You had plans to go for a run after eating a homemade dinner, but your friend just texted you something that felt like a brush-off, and now you’re caught in a spiral, wondering if you’re being left out. How could they do this to you? Maybe you should text another friend and see if you can find out what’s happening?
Before you know it, you’ve spent the entire evening stuck on your couch texting, calling, and ruminating, feeling frantic and upset, with fewer answers and more questions than ever. You DoorDashed dinner, and you never went for that run.
Then the shame sinks in: why is your life like this, why can’t you ever stick to a routine? You want to do the right things, but you keep getting distracted, and then you’re back at square one, feeling worse about yourself and your life than ever.
Why do people with BPD struggle with routines?
Why do people with BPD struggle with routines?A consistent symptom of borderline personality disorder (BPD) is emotional instability, a major disruptor of routines. It’s hard to focus on going to bed on time or eating a nutritious dinner when you’re focused on intense emotions like a new love interest or deep anger at a perceived slight. Then the shame of falling short on maintaining your routine can add to that overwhelm. Being derailed like this can lead you to want to throw away all your progress and stop trying.
For adults with BPD, structure and routine can be very positive life influences, creating consistency and dependability that can reduce the impact of intense emotions and distressing thoughts. It can give you a stronger sense of self, making you less vulnerable to feelings of emptiness and fear.
But if routine and consistency are so hard because of BPD, how can someone with BPD actually create and stick to routines?
How does a New York DBT program provide structure for adults with BPD?
Dialectical behavior therapy (DBT) is built a little differently than talk therapy, focusing first on behavior activation, or actions that focus on managing your behavior and adjusting your responses to BPD symptoms.
For people who struggle with routines because of BPD, the structure, expectations, and accountability built into DBT therapy can make a meaningful difference, right from the start.
DBT therapy gives you structure and support you can count on
As part of a DBT program, you’ll attend both individual therapy and DBT skills group therapy every week. Your therapists and your DBT group members will be there for you each week. Their consistency will help you prioritize consistency for yourself.
The dependability of therapy sessions helps you feel less alone and is something to build a routine around. It’s even self-reinforcing. As you stick to DBT therapy, you start to see positive changes in your life from the insights and accountability in individual therapy, and that positive change makes it easier to pursue more change!
The DBT diary card helps you cope and provides structure even when BPD is at its most disruptive
DBT recognizes emotional dysregulation as a regular occurrence for people with BPD, and the DBT diary card can help give you stability in these less stable moments. The diary card is a place to record life-disrupting emotions, urges, and behaviors as they happen, and a place to keep track of the DBT skills you use to manage these experiences.
You then share your diary card with your individual therapist at weekly sessions, taking a non-judgmental look at your experiences and problem-solving with your therapist to adjust your behavior activation in ways that better match your therapy goals.
On-call phone coaching can help you remember what to do when you veer off-course
When you notice your BPD symptoms are disrupting your life, a quick phone coaching call with your therapist can remind you of your therapy goals and help you recall DBT skills that can help you in this moment so your behavioral activation can put you back on track.
Calls like this can remind you that the goal of DBT isn’t perfect routines and constant structured living; that’s not how life works! The goal is remembering that you get to decide what you do when BPD disrupts routines, and adjusting in the difficult moment to better align with the life you want.
Behavior chain analysis in DBT therapy creates a chance for accountability around routines
BPD symptoms can feel so overwhelming, and the shame that comes after an emotional outburst can be so intense, it can be hard to see the cause and effect of your behaviors. In DBT, your individual therapist will use behavior chain analysis to help you see what your triggers are and your common responses.
Understanding your patterns can be a powerful first step in changing them. When you recognize that texting your partner often throws you into an emotional spiral, you can change your behavior (like only speaking to your partner on the phone or in person), and remove a major emotional trigger, making it easier to go about your routine.
How do DBT skills help with routine stabilization for adults with BPD?
DBT doesn’t just provide stabilization through its own structured approach to managing emotional and behavioral dysregulation. DBT skills are designed to help you regulate emotions, stay present, and maintain structure in your life.
ABC PLEASE emphasizes the need for routine care of your body and mind
The creators of DBT understood that a body and mind routinely supported by medical care, movement, and nutrition was one that would have an easier time withstanding intense, difficult emotions.
The DBT skill of ABC PLEASE guides you on how to prioritize your wellbeing as part of your routine, and can be a great skill to turn to when you’re ready to blow off your routine because of BPD.
ABC PLEASE encourages you to:
- Accumulate positive emotions by pursuing pleasant activities.
- Build mastery by focusing on learning to do new things.
- Cope ahead by rehearsing how you’ll respond in stressful situations.
- Treat physical illness and follow medical advice.
- Eat well to support mood stability.
- Avoid alcohol, drugs, and other mood-altering substances.
- Sleep well, with regular bedtimes and wake times.
- Exercise to keep body and mind active and healthy.
When ignoring a routine feels irresistible, STOP and Opposite Action empower adults with BPD to choose differently
When BPD is overwhelming you, it can help to just stop for a moment instead of feeding the emotional dysregulation with behavior dysregulation. The DBT skill STOP can help you take a beat, a breath, and decide what you want to do next, instead of derailing routines.
To use STOP when BPD is interfering with the structure of your life:
- Stop: Don’t move, don’t think. Stop.
- Take a step back: Give yourself mental and physical space. Ask for a minute.
- Observe: Notice your thoughts, feelings, bodily sensations. Observe and describe what’s happening around you.
- Proceed mindfully: Decide what you want to do next. Deliberately choose behavior activation that matches your routine.
Opposite action is another foundational behavior activation DBT skill; instead of doing what BPD is urging you to do (ignore your routine and react), you choose to do the exact opposite (stick to your routine and regulate your behavior). For example, if BPD is trying to get you to focus on your fears over being abandoned, you choose the opposite, put your phone down, and start to cook dinner.
Suffolk DBT helps Long Island adults with BPD to build stable, meaningful lives using DBT
Adults with BPD often struggle with maintaining a routine, and moments of emotional overwhelm can derail their ability (and interest) in following through. This can lead to major life disruption for folks with BPD, but it’s important to remember that susceptibility is not the same thing as inevitability.
Many adults with BPD effectively manage their symptoms and create lives that are structured and rewarding, especially with the help of a comprehensive DBT program. At Suffolk DBT, our expert therapists can help you increase consistency through the routines and accountability of therapy and use practical DBT skills to reduce the chaos BPD introduces into your life.
If you’re ready to give yourself the gift of the comforting stability of routines and to learn empowering skills that help you better manage your life, we welcome you to connect with us today to schedule a free consult and get started on a life worth living!