that's plenty and it was it was sold out in a couple hours it was done and so we had no more it's great i hope a lot of people get their questions answered because that's information's power so yes yes well as people uh start to log on thank you for being here i know a lot of you are brand new to med circle maybe you've seen a couple of dr romney's videos on youtube maybe you've gone to the med circle site and seen some stuff but we're going to go in depth and i want to make sure that the majority of our time today is spent answering your questions the questions you have specifically related to personality disorders and how you can be a better supporter in your relationships a better supporter for the individual who has a personality disorder is living with one and if you're someone living with a personality disorder perhaps some self help strategies from dr romney on that as well well we're almost at 86 people i'm going to give people a couple minutes i know it's corn i've got my computer is on a sheet on a pile of sheets right now so i've got my own little homestead office so we'll give people a little bit of time to uh get in here uh naomi thank you so much dr romney people are chatting in the chat uh so we are very excited to see you you guys are more than welcome to chat using the uh chat button at the bottom if you have a question for dr romney however use the q and a button at the bottom you can submit your question uh from there and we'll get to as many as possible i'm going to give them one more minute dr romney but as people are coming in what are you uh hoping to accomplish when we talk about personality disorders today well a couple of things is that your number one as we know and you know my work is very much on narcissism in general is that today i think is a special focus specifically on personality disorders so we really are talking about people who may you know you're seeing someone who might a person you're in a relationship with family member with who who has been getting therapy for this because odds are they wouldn't know they have a personality disorder unless they've been formally diagnosed and if people do have questions like what's the difference how do i know if they have a disorder or not i'll talk about that but i think that what ends up happening is that personality disorders are very unique in the relationship space because if there's such a risk of people personalizing what happens in this and you know just as like imagine you were in a relationship with somebody who was living with a substance use disorder okay so they may wake up or not you know wake up very late and be very irritable until they're using again a lot of people wouldn't personalize that irritability they say oh you know they're an addict they got to get their drugs and they're not getting their drug and they wouldn't blame themselves interestingly with the personality disorders people blame themselves when they're in those relationships because again personality disorders by definition particularly the ones i shouldn't say all the ones that the narcissistic borderline those kinds of personality disorders have associated with them a fair amount of interpersonal instability interestingly the other people in those relationships the the person who may not have the personality disorder tends to blame themselves and so that piece of it is why i want people to understand the boundary between you and them what responsibility what responsibility lies with them and to be very realistic about what it is you can do and how to take good care of yourself in one of these relationships so you can be there with someone but not get lost in the relationship and not get harmed by it quite frankly yes yes um okay well i'm gonna turn off my air conditioning since it's a little loud and i think we have a lot of people in our first live event so excited i woke up like it was christmas today uh thank you for putting in your questions there's a q a box on the bottom put in your questions there and if you feel so inspired right now i'm going to do it dr romney you can you cannot whatever you want um i am going to just take a picture of myself and put it on social media one thing that med circle is doing of course taking up the screen okay i'm just gonna do one of these like i'm gonna take it of the screen because i don't have such capabilities there you go yeah always you always don't quite understand how limited i am and look i don't even have the words that yeah i'll get up i'll get done yes i'll try that other thing you just told me to do but that just feels like a lot to me uh yeah that's i look a little crazy but my kids would say why don't you know how to do this but there we go all right and mental health can be a personal journey it can be one you share with family and friends i by no means want to pressure anybody to share what they're doing here today but for those of you who do feel comfortable sharing that you took time out of your day today to get educated on mental health uh that is a really courageous and proud thing to uh to share i think so if you feel uh strongly about that tag me tag dr romini um tag med circle and uh we'll connect on social media after this but let's get in to this discussion about personality disorders what types of relationship issues do you see in your practice dr romney treating personality disorders um in regards to how that affects the relationship so what i work predominantly with survivors of relationships people who are in relationships either if not full-blown personality disorders with relatively difficult personality patterns and and you know these are often high conflict antagonistic dysregulated manipulative kinds of relationships and many people have been in these relationships for years and have been second guessing themselves and been confused and assuming it was them and wondering what they're doing wrong for years my goal has often been in working with clients is to educate them about these patterns because sometimes that actually clears up most of the other saying oh i didn't even know this was a thing i thought i was doing something wrong especially when and again i talk about this word a lot so we might as well get it out you know right in the beginning so i'll use it is gas lighting gas gaslighting is a classical part of any relationship with somebody who has a lot of personality stuff going on and gaslighting is the denial of another person's reality it can take several forms including literally denying reality i never said that i never did that and yet you literally have the text message in your hand where they said that it might be things like you're being too sensitive you have no right to feel that way you know you're the one who has a problem um you know it's it's it's definitely it's either it's a deflection they'll minimize it you know there's um you're making too big a deal about this that tends to be the landscape of a relationship with somebody who has really personality issues particularly narcissistic personality issues and so it's helping clear the air and help them understand that's what gaslighting is your reality is being played with that's why you're so confused and for most people kyle these are what we call legacy issues they're issues that started in childhood they either had one or two narcissists narcissistic or other high conflict difficult personality parents and that can set a person up for thinking this kind of relationship manipulation is normal in fact abuse equals love the trauma bonded kind of a situation so it's helping people understand that history in addition people who do have histories of trauma are actually more actually more vulnerable to entering these relationships with people with high conflict personalities and getting stuck in them as though this is what love love is supposed to be confusing and upside down and i feel bad about myself and all of that like all of those things are almost equated in this toxic stew of love it's helping a person create a new paradigm of what a loving relationship is supposed to look like when we talk about personality disorders on med circle narcissism seems to be the most uh sought-out topic of the personality disorders after that we have borderline personality disorder very briefly what is that which one narcissism or borderline person borderline okay so borderline personality disorder is a personality disorder characterized by instability instability in emotion instability and mood instability and behavior and instability in relationships the person experiencing borderline personality disorder really really suffers with a sense of internal chaos almost at all times and all of this is very much fueled by a chronic fear of abandonment in classical pure borderline personality disorder the person is not only terrified of abandonment but really often very much devalues themselves they there's a lot of despair in this so there's the assumption of i'm no good i'm worthless of course people are going to leave me what do i need to do to keep them close and because of that there can sometimes be a sort of desperation in their communication and that can put other people off many people may feel manipulated in these relationships and it's not more often than not it's not intentional on the part of somebody with pure borderline personality disorder in the sense that they they don't know how to appropriately reach out to someone because imagine they're in a sense of panic and that's the best way i can describe it a person with borderline personality disorder often feel so much panic that they feel like they're drowning so when they go to be with their supporter the supporter feels like they're going to go down with them although they're trying to rescue them from drowning anyone knows that it's sort of drowning 101 is sort of like you have to get a person in a kind of a hold and get them out of danger but the borderline individual the person with that personality disorder often feels like they're they're drowning and they feel panicked and they feel in a chronic sense of psychological pain it's an incredibly incredibly difficult pattern and difficult legacy to carry so it can be very confusing for supporters of the person with borderline personality dr romney has a few series on borderline personality disorder at med circle at the end of this stream if you're watching live i'm going to provide some discount codes if you do not have a med circle membership so you can access those series and more um if you're watching this on replay you can fast forward if you want to get there otherwise it'll be at the end of this video i want to go through avoidant personality dr romney paranoid personality and obsessive compulsive personality disorder and could you talk about very briefly what those are and maybe some of the relationship struggles that can come with those disorders so those are all very different kinds of personality disorders i most often speak about for example narcissistic personality disorder a little less about borderline but narcissistic and borderline personality sort of live in the same section of the diagnostic world again very much characterized by you know instability dysregulation that sort of thing when we talk about paranoid personality we're in a different area of sort of the personality and the personality disorder kind of a world people with paranoid personality disorder literally do always feel like people are out to get them that people are watching them people are talking about them they're very suspicious they're very mistrustful to a degree that it's getting in the way of being able to establish any kind of meaningful relationship collaboration anything like that with anyone you could imagine a relationship with somebody who has paranoid personality disorder it's all but impossible the person with paranoid personality will seem very almost victimized they always feel people are out to get them there and as a result they can be people can experience them it's very combative and oppositional like you know they're out to get me and they're talking about me or you're out to get me and your friends are out to get me and you'll feel like i can't i mean there's it's almost like it feels impossible to integrate a person with that kind of personality into your life and as you can imagine close relationships are not going to be the strong suit of someone with paranoid personality my guess is actually that people may run into this more in a family member so in other words not a relationship that they chose but a relationship with someone who's already built into their life like a sibling or potentially a parent that lives in the part of the the personality disorder world that all almost tends to be a little bit more odd and unusual behavior that almost feels on the low end of psychotic but it's not it's just again it's incredible suspiciousness what's interesting is that suspiciousness and almost paranoid suspiciousness can carry through narcissistic personality so some people might be saying how do i know the difference between the two it can be because the person with paranoid personality won't have the grandiosity the entitlement they won't have those things okay but many people with narcissistic personality styles or narcissistic personality disorder can be incredibly sensitive to criticism to a level that it looks paranoid and because they are so they're so insecure people with narcissism are so insecure they kind of think everyone's out to get them out to steal their ideas out like they're they're like they want like they literally want people to sign non-disclosure agreements when they walk in their front door and like what are you talking about like this is a going out to dinner and so there's that that's also seen in narcissistic personality too now when we jump the rails to these other two disorders you're talking about avoidant personality and obsessive compulsive personality avoidant personality disorder is more of an anxious presenting personality style people with avoidant personality disorder actually look a lot like they have a another kind of a mental illness called social anxiety disorder people avoiding personality very much want to be with other people but they're so afraid of negative scrutiny that they're going to look foolish that people are going to criticize them they're so afraid of that that they either don't put themselves into a social realm or they avoid the situations altogether thus the name avoidant but the trick and i don't like the name of that because actually people with avoidant personality want to spend time with other people but they feel so socially unskilled that they hold back or when they do engage there's a sort of an awkwardness about it and they may even agree to do things that they're not necessarily comfortable with just so they feel like they could fit in people with avoidant personality may also have a greater risk for example of using alcohol to kind of lubricate social situations so they feel a little bit looser and more comfortable so that's you know that's and now for people with avoidant personality relationships can be difficult but i don't think impossible i think a person may experiencing that experience them is very slow to warm up very socially anxious may regularly sort of seek reassurance like is this a good idea like i will do anything you want i and so it has an almost dependent feel to it but what a person in a relationship with someone with avoidant personality may see is that it's very difficult to bring this person into a larger social group you're like hey let's go to this party they'll be like oh no no no no thank you and so it might be the kind of thing where you may get into a relationship like this but sort of helping this person into larger social situations and issues like that might be harder and then going to the last the the last personality pattern you talked about obsessive compulsive personality first of all i want to distinguish that from obsessive-compulsive disorder they're actually pretty different obsessive-compulsive disorder has more of an anxiety feel to it people who have intrusive unwanted thoughts and engage in in behaviors to help ease their anxiety such as washing their hands or checking a lock or ensuring that there's a lot of symmetry in their world people with obsessive-compulsive disorder also seek out reassurance a lot and they're very plagued by doubt that's very different than obsessive compulsive personality disorder again a very unfortunately named person all the personality disorders by the way were badly named i don't know if the dsm people were like out to lunch or what the heck was going on today but they're all badly named okay but so if i if i named them all i would call obsessive compulsive personalities sort of sort of you know pathologically rigid or something like that because that's what it is it's characterized by rigidity perfectionism um self-righteousness hyper-high levels of morality and a judgmental quality and about the probably the thing that is most common in people with obsessive-compulsive personality is they're workaholics they work all the time they derive a lot of their identity from working they judge people who don't work as hard they work to the detriment of their family their relationships everything okay and so people with obsessive-compulsive personality are really stingy with money like if you go if you go and get two cups of coffee with them and maybe you got a large and they got a small they'll expect you to give the extra 50 cents for the large coffee like they're really really they get into the minutia of those things they they keep records of all that stuff again there's a mean miserly almost quality to them and so not exactly very easy to have a relationship with because there's a lot of judgment there is this miserliness there's this um they're cheap but i don't mean cheap money just cheap with everything cheap with their time cheap with their affection cheap with their warmth it's just sort of this it's kind of like i don't even have to describe it like this holding back and restrictive quality they're very very rigid if you have a date at six and you got stuck in traffic they'll say well i'm canceling the day because i said six so no date you know so it'll feel really really rigid and uncomfortable they'll give you a gift and they'll say well we've decided to spend fifty dollars on gifts so please don't spend more than that and oh this year i spent 75 dollars on your gift so next year i'm only going to spend 25 on your gift like they'll go there they will go there not an easy relationship to have people with narcissism can have overlaps into that obsessive compulsive space yes okay so um we've talked briefly then today about narcissism person or narcissistic personality disorder and the traits of narcissism borderline personality disorder avoidant paranoid and obsessive-compulsive personality disorder rigid is on this chat as well she is our producer she's going to throw a poll up in front of you guys if there are any personality disorders that we would like to talk about that we have not talked about please vote very quickly so we can give uh some attention to the one with the highest vote so you should see that on your screen somebody while that's going on dr ramedy somebody asked a question on the differences between avoidant personality disorder and social anxiety okay here it's a very difficult differential in fact each year i always put my students in in my abnormal psych class like to help discern that difference i actually think the main difference would be what we'd call pervasiveness and severity people with avoidant personality it's a much more severe kind of a presentation like they're more they're more um uh more limited by their social anxiety it cuts across more different kinds of situations and so because of that because of that that pervasiveness and severity and frankly stability of it i think people with avoidant personality it looks more severe people with social anxiety will actually do pretty well with small groups so they'll they might do well with their closest best friends with their brothers and sisters even with a partner they get to know people with social anxiety will struggle when they're in maybe a larger group a lot of people social anxiety only have it in performance situations like if they have to give a speech a person with a void and personality it's almost like it's hard for them to ever kind of get out of that and in fact for some people actually a bigger issue with the differential is avoidant personality versus autism spectrum because we will see that sort of discomfort sometimes with social situations because a person on the spectrum is going to have many many other sort of social processing and potentially other issues that differential becomes clear but if in some cases it's not always clear particularly a person who's on the spectrum but is functioning in workplaces and all of that so by a landslide most people chose borderline personality disorder okay to discuss further so can you talk about this more than anybody you probably don't even need to be asked the questions what do people need to know when they are in a relationship with somebody who is living with bpd how can they be a great person for themselves and their partner a couple of things okay one thing i want to say because this is actually an i'm going to be frank with you kyle a very angry email i've gotten more than a few times and so i want to open with this point because i think that there are people living with borderline personality who think i don't understand this correctly and i apologize because i think i didn't articulate it correctly one of the biggest struggles is how to understand empathy in a person who has borderline personality here's a bottom line people with borderline personality have almost too much empathy most of the time they break themselves in trying to be there for other people and listen to them and really will actually put themselves at risk and harm to be there for other people where it gets problematic is when the distress for a person living with borderline personality becomes so overwhelming they're so despairing they're so fearful they feel so worthless and they feel so awful about themselves at those times they're terrified and it feels like their empathy has gone away it hasn't really gone away it's almost like it's being eclipsed by this internal pain that that person with borderline personality is feeling then the person with borderline personality feels intense remorse at not having been appropriately empathic at the time they were distressed and then they feel even more worthless and you see how that cycle plays out so to anyone who has heard that and if it has anyone on this call i do want to be ensured that that got heard properly because i may have said it quickly once and it may have come out insensitively so i apologize because i i work with clients who live with borderline personality i know how despairing they are how much pain they are in it is it is incredibly difficult for them so i think let's start with that number one this person is in a tremendous amount of pain okay and so i can't just explain it it's as though they're they're drowning and these voices in their head are just saying you are no good and everyone's going to leave you and it it feels real okay there i interviewed someone with bpd and they told it to me like this they said imagine trying to feel whole to feel full but no matter how much you felt you filled yourself up it was like shoveling dirt into a bottomless pit they could never feel full but craving that their whole life yes craving that and in them and often very so kind almost too kind they're here's the here's the paradox of a person with borderline personality classically and i am talking about pure borderline okay i and some people call it a quiet borderline all right and there's there's a variant of borderline i can get to in a moment that can sometimes get more challenging but in the case of sort of the pure quiet borderline okay that the the person is in so so much pain and they are they will be so kind almost too kind to other people they give the best of themselves to other people they have so much empathy for other people i work with people who are borderline personality who are health care providers and who are teachers when i tell you they don't go the extra mile they go the extra thousand miles but then they exhaust themselves and so i think that's the struggle is helping them find that balance of i just i tell any borderline client a person living with borderline i work with can you be as kind to yourself as you are to me and to everyone else we could even get you there like we'd be so good and so you guys that that's a moment i mean there's 165 people watching this live right now every single person who just heard that i don't care if you've never been told you were even close to bpd why wouldn't we all take that advice remember that yeah most don't to ourselves and and people who live with borderline personality are they are so unkind they're cruel to themselves so i think that if somebody's living with someone with borderline personality you've got to stop be mindful and catch yourself and recognize this person is in pain and before you start yelling at them and getting impatient with them it's no more than you would scream at anyone who isn't like somebody was bleeding in front of you you wouldn't yell at them and say stop that bleeding you would say how can i help you and you would get down and you would help them so i say to people who are supporters of and love people and care for people who have borderline personality breathe and understand they're not acting this way to ruin your day they're hurting and that it is that's number one number two is it's absolutely essential that you encourage and support their attendance and treatment and i would say if you're supporting someone whether this is your partner your friend a family member please read about it there are some magnificent books out there about borderline personality you know there's one it's called the essential i think the essential family guide to borderline personality read it because if you could understand this then it may be an opportunity to say ah i get this and this is what's happening now i was recently talking with someone borderline personality and she said i am about to get really angry at you and yell at you and it's because i am falling apart inside and i'm in so much pain i don't know what to do with the pain i actually thought that was great because i'll tell you what ended up happening for me was i was prepared and i understood she was in pain so while it wasn't easy to listen to i knew it wasn't targeted at me i happen to be the human being with right now and i thought from a loving place instead of making it personal let me just reassure and say it's okay you know is there something else we could be doing would you like a little time and space for yourself and i'll just be in the other room kind of thing to let them know you can be safe i'm not going to abandon you i'm not going to run away from you but what would help you how can i help you now watching your tone of voice and all of that to understand again there is a lot of despair but on the flip side kyle you also need to take care of yourself because it can be difficult taking care of somebody or loving somebody who may at times lash out at you and so you want to be a good supporter how are you a good supporter you take care of you just as i want the person who's living with borderline personality to learn to take care of them but that that's going to be a requirement of any person so if somebody i noticed that someone had made a comment about the book walking on eggshells that's also another important book because it really does deconstruct you know how to communicate with someone who's living with borderline personality without personalizing it because that's the key this isn't personal they are struggling with something and so it is not about you it's about them yes i love that it's not about you it is about them it's their journey it's their experience yeah um i want to go right into our questions i want to get to as many as we can our first question comes from an anonymous attendee how do i tell if you're gaslighting herself and how do we recognize the difference between our own anxieties or paranoia if you will versus someone gaslighting us what if we're so far gone that you now lose trust in everyone and yourself and become as hyper-sensitive as a narcissist catch yourself catch yourself the first time you say to yourself i think i'm being too sensitive i think i'm making too big a deal of this stop pay attention and ask yourself the question sorry um sorry about that um but maybe you know take a step back and say okay let me break this down because the minute you say i think i'm being too sensitive there's a real strong likelihood you are gaslighting yourself so then break down the situation in front of you and say what is happening here what was the stimulus how am i reacting to this do i have all of the information so it's all of those things that you to be aware of you know how are you how how are you reacting in the situation but take every gaslighting statements ever said ever been said to you you're being too sensitive um that never happened you're making too big a deal and if you're saying things like maybe i'm being too sensitive ah maybe i'm wrong maybe that never did happen maybe i am making too big a deal out of this odds are you are gaslighting yourself and at that moment catch yourself stop and ask the question am i am i how am i reading this situation it's really about learning to be present with yourself i tell people that one of the most sacred parts of yourself is your reality don't let anyone take that away and here's the thing to say i'm being too sensitive is to judge your own reaction you know i mean it's to judge your own reaction and so to me that's a judgment and that's not healthy who's to say there's no sensitivity leader in the world there really isn't so once you say no i am i am feeling i am having a feeling if you can change i am being i feel i'm maybe i'm being too sensitive into i'm feeling hurt now i'm feeling anxious now turn it into the i am feeling statement now you've brought yourself back into your reality and instead of judging your feeling you're naming your feelings i think that's a great pushback on gaslighting no i get it you you told me that once we did uh it's on youtube a live therapy session you and me on on my uh on my issues and you go kyle you're judging your own feelings in your own emotions like oh my god i totally am i'm totally doing that great question thank you for doing that um let's go to our next question guys when you thumb up a question uh it goes to the top so if you see a question that you really like give it a thumbs up why are psychotic or a psychopathic and sociopathic people and people with bpd attracted to each other and what are the long-term effects likely to be on the children of such a couple okay so let's first start by talking about the trauma bond because i think that the idea of the trauma bond gives people a tool to understand a lot of these kinds of relationships okay the trauma bond is what a person learns early in life a person who's had early relationships in life carried characterized by chaos invalidation manipulation and confusion or abuse will then because their early relationships during childhood conflate or confuse those kinds of things in validation and manipulation with love because that's your earliest sort of depiction of love then as you get into adulthood relationships that have those qualities of invalidation or abuse or chaos get equated to love and are almost impossible to break just as when you were a child you made justifications for that person's behavior for their invalidation and all the rest of it you'd make the same kinds of justifications as an adult and that trauma bond can feel almost impossible to break well as you can imagine a person who has a very vulnerable and fragile and unstable personality style as we might observe in a person living with borderline personality or who has borderline traits who may then fall into a relationship with somebody who is very egocentric who is very manipulative who's invalidating and cruel you could see how that that could replay an earlier narrative create a trauma bond and the person with borderline personality who maintains such a severe fear of abandonment will stay in that relationship not understanding it and the person who it might be more psychopathic or narcissistic will take advantage of that knowing this person ain't going anywhere and that will sustain so sadly that cycle this is why people understanding the trauma bond and this is what some people say but the other kind of relationship doesn't feel as interesting to me that's okay because in your case interesting and those bonds are not healthy and that may very well be that not very interesting initially is healthy and so it doesn't have the same kinds of old evocative nostalgic sparks to be honest with you so those are the things to keep in mind on why those personality styles may be drawn the psychopathic sociopathic narcissistic people tend to exploit a person in a relationship a person with a more fragile personality style is very easy to take advantage of and that's how that terrible partnership can take place well this uh is on the same topic an anonymous attendee asks is there even a remote possibility of having a healthy romantic relationship with someone diagnosed with bpd with the help of therapy absolutely i i truly believe that i think that this is where you know we know that people who are living with borderline personality they bet the treatment of choice is something called dialectical behavioral therapy dbt has a very strong mindfulness component to it and helping this the black and white of borderline personality turn into better tolerance of the gray i there is no two ways about it a person in a relationship with somebody with borderline personality should join well-run support groups or group therapy with people who to have those conversations about what works and what doesn't work okay because i think that what you you'll find then is to the degree that a person is in a relationship with someone with borderline personality to understand that yes there will be a need for reassurance there will be a need for sort of how safety is set up you know that i'm going out i'll be back at such and such a time so if you say to your your partner who's living with borderline personality says i'm going to be home at 6. now it's 5 40 and you're not close to home say i want to call you there was a crisis at work i just wanted to let you know that it's probably going to be closer to eight everything's okay you don't just roll up at eight o'clock that's right home work right and so you love so many other things about that we all make compromises for love kyle we all do nobody we fall in love with is perfect and none of us are perfect either we all have our thing and i believe that with communication with understanding and also for the partner to understand that there are moments in a person's life who's living with borderline personality that they are despairing that they may feel chaotic and out of control that's not about you and it's not always your job as that person's partner to fix it i highly recommend that somebody who's in a relationship with borderline personality get educated about the techniques of dbt and if anything maybe even figure out like work with a couple's therapist who has a dbt background who then can guide you to how to be a good supporter for that i absolutely think it's possible but it's a commitment on from both partners it's work and i actually do think that couples therapy on a regular basis would sort of be an essential part of that of a relationship being healthy in that way um on med circle if you do not have an all-access membership at the end of this i'm going to give you guys a discount code that you guys can use to try it out but you can also start with a free trial in our all access library dr romney has a full series on what borderline personality disorder is she has another series that's uh targeted to fan to the family members and loved ones and it's strategies for living with someone or being in a relationship with someone who has bpd we also have great patient spotlights on that as well so make sure you look that up if you're interested in bpd in the chat dr romini people were asking but what if my what if my partner with bpd is not going to get any therapy what is the likelihood of me having a healthy relationship with them yeah if your partner with bpd it's not going to get therapy i don't see it i really don't because i do think that the very qualities of borderline personality which can make relationships very fraught spaces that first of all that shows a lack of commitment to the relationship right because that's something that's going to be healthy for the relationship and this person's saying no i'm not going to do this thing that's that's respectful of the other person in the partnership so this has nothing to do with bpd this has to do with anyone if you're in a relationship with an addict if you're a relationship with anyone who says yeah no i'm not going to get help for what i'm struggling with then no that's showing a lack of commitment to this thing and i think it's probably worth mentioning what we're discussing here are people living with bpd not somebody who watched you know a video on youtube and diagnosed their partner with bpd no no no no no yes there are so many people who go i think my girlfriend has bpd so you can't you're not unless you're a therapist or a psychologist you can't even then we really can't i would i would not diagnose someone i i'm close to yeah yes uh let's go to our next question what advice do you have for someone moving forward forward when they've cut off their family due to toxic toxicity emotional abuse i'm in dbt which is dialectical behavior therapy for bpd and ptsd and i feel a bit overwhelmed by all the work i need to do moving forward to have a healthier relationship and to unpack what happened to get me uh what happened to me growing up she also says thank you dr romney for helping destigmatize bpd because things do get better good i'm glad i'm so first of all that's the most important thing of all that but i i think that question is important on so many levels which is this is a lot of work yeah it is a lot of work however you know what kyle i don't think a lot of people are doing all the work they should be doing in in therapy i'll be honest with you like a lot of people out there are walking around thinking that they've got nothing going wrong with them and there's a lot of challenges there are challenges they're encountering my my read on that question was initially this person has said that they have created some distance between them and their family of origin as part of working through this process a part of db gbt in any form of therapy is to give yourself permission to create safety in any way that you need or want and listen some families are are open to it and some aren't it sounds like the person who wrote this is saying you know this is not going easily this is not easy like i feel that my family of origin system was toxic and i had to create a boundary the idea of creating safety for yourself is a big theme in borderline personality a lot of people living with borderline personality don't feel safe and so the big part of the issue is learning how to keep yourself safe and that means setting a boundary her family of origin may not like it and they may even be being very difficult with her as a result of it which can also be replaying out all of this trauma i'm really happy to hear and this is her question raised is something very important people living with bpd should always also be doing trauma-oriented work and dialectical behavioral therapy in and of itself is not necessarily designed to deal with trauma it's not a trauma-oriented therapy per se it's a very mindful in the moment oriented therapy and it's real gift is also managing some of the dangerous suicidal crises we see in borderline personality as well as the black and white thinking and all of that an enhancement of dbt with trauma-oriented therapy whatever form that takes it could be emdr it could be something else that to me is the perfect pairing yes it's a lot of work but on the other side of that can be a very very productive mindful healthier life living with borderline personality i think i mean it's work it's work it is when you mention the emdr our next question was can emdr i've lost the question i think i think she asked or the user asked can emdr is there any evidence on emdr being used for somebody who has uh suffered the abuse from a narcissist that's a really great question so for everyone to know emdr is a very particular specific form of trauma therapy that focuses on using sort of a present focused event and in this case sort of how you focus on eye movements and then being able to use your traumatic and focus on traumatic experiences in a way that they're not as paralytic and i'm simplifying it to a fault it means obviously much much more nuanced than what i'm saying here i think that emdr is it can be used for any kind of traumatic experience what an emdr therapist is probably going to work on with you is not just the trauma from the relate the narcissistic relationship but it's going to go on into earlier trauma from early in life that may have been sort of the um the foreshadowing of entering into this relationship and help you understand how you might have even gotten stuck in this traumatic space and how so yes it could help you with that for sure but i think in addition to a trauma focused therapy like emdr to help with narcissistic abuse you would also need to work with someone or if the mdr therapist gets it i'm not getting educated about narcissistic abuse how it's specifically played out in your case and how to ensure that it may not happen again excellent uh naomi hi welcome to uh the med circle live event she asked can personality disorders be connected to various forms of childhood abuse and if i go through the work of dealing with my childhood abuse will my avoidant personality disorder get better or even go away that's a great question so the fact of the matter is much of the research suggests that nearly all personality disorders do have an origin into childhood experience and in many cases yeah childhood abuse they tend to be very developmental in their arc they reflect experience disruptions and attachment in in something that tend to happen in childhood however however kyle more and more research is coming out all the time showing some level of a biological temperamental vulnerability in the case of borderline personality and certainly and even in psychopathy we definitely are seeing that there might even be genetic involvement there's definitely brain areas that are involved in terms of dysregula dysregulation and so we know that there's a biological piece in fact marsha linehan's model for understanding borderline personality is called a biosocial model where she looks at biological vulnerability up against parental invalidation but that parental invalidation piece is really really important so just about all personality disorders have their origins in childhood it's interesting i was just writing a lecture on avoidant personality yesterday so this is fresh in my mind on um one thing we know is that for people who have avoided personality disorder some of the origins of that may be if you come from a family where shame was used as a method of discipline or control that there's this sense of you're a shameful person your social interactions are shameful and so for i think you said naomi naomi's question is that absolutely doing some of that deep dive into childhood issues can definitely sort of help you understand where some of these early schemas and narratives came from and once you start understanding some of that you can start dismantling them awesome awesome well said uh naomi thank you great question remember if you go to the q a section at the bottom you can vote up your favorite questions so they go to the top next up is steve steve thank you for being here steve says dr romini in your opinion are there any personality disorders which have not yet been formally identified but maybe in the next 10 or 15 years that's a really really really interesting question i actually think that to steve's question what we're going to see it's less of what hasn't been identified but rather the subtypes of the existing personality disorders we have does that make sense so we know we have personality issues we know about all of which need to be renamed but within those there's likely subtypes uh theodore milan is a was he's passed away he's a well-known personality researcher and he was somebody who had already started on that path like for example when it came to borderline personality he identified subtypes of borderline personality discouraged submissive so on so that that subtyping is where we're going to start seeing for example in the narcissism world we talk about covert narcissists grandiose narcissists uh malignant narcissist i think the subtyping is really where the money is going to be but to steve's question there are other personality disorder types that have been floated that have not landed in the dsm i don't think they ever will land in the dsm but people like milan's theodore milan's framework and others like that have talked about things like negativistic personality and that's more of a sort of a self-defeating passive aggressive personality style that style can often be a little overlapping with um with narcissistic but it doesn't fully capture it we may also see more of um what we call a self-defeating personality style a person who actually consistently almost gets in their own way through negative sort of ideation and then there's also been talk of the more malignant side of a truly sadistic personality style somebody who gets pleasure out of deliberately asking harm i'm sorry creating harm to other people so these are subtypes that already exist but that never fully landed and they're you know so there's always new ones sort of being developed but getting the research substantiation can be hard but those are some of the other ones that are floating out there okay good to know uh tierra says my daughter is 11 years old diagnosed with dissociative identity disorder how can i find her the appropriate help all counselors in our area only work with teens or adults that's a tough one so when you have an 11 year old who is having dissociative symptomatology you know i'm going to i'm going to guess that business the majority if not almost almost all individuals living with dissociative identity disorder which by the way is not a personality disorder this is a separate cluster of of mental illnesses which i actually think should belong alongside trauma-related disorders because almost everyone with dissociative symptomatology has endured trauma that her daughter has endured trauma and so i would say that in that case if she can't find someone who's specifically did focused that she would do well working with somebody who has tremendous expertise in working with childhood trauma and understands the dissociation that occurs in people living with childhood trauma so just simply finding trying to find a specialist in d.i.d might keep ending up on a dead end because very few of us specialize and i can think of one person who's ever been brought to my attention who does work in that area it's pretty rare however finding a very very very good child pediatric child trauma therapist because people do a lot of work in that area they should be able to understand the dissociative symptomatology that her daughter is experiencing as well and i really wish her strength in that journey because that is not an easy journey to be taking and to watch that happening for your child absolutely uh leah is here leah thank you for being here she asked how can someone access emotions and get them out i hold my emotions in and struggle to feel them leah it's like you're asking my question i have so much built up but i have so much built up but i'm scared to let them out so i guess the first question would be if you're if she was in front of me i'd be like what are you afraid of i would love to direct her to some of the wonderful work out there on acceptance and commitment therapy because a lot of the work of acceptance and commitment therapy is like there's all this stuff happening in us and it's good like it's all good there's no feeling that's going to break us it may make us uncomfortable but that on that discomfort is okay you can accept that that's simply part of being a human being but i think the question would also be for her is what is the message she got earlier in her life about what emotion means what does it mean to show emotion a person may very well have been taught as a child don't show emotion emotion is shameful how dare you we might have seen she might have very well seen people being punished for showing emotion so it's also what it what are the what were the earliest teachings on what emotional expression means and for some people they feel like once i open up this floodgate i'll never be able to stop trust me again back to your acceptance commitment therapy you will be able to stop it'll hurt but you will be able to stop and letting it go will actually set you free unfortunately though kyle and this is i really want to let her know there's also we live in a society where everyone's uncomfortable with feelings imagine you go to dinner with someone and they say you know i want to talk about how i'm feeling i'm feeling i'm really despairing and i'm in a lot of internal pain and the other person's hands is like well i just want to find out what movies you've been seeing we don't want to talk about pain we don't want to talk about it and yet to me that's the problem because it's as though it's shameful to talk about pain your pain isn't shameful your pain is beautiful it's part of who you are and if we could just get out of our own way questions like hers wouldn't be something that so many people are struggling with because somehow we think it's untoward and if somebody does talk about their feelings they're labeled as being odd or weird or something like that we stigmatize people who talk about their feelings so we need to catch that you know that again it is these difficult experiences there's that roomy quote rumi's a poet who wrote the wound is where the light enters you your pain is your magic your pain your pain is your power you know own it harness it and don't let anyone else tell you it's ugly oh wow excellent um i'm so glad you mentioned acceptance and commitment therapy i just listened to our series on that two days ago i was even talking about it on instagram and uh my big takeaway from the using the first or second session of that series was when i have the feeling like i'm um you know i'm i'm a i'm a bad uh son or i'm a bad brother or that person doesn't like me instead of that thought putting the the i don't know what you call but a segment before it that says i am having the thought that nobody likes me i am having the thought that i'm not a good uh son and that separation allows you to work um from or to that thought i guess rather than than from this thought that may not even be true uh i i it's a great series a c t love it um okay we got a seven minutes i'm going to ask some people are asking questions there will be a recording that sends out to members who signed up for this uh med circle live event thank you um there will be no way we're going to be able to get to all of these questions there's you know a few coming in every single minute however we will be doing more of these in fact i'll just give everybody right now we'll do one more question from dr romini and then we'll wrap up but um we are doing another one of these tomorrow um our med circle live event tomorrow is for our all access members only it'll be a smaller more intimate uh meeting dr romney will be here it'll be on personality disorders communication styles and relationship tools and also another chance for you guys to ask her your questions if you already have a med circle all access membership you're good to go you can register all good if you do not have an all-access membership but would like one you can start with a free trial you get seven days for free you can even just go sign up for the free trial then you're an all access member come to our event tomorrow um and you will get in we also want to provide you with a code for 25 off your first month first month just use romini 25 at checkout for your monthly membership romney25 we'll have bridgette put it in the uh in the chat here this code is time limited i actually don't know how long they'll be a good uh so but i would say a couple days or so so make sure that you if you are going to do it do it sooner rather than later there it is romney 25. um we also have a brand new med circle app you can download it for free there are free series available on the app there's also dr romini's entire video library on the app as well and you can start there melanie asks how much is the all-access monthly membership is twenty dollars a month start with a seven-day uh free trial or you can do a 120 for the year it's the best deal you pay it all up front as 120 but make sure you use romney 25 at checkout for those monthly memberships uh let's go to another question dr romney thank you for all of your time today um anonymous hello anonymous ask can you talk about high functioning bpd what does that really mean a psychiatrist once told that to me because i was in grad school at the time and i have a career but still struggling with bpd i'm so glad she asked that question because here's the thing so many people say oh i have bpd i'm not going to be a functioning person the heck you're not in fact look at dr marshall linehan who has been very public about the fact that she lives with bpd and dr linehan herself has sort of revolutionized how we manage this uh how we manage borderline personality disorder i work with colleagues who who live with borderline personality i have clients who have borderline personality have amazing careers so i think this idea is that i think all many people would not say all of any of us but many people living with borderline personality definitely have that opportunity to be a person who's high functioning living with borderline but it is also understanding that there is often a struggle there's a depletion that comes from some of that internal despair and some of that internal dysregulation and the um and the and the negative feelings that are constantly coursing and some of again the fears that can really sap a person of confidence that could lead to second guessing in a workplace situation that may even contribute to sometimes there being some difficult interactions with colleagues who may or may not understand where you are coming from so i think that that question raises the absolute critical issue of treatment and access to treatment everybody out there living with borderline personality had access to long-term consistent dbt as well as enhancements including trauma therapy and support groups we wouldn't be viewing this as this big clinical morass would be viewing this as a manageable mental health issue we've managed to make we've managed to manage lots of physical health issues in our world but yet mental health still remains this very marginalized space this is about access this is about everyone who's living with any mental health issue right now we're talking about borderline is that you absolutely i of all the personality disorders i'll be frank with you borderline personality is the one that's been subjected to the most evidence-based clinical trials and has shown real promise in terms of treatment so i think anyone on this call who's living with borderline please understand that in some ways it's lifelong work but i'm convinced everyone's mental health is lifelong work every one of us will be doing the long-term work on our mental health i think we view it as a one-off and i think that's an amazing question to end on because this idea that you know somebody she's it sounds like she's an incredible career and yet she's acknowledging some days are harder than others but she's doing the work and i think if you do the work there is tremendous tremendous possibility dr romney wonderfully said i just want to let everyone know in the chat i have linked to dr romini's med circle page you can get her books there learn more about her in fact she has a great uh meet the doctor video that's never been publicly released it's just sitting on that website so a little secret easter egg there for you um dr romney always wonderful to see you i hope we can see each other in person very soon and i'm very excited to see you tomorrow for our all access yeah circle live event hopefully we'll do a lot more of these uh we take your feedback very seriously med circle members so when you email support medcircle.com that goes to me i read every email we go through it we do not just you know reply and move on to the next thing we track it we want this to be valuable to you i really appreciate everybody showing up here i really appreciate all of you that share med circle with your family and your friends and uh who and you guys are working to destigmatize mental health to make this conversation normal to make mental health a part of our everyday dinner conversation and so thank you for showing up and doing this we sold out in like a few hours so it was amazing you guys are great and we're going to keep doing these awesome awesome uh dr romini you're the best and remember whatever you're going through out there you got this

Channel: MedCircle

Views: 318,976

Rating: 4.8793969 out of 5

Keywords: personality disorders, dr ramani, medcircle, kyle kittleson, personality disorder, personality, disorder, disorders, relationship, relationships, tools, advice, help, mental health, mental illness, borderline personality disorder, bpd, narcissism, narcissistic personality disorder, narcissist, borderline, histrionic personality disorder, antisocial personality disorder, schizoid personality disorder, paranoid personality disorder, schizotypal personality disorder, avoidant personality disorder

Id: Jr9oIxOwOFQ

Length: 58min 16sec (3496 seconds)

Published: Tue Aug 11 2020