Borderline Personality Disorder

Learn how ADHD-related impulsivity affects emotions, relationships and daily life, and how practical DBT skills can create more pause, choice and self-control.

xplore anger through a DBT lens, including emotional vulnerability, nervous system activation and practical skills to reduce escalation and respond effectively.

Learn why meaningful change does not follow the calendar, and how DBT supports steady emotional, behavioural and identity growth through practice over time.

Learn why change feels difficult and how DBT uses acceptance, willingness and practical skills to reduce resistance, build confidence and help you move forward.

Learn how catastrophising intensifies fear and impulsive reactions in BPD, and how DBT skills can help you check the facts and respond with greater control.

Learn how trauma and chronic stress affect your sense of safety, and how DBT, mindfulness and healthier coping can support resilience, healing and inner peace.

In DBT, we see inhibited grieving as one side of a dialectic—a tug-of-war between avoiding grief to protect oneself from pain and, on the other side, the need for emotional processing, where we confront and work through our feelings to find healing. Finding a healthy balance between these two extremes is essential for moving forward in a healthy way. What is Inhibited Grieving? Inhibited grieving is when someone suppresses their emotional response to loss or trauma. This can happen for several reasons: fear of being overwhelmed by grief, social pressures to “stay strong,” or lacking emotional support. Some people may even believe, often unconsciously, that allowing themselves to grieve fully will be too painful or make them feel out of control. To avoid this pain, they might throw themselves into work, use substances, or distance themselves emotionally from others. While these strategies might work temporarily, they prevent natural grieving from happening. Over time, unprocessed grief can show up as numbness, irritability, or even physical issues, making it harder to find joy or connection in daily life. The Dialectic of Inhibited Grieving and Emotional Processing Dialectics in DBT teach us that two conflicting truths can coexist. For inhibited grieving, the tension lies between the need to shield oneself from emotional pain and the necessity of facing that pain to heal. Inhibited grieving involves holding back or avoiding painful feelings, which might seem helpful in the short term, allowing someone to function without becoming overwhelmed by sadness or despair. However, the long-term consequence of avoiding grief is that unprocessed feelings remain unresolved, leading to greater emotional distress later. On the opposite side is emotional processing, which means fully experiencing and acknowledging the pain of loss or trauma. Processing doesn’t mean being consumed by grief forever; rather, it’s about moving through it and eventually integrating the loss in a way that allows for resolution and peace. The Importance of Emotional Processing in Healing Emotional processing is critical to healing grief. It requires recognising and accepting the full range of emotions associated with loss—sadness, anger, guilt, or even relief—and finding healthy ways to express and release these feelings. While this process is painful, it’s necessary for long-term well-being. Inhibited grieving, meanwhile, often prolongs suffering, as the unresolved emotions continue to build over time. In DBT, I guide people to find balance through mindfulness, distress tolerance, and emotional regulation skills. These techniques help individuals approach their pain without becoming overwhelmed, allowing them to process grief in manageable steps. Strategies for Balancing Inhibited Grieving and Emotional Processing Mindfulness of Emotions: Mindfulness allows you to observe and acknowledge your feelings without judgment. In grief, this can help you notice sadness, anger, or fear without pushing them away, making room for natural emotional processing. Distress Tolerance: When grief feels too intense, DBT’s distress tolerance skills (like the TIPP method: Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation) can help you manage these feelings without resorting to avoidance. Staying present with emotions, even when they’re painful, allows healing to begin. Opposite Action: Sometimes, emotions like grief can encourage avoidance. Practising opposite action—doing the opposite of what your emotions urge—can help. For inhibited grieving, this might mean letting yourself feel sadness, talking to a therapist, or journaling instead of blocking those feelings. Building a Support System: Processing grief doesn’t have to be done alone. A strong support network of friends, family, or mental health professionals can provide essential validation and understanding, reducing the isolation often felt with inhibited grieving. Radical Acceptance: This DBT skill helps you fully acknowledge the reality of your loss, without denying or resisting it. Radical acceptance isn’t about approving of the loss; it’s about recognising it as real, which can make it easier to take steps forward. Moving Forward: Embracing Grief for Healing Finding a balance between inhibited grieving and emotional processing is essential for true healing. Though it’s natural to want to avoid pain, long-term healing only happens when we allow ourselves to experience and process grief fully. DBT skills like mindfulness, distress tolerance, and radical acceptance can help you face your grief, creating space for eventual peace and resolution. Grieving is a natural response to loss, and processing it honours what we’ve lost. By giving ourselves space to feel, we create room for growth and healing. Processing grief isn’t about “moving on”; it’s about integrating the loss into our lives in a way that allows us to live with strength and resilience.

At its core, the concept of unrelenting crisis highlights the interplay of heightened emotional vulnerability and the difficulties in regulating these emotions. Many people who experience these crises often feel trapped in a cycle of distress and avoidance, which can prevent them from making meaningful progress in their lives. In DBT, we understand this as one side of a dialectic—a push-and-pull between ongoing crisis and the need for acceptance. The opposite side of this dialectic is a concept that is central to DBT: Radical Acceptance. What Is Unrelenting Crisis? Unrelenting crisis can be described as a pattern of recurrent emotional or situational crises that feel impossible to escape. For some individuals, life becomes a series of intense challenges, and just as one situation seems to resolve, another arises. This cycle is often underpinned by both external factors—like unstable relationships, financial problems, or job insecurity—and internal factors, such as emotional dysregulation, impulsive behaviours, and deep-seated feelings of shame or worthlessness. In DBT, we see this state as a result of the interplay between heightened sensitivity to emotional triggers (biological predisposition) and a lack of effective coping strategies to manage distress. Individuals caught in this cycle may be unable to prevent emotional crises from escalating and may also have difficulty resolving these crises in a healthy way. Thus, they live in a state of emotional exhaustion, constantly feeling as though their world is collapsing around them. The Dialectic: Unrelenting Crisis vs Radical Acceptance Dialectical Behaviour Therapy teaches us to embrace dialectics—the idea that two seemingly opposing truths can coexist. In the case of unrelenting crisis, the dialectical tension is between the reality of constant distress and the need to accept this reality fully. Radical Acceptance is about recognising the limitations of our control and embracing life as it is, rather than how we wish it to be. This acceptance is not passive resignation or giving up; rather, it is the active choice to stop fighting reality. It is an emotional shift that allows individuals to accept the present moment and make wise decisions about how to respond, instead of becoming paralysed by anger, shame, or resistance. Radical acceptance can feel counterintuitive to someone in a constant state of crisis. The natural instinct might be to reject or fight against the hardships in an attempt to avoid further pain. However, this refusal to accept reality often perpetuates the cycle of crisis, leading to frustration and increased suffering. It is only through acceptance that we can stop being consumed by the crisis and begin to focus on what is within our control—our responses, actions, and future choices. The Role of Radical Acceptance in Breaking the Crisis Cycle The power of radical acceptance lies in its ability to transform the way we relate to pain and crisis. When we refuse to accept reality, we expend valuable energy fighting against what is. This can lead to behaviours such as self-harm, substance use, or avoidance strategies that, while providing short-term relief, often exacerbate the situation in the long run. Radical acceptance allows us to release this internal battle, creating space for more adaptive coping strategies. Consider this: a person caught in a cycle of unrelenting crisis may feel intense frustration with their inability to change certain aspects of their life, such as a partner’s behaviour or a traumatic past. Without acceptance, they may find themselves ruminating over their misfortune or trying to force change in ways that are unproductive. Through radical acceptance, however, they come to terms with the fact that they cannot change these external realities. What they can change is their approach to these situations, their reactions, and ultimately, their path forward. Acceptance does not mean liking or approving of the current situation. It simply means acknowledging it as real and as something that cannot be changed in the present moment. From this place of acceptance, individuals can begin to make mindful, deliberate choices that align with their values and long-term goals. This shift can break the cycle of crisis, helping individuals move from reaction to response. Practical Strategies for Practising Radical Acceptance Notice and Name the Emotion : The first step to radical acceptance is recognising the feelings associated with the crisis. By naming the emotion (e.g., "I feel frustrated," "I am scared"), individuals can begin to distance themselves from the automatic urge to react impulsively. Understand the Role of Resistance : Ask yourself, "Am I fighting reality?" Notice if there is tension between what you want to be true and what actually is. Recognising this resistance can help shift towards acceptance. Breathe and Pause : Practising mindfulness and grounding techniques, such as focusing on the breath, can create space between the emotion and the reaction. This allows time to reflect on what acceptance would look like in the given situation. Make a Choice : Radical acceptance is an active decision. It might be helpful to remind yourself, "I cannot change this reality, but I can control how I respond to it." Practice Self-Compassion : Acknowledging that acceptance is hard is crucial. It’s natural to struggle with accepting painful realities. Be gentle with yourself throughout this process. Moving Forward: Healing and Growth Balancing the dialectic of unrelenting crisis and radical acceptance is not easy, but it is a crucial part of emotional growth. The process of moving from crisis to acceptance is a journey—one that requires patience, practice, and support. Over time, individuals can learn to break free from the constant state of emergency and begin to build a life worth living, where they feel more in control of their emotions and choices. In DBT, we emphasise that acceptance does not mean passivity. Rather, it is an empowering tool that allows individuals to navigate life’s challenges with resilience and wisdom. Radical acceptance offers a pathway out of the suffering cycle and into a space where healing can begin.

In DBT, we identify three main dialectics: apparent competence versus active passivity, inhibited grieving versus unrelenting crisis, and self-invalidation versus emotional vulnerability . These dialectics represent the push and pull of emotional and behavioural patterns. Just as the ocean's waves are influenced by the moon and the weather, these dialectics are shaped by both our biology and our environment. Let's explore these dialectics and their secondary targets, using the metaphor of the ocean to guide our understanding. The Three Dialectics: Navigating the Tides Apparent Competence vs. Active Passivity: This dialectic can be likened to the waves that appear calm on the surface but conceal a strong undertow beneath. Apparent competence is the behaviour of seeming to handle everything smoothly, like a serene ocean, even when turmoil brews beneath. It's a learned pattern often developed in invalidating environments where showing vulnerability is discouraged. On the flip side, active passivity resembles being swept away by the current, feeling helpless and relying on others to rescue us. This vulnerability arises from a biological predisposition to intense emotional responses, influenced by the current environment's impact on our emotions. Inhibited Grieving vs. Unrelenting Crisis: This dialectic mirrors the waves that never seem to settle, crashing against the shore relentlessly. Inhibited grieving is like holding back the tide, refusing to let the waves of grief and loss wash over us. It often stems from past environments where emotions were dismissed or suppressed. Unrelenting crisis, on the other hand, is akin to a stormy sea, where the waves are constantly churning, and the person is in a state of perpetual crisis. This secondary target has a biological basis, with environmental triggers setting off intense emotional responses that feel overwhelming and unending. Self-Invalidation vs. Emotional Vulnerability: Picture the ocean during a storm—waves crashing against each other chaotically. Self-invalidation is like judging those turbulent waves, criticising ourselves for feeling as intensely as we do. This behaviour is often learned from environments where one's emotions were dismissed or minimised. Conversely, emotional vulnerability is being in the midst of the storm, feeling every gust of wind and wave of emotion deeply. It's a biological tendency to experience emotions intensely, influenced by how our current environment interacts with our emotional responses. The Fluidity of Waves: Switching Between Extremes Just as the ocean can change from calm to stormy in an instant, we can fluidly switch between these secondary targets in real-time. One moment, we might be the calm ocean, displaying apparent competence, and the next, we're caught in a rip current of active passivity. The same fluidity applies to the other dialectics. We may suppress our grief like the stillness before a storm (inhibited grieving) and suddenly find ourselves in the throes of an emotional hurricane (unrelenting crisis). The Impact of the Environment and Learning to Navigate Biological secondary targets such as emotional vulnerability, active passivity, and unrelenting crisis arise within us, much like how weather patterns can suddenly stir the ocean into motion. These responses are influenced by how our current environment interacts with our emotional sensitivity. Meanwhile, the patterns of apparent competence, inhibited grieving, and self-invalidation are often learned behaviours, developed over time in invalidating environments. These learned patterns are similar to how the ocean shapes the shoreline; repeated exposure to invalidation can carve deep grooves in our behaviour, leading us to question our emotional responses and suppress our grief. For many, this process of invalidation began early in life. They looked to others—parents, caregivers, or peers—to help make sense of their intense emotional experiences. But when their emotions were dismissed or not mirrored by others, they began to judge their own feelings as wrong or too much. Like a shoreline that learns to brace for the incoming tide, they learned to hide their emotions, pretend everything was okay, and feared being rejected as "emotionally weak." DBT Skill: Opposite Action One DBT skill that can be incredibly useful when addressing secondary targets is Opposite Action. This skill involves identifying an emotion and then taking action that is opposite to what that emotion is urging us to do. For example, if self-invalidation is causing you to withdraw and isolate, the opposite action would be to reach out for support or engage in activities that affirm your self-worth. Similarly, when dealing with inhibited grieving, rather than avoiding reminders of loss, opposite action encourages engaging in activities that help you connect with and express your grief in a healthy manner. This skill helps create new patterns of behaviour that counteract the extremes of the secondary targets, promoting emotional balance. Learning to Surf the Waves DBT teaches us to become skilled surfers of these emotional waves. Recognising these secondary targets and understanding how they manifest in our lives is the first step toward change. While everyone experiences these patterns to some degree, they can be more intense and frequent for those in treatment. By acknowledging the dialectics and the push and pull within us, we can learn to balance on the surfboard rather than being tossed around by the waves. Through DBT skills, such as mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and opposite action, we can learn to ride the waves of emotion without being swept away. Instead of suppressing our grief like an inhibited tide, we can allow ourselves to feel and process our emotions. Rather than judging our vulnerability, we can learn to embrace it as a part of our human experience. The ocean is ever-changing, and so are we . By understanding the dialectics within DBT and recognising the patterns of our emotional waves, we can navigate our internal seas with greater compassion and skill. In doing so, we can learn not just to survive the stormy seas but to ride the waves with confidence and grace.