The Borderline Personality Disorder Workbook – by Dr. Daniel Fox

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Personality disorders in general get a bad rep. In part, because their names and descriptions often focus on how the disorders affect other people, rather than how they affect the actual sufferer:

  • “This disorder gives you cripplingly low self-esteem; we call it Evil Not-Quite-Human Disorder”
  • “This disorder makes you feel unloveable; we call it Abusive Bitch Disorder”
  • …etc

Putting aside the labels and stigma, it turns out that humans sometimes benefit from help. In the case of BPD, characterized by such things as difficult moods and self-sabotage, the advice in this book can help anyone struggling with those (and related) issues.

The style of the book is both textbook, and course. It’s useful to proceed through it methodically, and doing the exercises is good too. We recommend getting the print edition, not the Kindle edition, so that you can check off boxes, write in it (pencil, if you like!), etc.

Bottom line: if you or a loved one suffers from BPD symptoms (whether or not you/they would meet criteria for diagnosis), this book can help a lot.

Click here to check out the BPD Workbook, and retake control of your life!

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Recommended

  • Felt Time – by Dr. Marc Wittmann
  • Strategic Wellness
    Dr. Michael Roizen advocates for optimizing health through lifestyle factors, including circadian eating and intermittent fasting, to improve overall well-being.

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  • Clean Needles Save Lives. In Some States, They Might Not Be Legal.

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    Kim Botteicher hardly thinks of herself as a criminal.

    On the main floor of a former Catholic church in Bolivar, Pennsylvania, Botteicher runs a flower shop and cafe.

    In the former church’s basement, she also operates a nonprofit organization focused on helping people caught up in the drug epidemic get back on their feet.

    The nonprofit, FAVOR ~ Western PA, sits in a rural pocket of the Allegheny Mountains east of Pittsburgh. Her organization’s home county of Westmoreland has seen roughly 100 or more drug overdose deaths each year for the past several years, the majority involving fentanyl.

    Thousands more residents in the region have been touched by the scourge of addiction, which is where Botteicher comes in.

    She helps people find housing, jobs, and health care, and works with families by running support groups and explaining that substance use disorder is a disease, not a moral failing.

    But she has also talked publicly about how she has made sterile syringes available to people who use drugs.

    “When that person comes in the door,” she said, “if they are covered with abscesses because they have been using needles that are dirty, or they’ve been sharing needles — maybe they’ve got hep C — we see that as, ‘OK, this is our first step.’”

    Studies have identified public health benefits associated with syringe exchange services. The Centers for Disease Control and Prevention says these programs reduce HIV and hepatitis C infections, and that new users of the programs are more likely to enter drug treatment and more likely to stop using drugs than nonparticipants.

    This harm-reduction strategy is supported by leading health groups, such as the American Medical Association, the World Health Organization, and the International AIDS Society.

    But providing clean syringes could put Botteicher in legal danger. Under Pennsylvania law, it’s a misdemeanor to distribute drug paraphernalia. The state’s definition includes hypodermic syringes, needles, and other objects used for injecting banned drugs. Pennsylvania is one of 12 states that do not implicitly or explicitly authorize syringe services programs through statute or regulation, according to a 2023 analysis. A few of those states, but not Pennsylvania, either don’t have a state drug paraphernalia law or don’t include syringes in it.

    Those working on the front lines of the opioid epidemic, like Botteicher, say a reexamination of Pennsylvania’s law is long overdue.

    There’s an urgency to the issue as well: Billions of dollars have begun flowing into Pennsylvania and other states from legal settlements with companies over their role in the opioid epidemic, and syringe services are among the eligible interventions that could be supported by that money.

    The opioid settlements reached between drug companies and distributors and a coalition of state attorneys general included a list of recommendations for spending the money. Expanding syringe services is listed as one of the core strategies.

    But in Pennsylvania, where 5,158 people died from a drug overdose in 2022, the state’s drug paraphernalia law stands in the way.

    Concerns over Botteicher’s work with syringe services recently led Westmoreland County officials to cancel an allocation of $150,000 in opioid settlement funds they had previously approved for her organization. County Commissioner Douglas Chew defended the decision by saying the county “is very risk averse.”

    Botteicher said her organization had planned to use the money to hire additional recovery specialists, not on syringes. Supporters of syringe services point to the cancellation of funding as evidence of the need to change state law, especially given the recommendations of settlement documents.

    “It’s just a huge inconsistency,” said Zoe Soslow, who leads overdose prevention work in Pennsylvania for the public health organization Vital Strategies. “It’s causing a lot of confusion.”

    Though sterile syringes can be purchased from pharmacies without a prescription, handing out free ones to make drug use safer is generally considered illegal — or at least in a legal gray area — in most of the state. In Pennsylvania’s two largest cities, Philadelphia and Pittsburgh, officials have used local health powers to provide legal protection to people who operate syringe services programs.

    Even so, in Philadelphia, Mayor Cherelle Parker, who took office in January, has made it clear she opposes using opioid settlement money, or any city funds, to pay for the distribution of clean needles, The Philadelphia Inquirer has reported. Parker’s position signals a major shift in that city’s approach to the opioid epidemic.

    On the other side of the state, opioid settlement funds have had a big effect for Prevention Point Pittsburgh, a harm reduction organization. Allegheny County reported spending or committing $325,000 in settlement money as of the end of last year to support the organization’s work with sterile syringes and other supplies for safer drug use.

    “It was absolutely incredible to not have to fundraise every single dollar for the supplies that go out,” said Prevention Point’s executive director, Aaron Arnold. “It takes a lot of energy. It pulls away from actual delivery of services when you’re constantly having to find out, ‘Do we have enough money to even purchase the supplies that we want to distribute?’”

    In parts of Pennsylvania that lack these legal protections, people sometimes operate underground syringe programs.

    The Pennsylvania law banning drug paraphernalia was never intended to apply to syringe services, according to Scott Burris, director of the Center for Public Health Law Research at Temple University. But there have not been court cases in Pennsylvania to clarify the issue, and the failure of the legislature to act creates a chilling effect, he said.

    Carla Sofronski, executive director of the Pennsylvania Harm Reduction Network, said she was not aware of anyone having faced criminal charges for operating syringe services in the state, but she noted the threat hangs over people who do and that they are taking a “great risk.”

    In 2016, the CDC flagged three Pennsylvania counties — Cambria, Crawford, and Luzerne — among 220 counties nationwide in an assessment of communities potentially vulnerable to the rapid spread of HIV and to new or continuing high rates of hepatitis C infections among people who inject drugs.

    Kate Favata, a resident of Luzerne County, said she started using heroin in her late teens and wouldn’t be alive today if it weren’t for the support and community she found at a syringe services program in Philadelphia.

    “It kind of just made me feel like I was in a safe space. And I don’t really know if there was like a come-to-God moment or come-to-Jesus moment,” she said. “I just wanted better.”

    Favata is now in long-term recovery and works for a medication-assisted treatment program.

    At clinics in Cambria and Somerset Counties, Highlands Health provides free or low-cost medical care. Despite the legal risk, the organization has operated a syringe program for several years, while also testing patients for infectious diseases, distributing overdose reversal medication, and offering recovery options.

    Rosalie Danchanko, Highlands Health’s executive director, said she hopes opioid settlement money can eventually support her organization.

    “Why shouldn’t that wealth be spread around for all organizations that are working with people affected by the opioid problem?” she asked.

    In February, legislation to legalize syringe services in Pennsylvania was approved by a committee and has moved forward. The administration of Gov. Josh Shapiro, a Democrat, supports the legislation. But it faces an uncertain future in the full legislature, in which Democrats have a narrow majority in the House and Republicans control the Senate.

    One of the bill’s lead sponsors, state Rep. Jim Struzzi, hasn’t always supported syringe services. But the Republican from western Pennsylvania said that since his brother died from a drug overdose in 2014, he has come to better understand the nature of addiction.

    In the committee vote, nearly all of Struzzi’s Republican colleagues opposed the bill. State Rep. Paul Schemel said authorizing the “very instrumentality of abuse” crossed a line for him and “would be enabling an evil.”

    After the vote, Struzzi said he wanted to build more bipartisan support. He noted that some of his own skepticism about the programs eased only after he visited Prevention Point Pittsburgh and saw how workers do more than just hand out syringes. These types of programs connect people to resources — overdose reversal medication, wound care, substance use treatment — that can save lives and lead to recovery.

    “A lot of these people are … desperate. They’re alone. They’re afraid. And these programs bring them into someone who cares,” Struzzi said. “And that, to me, is a step in the right direction.”

    At her nonprofit in western Pennsylvania, Botteicher is hoping lawmakers take action.

    “If it’s something that’s going to help someone, then why is it illegal?” she said. “It just doesn’t make any sense to me.”

    This story was co-reported by WESA Public Radio and Spotlight PA, an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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    Subscribe to KFF Health News’ free Morning Briefing.

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  • How To Reduce Cortisol Levels Naturally

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    Cortisol is a hormone that is important for us (we’d struggle to get up in the morning without it, for a start), but in this modern world we often have too much of it, too much of the time. How can we rebalance it? Dr. Mindy Pelz explains:

    Lifestyle adjustments

    A note in advance: the video makes frequent reference to things that “spike cortisol levels”, but this is probably intended as a stand-in for “raise cortisol levels”. Because, unlike for some things, in the case of cortisol, spikes aren’t usually a problem (indeed, they can be beneficial, and this is a large part of why cold showers and ice baths can be healthy; it’s an artificially induced cortisol spike, and this hormesis has an assortment of healthy benefits, each related to improving our body’s ability to switch quickly between states as appropriate); rather, it’s chronically high cortisol levels that are the problem. However, the video discusses things that can increase resting cortisol levels, so where she says “spike”, we suggest to read “raise”.

    Dr. Pelz, an advocate of intermittent fasting, mentions that done incorrectly and/or for the same way for too long, fasting can raise cortisol levels and thus sabotage our efforts—so varying our fasting style can help avoid that. For example, 16:8, 5:2, longer fasts less frequently, etc.

    On the topic of food, she also warns us of the dangers of ultra-processed food, harmful oils, and foods with added sugar, as these can all raise cortisol levels.

    When it comes to exercise, she notes that intense exercise without adequate recovery can raise cortisol levels, so again it’s good to mix up one’s methods, vary one’s exercise routine, and allow each well-worked muscle-group adequate rest afterwards.

    Dr. Pelz also talks mindset, and has her own interesting way of framing the well-established science that chronic stress means chronically high stress hormone (cortisol) levels; Dr. Pelz prefers to see it as negative vs positive thoughts, environments, etc.

    Any discussion of cortisol management would be incomplete without discussing the importance of good quality sleep. Dr. Pelz doesn’t mention this at all in her video, but it’s important to bear in mind too!

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Lower Your Cortisol! (Here’s Why & How)

    Take care!

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  • The 5 Love Languages Gone Wrong

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    Levelling up the 5 love languages

    The saying “happy wife; happy life” certainly goes regardless of gender, and if we’re partnered, it’s difficult to thrive in our individual lives if we’re not thriving as a couple. So, with the usual note that mental health is also just health, let’s take a look at getting beyond the basics of a well-known, often clumsily-applied model:

    The 5 love languages

    You’re probably familiar with “the 5 love languages”, as developed by Dr. Gary Chapman. If not, they are:

    1. Acts of Service
    2. Gift-Giving
    3. Physical Touch
    4. Quality Time
    5. Words of Affirmation

    The idea is that we each weight these differently, and problems can arise when a couple are “speaking a different language”.

    So, is this a basic compatibility test?

    It doesn’t have to be!

    We can, if we’re aware of each other’s primary love languages, make an effort to do a thing we wouldn’t necessarily do automatically, to ensure they’re loved the way they need to be.

    But…

    What a lot of people overlook is that we can also have different primary love languages for giving and for receiving. And, missing that can mean that even taking each other’s primarily love languages into account, efforts to make a partner feel loved, or to feel loved oneself, can miss 50% of the time.

    For example, I (your writer here today, hi) could be asked my primary love language and respond without hesitation “Acts of Service!” because that’s my go-to for expressing love.

    I’m the person who’ll run around bringing drinks, do all the housework, and without being indelicate, will tend towards giving in the bedroom. But…

    A partner trying to act on that information to make me feel loved by giving Acts of Service would be doomed to catastrophic failure, because my knee-jerk reaction would be “No, here, let me do that for you!”

    So it’s important for partners to ask each other…

    • Not: “what’s your primary love language?” ❌
    • But: “what’s your primary way of expressing love?” ✅
    • And: “which love language makes you feel most loved?” ✅

    For what it’s worth, I thrive on Words of Affirmation, so thanks again to everyone who leaves kind feedback on our articles! It lets me know I provided a good Act of Service

    So far, so simple, right? You and your partner (or: other person! Because as we’ve just seen, these go for all kinds of dynamics, not just romantic partnerships) need to be aware of each other’s preferred love languages for giving and receiving.

    But…

    There’s another pitfall that many fall into, and that’s assuming that the other person has the same idea about what a given love language means, when there’s more to clarify.

    For example:

    • Acts of Service: is it more important that the service be useful, or that it took effort?
    • Gift-Giving: is it better that a gift be more expensive, or more thoughtful and personal?
    • Physical Touch: what counts here? If we’re shoulder-to-shoulder on the couch, is that physical touch or is something more active needed?
    • Quality Time: does it count if we’re both doing our own thing but together in the same room, comfortable in silence together? Or does it need to be a more active and involved activity together? And is it quality time if we’re at a social event together, or does it need to be just us?
    • Words of Affirmation: what, exactly, do we need to hear? For romantic partners, “I love you” can often be important, but is there something else we need to hear? Perhaps a “because…”, or perhaps a “so much that…”, or perhaps something else entirely? Does it no longer count if we have to put the words in our partner’s mouth, or is that just good two-way communication?

    Bottom line:

    There’s a lot more to this than a “What’s your love language?” click-through quiz, but with a little application and good communication, this model can really resolve a lot of would-be problems that can grow from feeling unappreciated or such. And, the same principles go just the same for friends and others as they do for romantic partners.

    In short, it’s one of the keys to good interpersonal relationships in general—something critical for our overall well-being!

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Related Posts

  • Felt Time – by Dr. Marc Wittmann
  • Nori vs Wakame – Which is Healthier?

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    Our Verdict

    When comparing nori to wakame, we picked the nori.

    Why?

    It was close, and both of these seaweed options are great!

    In terms of macros, nori has more protein while wakame has more carbs; they’re about equal on fiber. While the difference in protein and carbs isn’t big, out of the two we’ll prioritize protein, and thus say nori gets a notional win here—but as it’s so close, one could just as easily call it a tie.

    In the category of vitamins both are very rich in many minerals, but nori has more of vitamins A, B1, B2, B6, B12*, and C, while wakame has more of vitamins B5, B9, K, and choline. Thus, a 6:4 victory for nori.

    *Yes, nori is one of those rare vegan foods that naturally contain vitamin B12; it’s because of the composition of the algae that this seaweed is made of, which includes some beneficial B12-making bacteria. Meanwhile, wakame is “just” a kelp, so it doesn’t have B12.

    When it comes to minerals, nori has more potassium and zinc, while wakame has more calcium and magnesium. They’re equal on other minerals, except: it’s worth noting that wakame is moderately high in sodium, while nori has very little sodium. So, either a tie-breaking win for nori, or just a tie.

    Adding up the sections gives nori the overall win; it’s only the margin of the win that’s reasonably debatable. Still, enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Enjoy!

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  • The Myth of Normal – by Dr. Gabor Maté and Daniel Maté

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    A lot of popular beliefs (and books!) start with the assumption that everyone is, broadly speaking, “normal”. That major diversions from “normal” happen only to other people… And that minor diversions from “normal” are just something to suck up and get over—magically effecting a return to “normalcy”.

    Dr. Maté, however, will have none of these unhelpful brush-offs, and observes that in fact most if not all of us have been battered by the fates one way or another. We just:

    • note that we have more similarities than differences, and
    • tend to hide our own differences (to be accepted) or overlook other people’s (to make them more acceptable).

    How is this more helpful? Well, the above approach isn’t always, but Mate has an improvement to offer:

    We must see flawed humans (including ourselves) as the product of our environments… and/but see this a reason to look at improving those environments!

    Beyond that…

    The final nine chapters of the books he devotes to “pathways to wholeness” and, in a nutshell, recovery. Recovery from whatever it was for you. And if you’ve had a life free from anything that needs recovering from, then congratulations! You doubtlessly have at least one loved one who wasn’t so lucky, though, so this book still makes for excellent reading.

    Dr. Maté was awarded the Order of Canada for his medical work and writing. His work has mostly been about addiction, trauma, stress, and childhood development. He co-wrote this book with his son, Daniel.

    Check out The Myth of Normal on Amazon today!

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  • Vit D + Calcium: Too Much Of A Good Thing?

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    Vit D + Calcium: Too Much Of A Good Thing?

    • Myth: you can’t get too much calcium!
    • Myth: you must get as much vitamin D as possible!

    Let’s tackle calcium first:

    ❝Calcium is good for you! You need more calcium for your bones! Be careful you don’t get calcium-deficient!❞

    Contingently, those comments seem reasonable. Contingently on you not already having the right amount of calcium. Most people know what happens in the case of too little calcium: brittle bones, osteoporosis, and so forth.

    But what about too much?

    Hypercalcemia

    Having too much calcium—or “hypercalcemia”— can lead to problems with…

    • Groans: gastrointestinal pain, nausea, and vomiting. Peptic ulcer disease and pancreatitis.
    • Bones: bone-related pains. Osteoporosis, osteomalacia, arthritis and pathological fractures.
    • Stones: kidney stones causing pain.
    • Moans: refers to fatigue and malaise.
    • Thrones: polyuria, polydipsia, and constipation
    • Psychic overtones: lethargy, confusion, depression, and memory loss.

    (mnemonic courtesy of Sadiq et al, 2022)

    What causes this, and how do we avoid it? Is it just dietary?

    It’s mostly not dietary!

    Overconsumption of calcium is certainly possible, but not common unless one has an extreme diet and/or over-supplementation. However…

    Too much vitamin D

    Again with “too much of a good thing”! While keeping good levels of vitamin D is, obviously, good, overdoing it (including commonly prescribed super-therapeutic doses of vitamin D) can lead to hypercalcemia.

    This happens because vitamin D triggers calcium absorption into the gut, and acts as gatekeeper to the bloodstream.

    Normally, the body only absorbs 10–20% of the calcium we consume, and that’s all well and good. But with overly high vitamin D levels, the other 80–90% can be waved on through, and that is very much Not Good™.

    See for yourself:

    How much is too much?

    The United States’ Office of Dietary Supplements defines 4000 IU (100μg) as a high daily dose of vitamin D, and recommends 600 IU (15μg) as a daily dose, or 800 IU (20μg) if aged over 70.

    See for yourself: Vitamin D Fact Sheet for Health Professionals ← there’s quite a bit of extra info there too

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