BPD Alliance, The Podcast

She directs a program that teaches skills for borderline personality disorder. Then her mother came to stay, and she lost her patience all weekend.Shireen Rizvi, PhD, is professor of psychiatry and behavioral sciences at Montefiore Einstein, where she serves as director of dialectical behavior therapy (DBT) services and research, and director of psychology training. The weekend before we recorded, her mother came to stay. Shireen was irritable most of the weekend and snapped at the people around her, and afterward she could name the skill she had skipped. She talks with host Jesse Finkelstein, PsyD, about why knowing a skill and reaching for it in the moment are two different things, and about the question she puts to herself and her clients: would you rather be right, or would you rather be effective?Try This Today: Think of one situation this week that you already know will be hard. Decide ahead of time what you want to do differently in it, then picture yourself doing it. Shireen calls this a cope ahead plan, and it is the one she says she will make before her mother's next visit.Chapters(00:00) – Why DBT Skills Matter(03:20) – Knowing What to Do vs. Doing It(05:40) – When a DBT Expert Loses Her Patience(07:48) – Why We Don’t Use the Skills We Know(09:50) – Would You Rather Be Right or Effective?(12:16) – What Happens When DBT Skills Don’t Work?(13:22) – How Families Can Help Without Becoming the Skills Police(16:09) – Progress, Not Perfection(17:06) – Finding Hope When You’re StrugglingMore ResourcesShireen walks through the skills for getting through a moment when you're too upset to think straight here.Dealing with Emotions is a free six-video series from BPD Alliance for anyone whose emotions feel out of control.To find a DBT therapist or program, and to learn what comprehensive DBT includes, start here. Research behind this episodeNeacsiu, A. D., Rizvi, S. L., & Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48(9), 832–839. https://doi.org/10.1016/j.brat.2010.05.017Barnicot, K., Couldrey, L., Sandhu, S., & Priebe, S. (2015). Overcoming barriers to skills training in borderline personality disorder: A qualitative interview study. PLoS ONE, 10(10), e0140635. https://doi.org/10.1371/journal.pone.0140635Barnicot, K., Gonzalez, R., McCabe, R., & Priebe, S. (2016). Skills use and common treatment processes in dialectical behaviour therapy for borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 52, 147–156. https://doi.org/10.1016/j.jbtep.2016.04.006BPD Alliance, The Podcast. Where research and real life meet around borderline personality disorder.This episode is part of the BPD Alliance 25th Anniversary Podcast, marking 25 years of standing alongside individuals and families living with borderline personality disorder with the belief that healing, growth, and recovery are possible.BPD Alliance is a nonprofit organization with a four-star Charity Navigator rating. To learn more or support our mission, visit bpdalliance.org.If this episode helped, following the show and leaving a review helps someone else find it.If you or someone you love is struggling, you can call or text 988 (Suicide & Crisis Lifeline) in the U.S.Series music: Lisbeth Scott, "Following The Sun," courtesy of Valley Entertainment, Inc. https://ffm.to/following-the-sun-feat-orchid-quartet.ODL

At 14, Krissy called home in tears and heard those words from her mom. She has borderline personality disorder. Then her mom learned to validate.Krissy grew up loved and unheard at the same time. The bullying started in fourth grade and followed her to boarding school. Her dad was deployed, her mom was stretched thin, and Krissy decided her pain was a burden no one could carry, so she white-knuckled it and said nothing. When it did spill out, what came back was “I don’t know what to do.” Hoping for anything else felt dangerous. What she needed was not a fix. It was someone saying “I see that you are in pain. I may not understand why it hurts this much, but I believe you that it does.” Krissy talks with host Diane DeMartino, LCSW, about what it is like to be going under while everyone at the edge of the pool tells you the water is three feet deep, and about coming home from treatment to parents who had taken a free class for families of people with BPD, taken it again, and kept practicing. What changed was not one conversation. It was knowing, every time, that if she fell apart in front of them she would be met instead of managed.Try This Today: The next time someone you love is in pain you do not understand, skip the solution. Say “I can see this hurts, and I believe you that it does,” then stay. If you catch yourself fixing anyway, name it: “I see I’m trying to solve this. Maybe that’s not what you need right now. What would be more helpful?”Chapters(00:00) The Phone Call Home(02:49) Three Feet Deep(05:00) Feeling Like a Burden(07:14) Learning to Validate(11:31) Try This(15:08) Words of HopeThe class Krissy’s parents took twice and then taught is Family Connections: free, 12 weeks on Zoom, for family members of people with BPD traits, with validation on the syllabus. Apply at https://bpdalliance.org/family-connections/. If you live with BPD, Dealing with Emotions is a free six-video course by Alan Fruzzetti, PhD, at https://bpdalliance.org/programs/.Primary sources on family validation and borderline personality disorder behind this conversation.Shenk, C. E., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30(2), 163–183. https://doi.org/10.1521/jscp.2011.30.2.163Hoffman, P. D., Fruzzetti, A. E., Buteau, E., Neiditch, E. R., Penney, D., Bruce, M. L., Hellman, F., & Struening, E. (2005). Family Connections: A program for relatives of persons with borderline personality disorder. Family Process, 44(2), 217–225. ⁠https://doi.org/10.1111/j.1545-5300.2005.00055.x⁠⁠Lee, S. S. M., Keng, S.-L., Yeo, G. C., & Hong, R. Y. (2022). Parental invalidation and its associations with borderline personality disorder symptoms: A multivariate meta-analysis. Personality Disorders: Theory, Research, and Treatment, 13(6), 572–582. https://doi.org/10.1037/per0000523BPD Alliance, The Podcast. Where research and real life meet around borderline personality disorder.This episode is part of the BPD Alliance 25th Anniversary Podcast, marking 25 years of standing alongside individuals and families living with borderline personality disorder with the belief that healing, growth, and recovery are possible. BPD Alliance is a nonprofit organization with a four-star Charity Navigator rating. To learn more or support our mission, visit bpdalliance.org. If this episode helped, following the show and leaving a review helps someone else find it. If you or someone you love is struggling, you can call or text 988 (Suicide & Crisis Lifeline) in the U.S.Series music: Lisbeth Scott, "Following The Sun," courtesy of Valley Entertainment, Inc. https://ffm.to/following-the-sun-feat-orchid-quartet.ODL

She read him the criteria, told him to look it up, and sent him home. What Peter found online about borderline personality disorder nearly undid him.Peter Googled it that night and found a week of relief, then a month of self-loathing. He is a member of the BPD Alliance Lived Experience Committee, a husband, and the father of two teenage boys, diagnosed three years ago at 37 after what he calls a million therapists and a half. In this episode he tells host Diane DeMartino, LCSW, about the therapist who diagnosed him in one session and then ended the treatment, the years of therapy that treated his sleep and his job stress and never named what was underneath, the intensive outpatient program he mistook for DBT, and how he went from searching Reddit for people like him to sitting on a committee of them.Try This Today: If you just got the diagnosis and are about to search it, borrow Peter's rule: you are not what you Google. Then make one call a search engine cannot. Ask a therapist whether they treat borderline personality disorder, and if the answer is no, ask who does.Chapters (00:00) A Million Therapists (01:18) Go Google It (03:40) Trying It Alone (07:27) The Wrong Path (10:31) Finding His People (13:57) Words of HopePeter found his way back through the annual Yale-BPD Alliance Annual Conference [https://bpdalliance.org/yale-neabpd-conference/] panels and the Lived Experience Committee he now sits on. If you have BPD and want to join him, the committee takes applications through the volunteer page: [https://bpdalliance.org/volunteer/]. For vetted books, videos, and programs, start with the BPD Alliance resource directory: [https://bpdalliance.org/bpd-resources/]. If you are the parent, partner, or friend of someone with BPD, Family Connections is a free class for families: [https://bpdalliance.org/family-connections/].  References:Broadbear, J. H., et al. (2025). Exploring the pathways to diagnosis for men with borderline personality disorder: A qualitative study. International Journal of Mental Health Nursing. https://doi.org/10.1111/inm.13413Broadbear, J. H., et al. (2026). Time to diagnosis and treatment for borderline personality disorder: Opportunities and pitfalls during the consumer mental health journey. Journal of Psychiatric Research. https://doi.org/10.1016/j.jpsychires.2026.06.023Sanchious, S. N., et al. (2024). Recognizing borderline personality disorder in men: Gender differences in BPD symptom presentation. Journal of Personality Disorders, 38(2), 195. https://doi.org/10.1521/pedi.2024.38.2.195Tedesco, V., et al. (2023). Diagnosing borderline personality disorder: Reports and recommendations from people with lived experience. Personality and Mental Health. https://doi.org/10.1002/pmh.1599About BPD Alliance, The Podcast:Where research and real life meet around borderline personality disorder.This episode is part of the BPD Alliance 25th Anniversary Podcast, marking 25 years of standing alongside individuals and families living with borderline personality disorder with the belief that healing, growth, and recovery are possible. BPD Alliance is a nonprofit organization with a four-star Charity Navigator rating. To learn more or support our mission, visit bpdalliance.org. If this episode helped, following the show and leaving a review helps someone else find it. If you or someone you love is struggling, you can call or text 988 (Suicide & Crisis Lifeline) in the U.S.Series music: Lisbeth Scott, "Following The Sun," courtesy of Valley Entertainment, Inc. ⁠https://ffm.to/following-the-sun-feat-orchid-quartet.ODL⁠

When your daughter has borderline personality disorder and calls in pain, the first ten seconds decide whether she stays on the line.Julie knows those ten seconds. Her daughter got up late, hit traffic, got written up, and quit on the spot, then called her mother and said so, loudly. Julie is a longtime BPD Alliance board member, and in this episode she tells host Jesse Finkelstein, PsyD, what she did not know at that moment, what she wanted to say, what she said instead, and why answering the emotion rather than the words is the skill that kept her daughter talking.Try This Today: Before you answer someone whose emotions are running high, borrow Julie's practice of relationship mindfulness: pay attention on purpose to the person in front of you, in this moment. Put down what you were doing. Notice their voice before you weigh their words. Learn more about Relationship Mindfulness. (00:00) “I Quit My Job”(04:11) Early Signs, No Answers(08:32) Invalidating Without Blame(10:37) Finding Family Connections(11:59) Try This: Relationship Mindfulness(13:46) Words of Hope  Learn more about supporting a family member, including Family Connections™, the free, evidence-based program developed by BPD Alliance for family members and loved ones supporting someone with borderline personality disorder (BPD) traits or chronic emotion dysregulation.Julie also mentions NAMI Family-to-Family, the free class where someone first told her about Family Connections. [https://www.nami.org/programs/nami-family-to-family/]Research mentioned in this episode: Shenk and Fruzzetti (2011) and Kuo et al. (2022) measured how validating and invalidating responses change emotional reactivity. Fruzzetti, Shenk, and Hoffman (2005) describe the transactional model taught in Family Connections.Fruzzetti, A. E., Shenk, C., & Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17(4), 1007–1030. [https://doi.org/10.1017/S0954579405050479]Kuo, J. R., Fitzpatrick, S., Ip, J., & Uliaszek, A. (2022). The who and what of validation: An experimental examination of validation and invalidation of specific emotions and the moderating effect of emotion dysregulation. Borderline Personality Disorder and Emotion Dysregulation, 9, Article 15. [https://doi.org/10.1186/s40479-022-00185-x]Shenk, C. E., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30(2), 163–183. [https://doi.org/10.1521/jscp.2011.30.2.163]About BPD Alliance, The Podcast:Where research and real life meet around borderline personality disorder.This episode is part of the BPD Alliance 25th Anniversary Podcast, marking 25 years of standing alongside individuals and families living with borderline personality disorder with the belief that healing, growth, and recovery are possible. BPD Alliance is a nonprofit organization with a four-star Charity Navigator rating. To learn more or support our mission, visit bpdalliance.org. If this episode helped, following the show and leaving a review helps someone else find it. If you or someone you love is struggling, you can call or text 988 (Suicide & Crisis Lifeline) in the U.S.Series music: Lisbeth Scott, "Following The Sun," courtesy of Valley Entertainment, Inc. https://ffm.to/following-the-sun-feat-orchid-quartet.ODL

What if borderline personality disorder isn’t best understood as a list of things that are “wrong” with someone?Carla Sharp, PhD, a professor at the University of Houston who studies the development of personality disorders, joins host Kiki Fehling, PhD, to discuss how our understanding of borderline personality disorder (BPD) is changing and how the way we define BPD affects the people who receive the diagnosis.The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, is the standard classification system for mental health diagnoses in the USA. The DSM-5-TR lists nine criteria for BPD, with five required for a diagnosis:1. Frantic efforts to avoid abandonment2. Unstable, intense relationships (idealization and devaluation)3. Unstable self-image4. Impulsivity in at least two self-damaging areas5. Recurrent suicidal behavior, gestures, or self-mutilation6. Mood reactivity and emotional instability7. Chronic emptiness8. Intense or poorly controlled anger9. Stress-related paranoia or dissociation. Dr. Sharp discusses another approach, the Alternative Model for Personality Disorders (AMPD). Introduced in Section III of DSM-5 in 2013, the AMPD looks at more than a list of symptoms. It considers the personality patterns a person struggles with and how much those difficulties affect their sense of self and their relationships with other people.It focuses on four areas: identity (how you understand who you are), self-direction (your ability to set goals and make choices), empathy (your ability to understand other people’s experiences), and intimacy (your ability to form and maintain close relationships).This gives clinicians a fuller picture of where someone is struggling instead of defining them by whether they check off a certain number of symptoms.The episode also addresses the idea that BPD reflects a flaw in someone’s character. BPD is a mental health condition, effective treatments are available, and people can improve.(00:00) The pain of not being understood(01:36) What is BPD? Moving beyond traits(03:18) There is no single pathway to BPD(06:21) A different way to understand personality disorder(09:13) From fixed traits to a capacity that can change(15:18) BPD is not a character flaw(15:33) BPD is treatable, and why early intervention helps(17:51) Try this: challenge what you believe about BPDTry This Today: Think of a belief you have heard about BPD: “Everyone with BPD has experienced abuse.” “BPD is a character flaw.” “People with BPD can’t change.” Write it down. Next to it, write something you learned in this episode that challenges that belief. Notice the assumptions you may have absorbed about BPD and consider whether they match what we now know.References:Sharp, C., Clark, L. A., Balzen, K. M., Widiger, T., Stepp, S., Zimmerman, M., & Krueger, R. F. (2025). The validity, reliability and clinical utility of the Alternative DSM-5 Model for Personality Disorders (AMPD) according to DSM-5 revision criteria. World Psychiatry, 24(3), 319–340.Krueger, R. F., & Hobbs, K. A. (2020). An overview of the DSM-5 alternative model of personality disorders (AMPD). Psychopathology, 53(3–4), 126–132.About BPD Alliance:BPD Alliance, The Podcast. Where research and real life meet around borderline personality disorder.This episode is part of the BPD Alliance 25th Anniversary Podcast, marking 25 years of standing alongside individuals and families living with borderline personality disorder with the belief that healing, growth, and recovery are possible.BPD Alliance is a nonprofit organization with a four-star Charity Navigator rating. To learn more or support our mission, visit bpdalliance.org.If this episode helped, following the show and leaving a review helps someone else find it.If you or someone you love is struggling, you can call or text 988 (Suicide & Crisis Lifeline) in the U.S.Series music: “Following the Sun” by Lisbeth Scott.