Highlights of a Ten-Week
Family Skill-Building Workshop
2014 NAMI Convention Workshop
September 5, 2014
Presented by Edith Mannion, Talya Lewis & Denise Hay
Moderated by Carol Caruso
Fight, Flight, Freeze
When your loved one is
dysregulated...
Fight, flight, freeze
We have to learn to regulate our
own emotions so we can think &
remember communication skills
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Mental Health Association of SE PA
The Borderline Experience
Born with exquisite sensitivity
Nerve endings have no “caps”
Endlessly exposed and raw
Little stressors can cause big
reactions
Once a reaction takes place it
takes longer to return to their
baseline
Fear of rejection
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Mental Health Association of SE PA
Emotion Regulation
Managing painful emotions in
healthy, non-destructive ways
(self-soothing, self-talk)
Staying focused on being effective,
even when distressed
Not just reacting to emotions and
urges
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Mental Health Association of SE PA
Emotion Regulation Skills
Pause and breathe
Notice & release tension
Notice what you are feeling
Notice what you are thinking
Replace distressing thoughts
with soothing thoughts
Take a break if necessary
Respond once regulated
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Mental Health Association of SE PA
Emotional Regulation vs.
Emotional Dysregulation
Individual has
an emotive
experience
Caregiver
validates
feelings
Individual feels
understood and
can process internal
experience
Emotional
Regulation
Caregiver
invalidates
feelings
Individual feels
misunderstood and
can’t process internal
experience
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Mental Health Association of SE PA
Emotional
Dysregulation
Emotional Validation
Viewing the situation from the
other’s perspective
Not condoning the behavior
Allowing their feelings
Understanding their feelings
Normalizing their feelings
Website for examples of
emotional validation:
www.eqi.org/valid.htm
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Mental Health Association of SE PA
What is the
Emotional Roller Coaster ?
 Loving someone who has
*Emotional Dysregulation
*Major Depressive Episodes
*Hypomanic, Manic or Mixed Episodes
 As family members we often go along for the ride
*Primary emotions we are wired to feel for survival
*The cascade of emotions about our emotions
*Fight, flight or freeze reactions
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Mental Health Association of SE PA
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Mental Health Association of SE PA
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Ten-Week Family Skill-Building
Workshop Model
 Developed in 2009 for families of people with
borderline personality disorder, bipolar disorder and
major depressive disorder
 Co-facilitated by a therapist with a loved one who has
one of these disorders and a person in recovery from
one of these disorders (peer specialist)
 A graduate of the workshop mentors the workshop
participants (family peer specialist)
 Teaching methods include slides, discussion, role
plays, recovery stories, homework
 Graduate Group
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PLATFORM FOUNDATION:
Self-Care
 “Put the oxygen mask on yourself
before assisting other
passengers”
 Good self-care reduces our
vulnerability to negative emotions
and improves wellness
 Caregiver burnout and
“compassion fatigue” are serious
risks of poor self-care
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Mental Health Association of SE PA
11
PLATFORM FOUNDATION:
Adjusting Expectations
 We experience multiple and
ambiguous losses when we love
someone with mental health disorders
 Grieving is complicated
 Working through grief is not easy, but
critical to adjusting our expectations
 Adjusting expectations helps us be
more effective and find peace
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Mental Health Association of SE PA
12
PILLAR 1:
Regulating Our Emotions
Tolerating or reducing our
emotions enough that we can
focus on being effective
Not just reacting without
thinking
If we cannot regulate, we
cannot think straight nor
access our skills
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Mental Health Association of SE PA
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PILLAR 2:
Validating Emotions
 Our loved ones can begin to regulate
when they feel understood
 Emotional validation means
acknowledging our loved one’s
emotions based on their perspective
 Even when disagreeing or setting
limits...
“A response that starts with validation
helps prevent more aggravation.”
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Mental Health Association of SE PA
Validate me!
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PILLAR 3:
Limit Setting
BENEFITS TO YOU
TO YOUR LOVED ONE
 Protecting your physical
 More consistency and
health, mental health and
safety
 Protecting others
 Protecting property
 Preventing unintended
legal consequences
 Preventing burn-out
compassion from you
 Helping them learn to
tolerate others’ limits
 Modeling this skill
 Safety in structure &
predictability
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Mental Health Association of SE PA
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PILLAR 4:
Crisis Management
 Crises common in these disorders
*Self-injury
*Suicidal thinking and attempts
*Violence or threats of violence
 Some limit setting skills can make crises
worse
 Family members need to learn skills for
responding to self-injury, suicidal thinking
and potential violence!
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Mental Health Association of SE PA
16
Professional/Peer
Co-Facilitation Model
 Having a therapist/family member
as a co-facilitator offers participants
skills of a clinician with empathy of
a peer
 Having a person in recovery offers
participants a window into their
loved one’s experience & hope
 A family member/graduate of the
workshop offers hope for using and
benefitting from the skills taught
©Copyrighted by Training & Education Center
Mental Health Association of SE PA
For Information about Bringing this
Workshop Model to Your County
Contact: Edith Mannion, LMFT
Mental Health Association of Southeastern PA
Training & Education Center (TEC)
1211 Chestnut Street (11th Floor)
Philadelphia, PA 19107
267-507-3863
emannion@mhasp.org
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Mental Health Association of SE PA
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