This was released as Episode 379 of Counselor Toolbox Podcast with Dr. Dawn-Elise Snipes. You can find specific episodes and CEU courses based on the podcasts at https://allceus.com/counselortoolbox You can also subscribe on your favorite podcast app like Apple Podcasts, Google Play or Castbox.

1. Treating Addictions and
Borderline Personality Disorder
Symptoms
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
Host: Counselor Toolbox Podcast
AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89

2. Objectives
 Review the characteristics of BPD and
Addictions
 Explore the functions of these symptoms
 Identify interventions to help the person more
effectively manage emotions and
relationships
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3. Internal Reality
 Lack of a sense of self—If they aren’t
someone’s something, then they are
nothing
 Unlovable for who they are
 Constant fear of abandonment
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4. Consequences
 Lack of emotional boundaries
 Anger is used to control others and is rewarded
 Emotional dyscontrol
 Inability to self-soothe/Impulsivity
 Lack of coping skills
 Relationship problems
 Physical health problems and complaints
 Cognitive distortions are reinforced
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5. First
 Identify the most salient symptoms
 Their function (and alternate ways to meet that
need)
 Identify what it looks like for that person
When X happens, how do you feel? What do you
think? What are your urges? What do you do?
 How that behavior is being maintained (what are
the benefits and other ways to get the same
benefit)
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6. Frantic efforts to avoid real or imagined
abandonment
 Function: The person only knows how to exist as a
role, such as being someone else’s spouse/parent etc.
(Co-dependency)
 Preventing abandonment means preventing death or
dissolution
 What does it look like (Benefits/Drawbacks)
 Hypervigilant/hypersensitive to rejection/criticism
 Anger at/belittling others to control them
 Acting out to control through guilt, manipulation
 Emotional dyscontrol
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7. Abandonment cont…
 Origins
 Failure to develop a sense of self due to constantly
trying to appease the caregivers
Addict –Don’t Talk, Don’t Trust, Don’t Feel
Borderline –Do as I say or else…
 History of abandonment/rejection/CPR
If they are something to someone then they are filling
a need and are less likely to be abandoned
History of neglect/abuse (You (as a person) are not worthy of
love)
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8. Abandonment Cont…
 Interventions
 Develop a sense of self and self-esteem
 Differentiate between who you are and what you do
 Explore what makes someone/something “lovable”
Dogs/horses
Children
Others
Which of those characteristics do you have in yourself?
 Identify and address messages/events in the past
that communicated unlovability
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9. Abandonment Cont…
 Interventions
 Explore the notion of responsibility (Who and
what are you responsible for)
Not responsible for the parent
Responsible for you
Nobody else can make you…
 Explore and address abandonment/rejection
triggers
Is it about you? What are alternate explanations?
Explore faulty thinking
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10. Relationships are Unstable
 Function: Controlling others provides a feeling
of safety and predictability
 What does it look like (Benefits/Drawbacks)
 Intense and unpredictable interactions
If you do what I want, I love you
If you do not, you are rejecting me and I hate you
 Everyone walks on eggshells
 Jekyll/Hyde
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11. Relationships are Unstable
 Origins
 Children were rejected (or the caregiver was
unavailable) at an age in which they were still
thinking in concrete, all-or-nothing terms
 The A/B expects rejection and has never experienced
an authentic relationship with self-or others
 Inability to self-soothe is terrifying and the A/B fears
they cannot cope on their own
 Repeated rejections become most salient and
support all-or-nothing thinking
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12. Relationships are Unstable cont…
 Interventions
 Use CBT to explore and address perceived rejection
From others in real life
From the gallery/hecklers
From yourself
 Use contextual approaches to separate REactions to
the present
 Differentiate dislike of actions/ideas from dislike of
person (People can disagree or dislike something you
do but that doesn’t mean they don’t like you
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13. Relationships are Unstable cont…
 Interventions
 Learn to identify and assertively communicate needs
and wants
 Explore characteristics of healthy relationships and
address parts that feel scary
Honesty
Trust
Hope
Faith
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14. Self-Damaging Impulsivity
 Function: Distraction/Escape
 What it looks like (Benefits/Drawbacks)
 Self-harm
 Spending
 Addictive behaviors
 Violence toward self or others
 Overly sexualized behavior
 Origins
 Lack of coping skills in the face of overwhelming emotions
 Inability to self-soothe
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15. Self-Damaging Impulsivity
 Interventions
 De-escalation/Distress tolerance
 Self-soothing
 Mindfulness
 Coping skill development
 Vulnerability prevention
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16. Transdiagnostic Interventions
 A/B both have high levels of HPA-Axis
overactivation and corresponding physical,
emotional and interpersonal issues
 Vulnerability Prevention
 Sleep
 Nutrition
 Pain management
 Temperament
E/I
J/P
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17. Transdiagnostic Interventions
 Acceptance & Tolerance / Serenity
 Urge surfing/Don’t swat the bee
 Distress Tolerance
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 Activities
 Contribute
 Comparisons
 Emotions
 Push Away
 Thoughts
 Sensations
 Imagery
 Meaning
 Prayer
 Relax
 One at a time
 Vacation
 Encouragement

18. Transdiagnostic Interventions
 Mindfulness/Honesty/Wisdom
 Increases awareness of
The present moment wants, needs, sensations, thoughts,
feelings in the present moment
Picture test
5-4-3-2-1
Picture memories and sensations
Scent memories and sensations
Sound memories and sensations
Current: Sensations, physical cues, emotions,
thoughts, urges, needs
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19. Transdiagnostic Interventions
 Mindfulness/Honesty/Wisdom
 Increases awareness of
The influence of the past on the present
Similar situations in the past The present situation (objective)
What I learned about myself, How I am different now
others and the world What my current needs are
What I did to protect myself/survive The best use of my energy
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Present
I feel,
think,
want to…

20. Transdiagnostic Interventions
 Psychological Flexibility
 The serenity to accept the things I cannot change
 The courage to change the things I can
 The wisdom to know the difference
Reactive behaviors Active behaviors
(What I want to do) (What I could to do toward a RML)
Reactive thoughts/feelings Reactive thoughts/feelings
(What I want to do) (What I could to think toward a RML)
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The
Present

21. Summary
 People with BPD first need to learn how to
safely deal with intense feelings
 Specific Issues which may trigger intense
feelings and interventions include:
 Poorly developed, or unstable self-image, often
associated with excessive self-criticism and feelings
of inadequacy
Development of self-concept
Differentiation of whats from whos
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22. Summary
 Interpersonal hypersensitivity (i.e., prone to feel slighted or
insulted)
 Desensitization
 Self-Soothing
 CBT Interventions
 Intense, unstable, and conflicted close relationships, marked by mistrust,
neediness, fear of abandonment, and difficulty trusting people due to
alternations between feeling appreciated and condemned
 Learn how to be honest with yourself about wants/needs/fears
 Develop the ability to trust self
 Learn what it means to trust others
 Learn how to set healthy boundaries
AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89