January 2020 Sanctuary Meeting – Christmas and Special Occasions, Dr Mario Naso

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Dr Maria Naso spoke to our January 2020 Sanctuary meeting about Christmas and Special Occasions.    The following notes were taken by Liz and Judy.


Special occasions and expectations

  • Christmas and other special events such as birthdays, Easter, graduations etc can be traumatic even in functional families – times of heightened emotions
  • Expectations can be a trap. We are all stressed if expectations are unrealistic and not fulfilled.
  • Social media – leads to too much comparison, has become a platform for narcissism. Is not real. More time on social media correlates with reduced happiness.
  • Be aware – of your expectations in new situations. Where do your expectations come from? If you’re disappointed, why?
  • At the next special occasion, be aware of your expectations now, and what may likely happen. Look for positives, savour and appreciate them. Don’t overestimate how happy you will be if you get what you want.


BPD – Maria’s criteria

  • Emotional dysregulation because consumer is so sensitive
  • Fear of rejection/abandonment
  • Sensitive personality structure
  • Low self-esteem. They hate themselves. No matter what, they feel they are worth nothing
  • Sense of internal emptiness
  • Boredom so their mind goes into nooks and crannies
  • Disassociation with extreme stress
  • All or nothing thinking
  • Destructive coping strategies. They do whatever it takes that they think will help
  • Anxiety is awful for all of us, but for our loved ones with BPD it is 100 times worse.
  • Life is so painful for them that they are like a person with third degree burns (Marcia Linehan)
  • They experience extreme devastation if a person is not nice to them


Effective Communication

  • Includes verbal and non-verbal. It’s not just what you say, but also how you stand, how you look
  • Defences come up and then there is no hope to help
  • Avoid misunderstandings/misinterpretations. They misunderstand all the time
  • We all get it wrong, that’s OK, we’re all human
  • Self-reflection is valuable and humbling
  • Self-reflection prior to communication can avoid disintegration
  • CLEAR and NEUTRAL – no innuendo. Be clear and factual so there can be no room for misinterpretation
  • If they are not in a good frame of mind they will twist things
  • Make space and time to sit with them and listen. eg don’t try to cook, be on your phone etc, avoid interruptions, summarise and clarify. Let them talk
  • We all deserve to be heard. No “yes buts”. Let him/her say what they are feeling
  • Don’t insult them. They already have low esteem
  • Agree to disagree


Threats of suicide

  • Sometimes need to call police
  • Too much responsibility for carers to decide how to manage/ what to do
  • “I got scared. I terrifies me to think I might lose you”
  • Xx
  • Xx
  • Xx (some points here that I missed)
  • Try to avoid angry confrontations


How to manage anger- theirs and our own!

  • Anger is normal. Accept that we too will get angry. Say “Stop, till I calm down”
  • Anger for our loved ones is driven by fear, fear that they will get dumped
  • Try not to be reactive
  • Consistent responses
  • Clear communication
  • Have boundaries in place
  • Treat all the children in the family the same way. Don’t let BPD person get away with things
  • Honest
  • If violent/aggressive, leave but say “I love you (not easy sometimes, Judy’s comment) and I’ll be back in 10 minutes


Helpful Tips

  • You are the most important person
  • Your own social, physical and emotional health are a priority
  • Space
  • Clear boundaries
  • Encourage and support
  • Hope is everything
  • Listen and reflect back the person’s distress – this is validation
  • Calm, non-judgemental, respectful.
  • It’s OK to say I can’t do this anymore



Planning for Events

  • Get support
  • Be realistic
  • Use distress tolerance activities
  • Say no
  • Distraction and time out for both carer and person we care for
  • Mindful of personal triggers
  • Appointments with therapist if able
  • Holiday/Special Occasion plan, but not too rigid:
    • BE proud, say no if don’t enjoy
    • Deep breathing
    • Put social media away
    • Spend wisely
    • Gratitude journal
    • Wander antique shops, conservation parks, and other nice places – make them yours.


Dr Maria Naso is a psychiatrist who works in one of our public hospitals and also in a practice in the city. She is very knowledgeable and passionate about BPD, its treatment, the use of medication, and improving the way clinicians see the illness She is a member of the BPD Foundation SA branch, and works part time at our BPD Co.

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