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In this section, we will discuss communication in treating faulty perception. Three aspects of communication as related to the BPD client include reflex communication verses conscious communication and the connection between shame and blame. We will also cover the "Three Steps to Conscious Communication" technique.
Three Aspects of Communication
♦ Aspect #1 - Reflex Communication
♦ Aspect #2 - Conscious Communication
Reluctantly, Leah agreed that to communicate more effectively, she needed to learn about what motivated her to speak and behave in non-productive ways. Essentially, when Leah decided to learn more about how and why she reacted in certain ways, she decided to become more conscious about herself. Do you agree that by focusing on themselves rather than faults in others, BPD clients like Leah can begin to depend less on reflex and more on conscious communication?
♦ Aspect #3 - The Connection Between Shame and Blame
For example, Leah’s boyfriend, Mike, mentioned Leah’s adolescent drug abuse problem. Leah felt shame because she was not proud of her previous chemical addiction. The result was reflex communication when Leah lashed out at Mike and accused him of not supporting him. Leah stated, "I hate it when Mike brings up the past. The other day he referred to me as an addict and I got so mad. I said, ‘Well you don’t know what you’re talking about! It’s people like you that push people like me into using drugs in the first place!’"
Clearly, for Leah, the connection between shame and blame led to ineffective communication. Think of your Leah. Is shame and blame a recurring problem for your BPD client? If so, you might consider the Three Steps to Conscious Communication technique to be explained next.
♦ Technique: 3 Steps to Conscious Communication
Leah stated, "If I know why something is happening or if I know why someone says something, I can better understand it. But sometimes I just get so confused." If your BPD client, like Leah, has trouble empathizing due to an altered perception of reality, later in this course we discuss additional techniques. However, by giving clients like Leah the tools for conscious communication early, I have found that techniques for implementation of the "Three Steps to Conscious Communication" technique are sometimes accepted easier in later sessions. Would you agree?
In this section... we have discussed communication. Three aspects of communication as related to the BPD client include reflex communication verses conscious communication and the connection between shame and blame.
In the next section, we will discuss rejection concepts. Three common rejection concepts regarding BPD clients are personal attacks, perceived judgment, and self deprecation.
Peer-Reviewed Journal Article References:
Bedics, J. D., Atkins, D. C., Comtois, K. A., & Linehan, M. M. (2012). Treatment differences in the therapeutic relationship and introject during a 2-year randomized controlled trial of dialectical behavior therapy versus nonbehavioral psychotherapy experts for borderline personality disorder.Journal of Consulting and Clinical Psychology, 80(1), 66–77.
Bedics, J. D., Atkins, D. C., Harned, M. S., & Linehan, M. M. (2015). The therapeutic alliance as a predictor of outcome in dialectical behavior therapy versus nonbehavioral psychotherapy by experts for borderline personality disorder. Psychotherapy, 52(1), 67–77.
Kliem, S., Kröger, C., & Kosfelder, J. (2010). Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling. Journal of Consulting and Clinical Psychology, 78(6), 936–951.