1. 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

2. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA

3. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA

4. Emotion Regulation  Managing painful emotions in healthy, non-destructive ways (self-soothing, self-talk) (self-soothing, self-talk)  Staying focused on being effective, even when distressed  Not just reacting to emotions and urges ©Copyrighted by Training & Education Center Mental Health Association of SE PA

5. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA

6. Emotional Regulation vs. Emotional Dysregulation Individual has an emotive experience Caregiver Caregivervalidatesfeelings Individual feels understood and can process internal experience Individual feels misunderstood and can’t process internal experience EmotionalRegulation EmotionalDysregulation Caregiverinvalidatesfeelings ©Copyrighted by Training & Education Center Mental Health Association of SE PA

7. 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 www.eqi.org/valid.htm ©Copyrighted by Training & Education Center Mental Health Association of SE PA

8. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA 8

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10. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA 10

11. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA 11

12. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA 12

13. 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 ©Copyrighted by Training & Education Center Mental Health Association of SE PA 13

14. 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.” ©Copyrighted by Training & Education Center Mental Health Association of SE PA 14 Validate me!

15. PILLAR 3: Limit Setting BENEFITS TO YOU  Protecting your physical health, mental health and safety  Protecting others  Protecting property  Preventing unintended legal consequences legal consequences  Preventing burn-out TO YOUR LOVED ONE  More consistency and compassion from you  Helping them learn to tolerate others’ limits  Modeling this skill  Safety in structure & predictability ©Copyrighted by Training & Education Center Mental Health Association of SE PA 15

16. 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 wors  Some limit setting skills can make crises wors e  Family members need to learn skills for responding to self-injury, suicidal thinking and potential violence! ©Copyrighted by Training & Education Center Mental Health Association of SE PA 16

17. 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

18. 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 (11 th Floor) Philadelphia, PA 19107 267-507-3863 emannion@mhasp.org ©Copyrighted by Training & Education Center Mental Health Association of SE PA 18