Borderline Personality Disorder Articles

Cheat Sheet / Updated 06-25-2021

To be formally diagnosed with borderline personality disorder (BPD), a person must show frequent signs of at least five out of nine symptoms of BPD. Manage your BPD by understanding various treatment options, and if you know someone with borderline personality disorder, consider ways you can help him or her cope.

Article / Updated 03-12-2021

Knowing whether you or someone you know has borderline personality disorder (BPD) requires careful scrutiny and input from a trained mental health professional. However, even professionals struggle with making this diagnosis because the symptoms of BPD vary dramatically from person to person. In a way, BPD is similar to the countless breeds of dogs that exist today. For example, cocker spaniels, terriers, Bernese mountain dogs, pit bulls, Russian wolfhounds, golden doodles, mutts, and Chihuahuas differ strikingly from each other, but they’re all dogs. Likewise, people with BPD don’t share all the same symptoms, but they do all have the same disorder. People who suffer from BPD experience a range of symptoms, which mental health professionals group into nine major categories. Currently, to be diagnosed with BPD, you must show signs of at least five of these nine symptoms. 1. Sensation seeking (impulsivity) To count as a sign of BPD, this sensation-seeking symptom has to involve a minimum of two types of impulsive, self-destructive behaviors. Impulsive people tend to act without thinking of the consequences. These impulsive behaviors trigger adrenaline rushes and intense excitement and include the following: Sexual acting out Substance abuse Uncontrolled spending sprees Binge eating Reckless behavior, including Highly aggressive driving Extreme sports Shoplifting Destruction of property The impulsive behaviors we’re talking about here are both risky and self-damaging. They often endanger the lives and well-being of the people who exhibit them. For instance, sexual acting out may consist of frequent, casual, unprotected sexual encounters with complete strangers, which can lead to STDs or unwanted pregnancies. Uncontrolled spending sprees can involve numerous, unnecessary purchases that max out credit cards and pile up debt. Shoplifting often involves stealing items strictly for excitement and can lead to jail time. The tendency to act impulsively is thought to be predisposed by inherited influences. Impulsivity often shows up early in life and continues throughout childhood, adolescence, and adulthood. However, it can be influenced by experiences and learning. In addition, some impulsivity can be treated with medication. 2. Self-harm Self-harm is a particularly common and conspicuous symptom in people with BPD. People who exhibit this symptom may threaten or attempt suicide and do so often. Others may deliberately burn themselves with cigarettes, slice their arms with sharp blades, bang their heads, mutilate their skin, or even break bones in their hands or bodies. Although this symptom is separate from sensation seeking, it also involves a certain level of impulsivity. People who exhibit this symptom have to be impulsive enough to try to kill themselves again and again. A common misperception is that suicidal threats rarely lead to real suicide attempts. You should take any threat of suicide by a person (whether he’s suffering from BPD or not) seriously and seek professional help immediately. 3. Roller coaster emotions People with BPD experience extreme emotional swings. They may feel on top of the world one moment and plunge into deep despair the next. These mood swings are intense but usually transient, lasting only a few minutes or hours. The emotional flip-flops often occur in response to seemingly trivial triggers. For example, a co-worker passes by someone with BPD in the hallway without acknowledging her. This unintentional and misinterpreted slight can spark powerful anxiety and distress in the person with BPD. That emotional distress can lead someone with BPD to overreact. Most people who are in a relationship with someone who has BPD find these mood swings quite difficult to understand or accept. 4. Explosiveness Dramatic bouts of anger and rage frequently plague people with BPD. Again, the events that trigger these rages may seem inconsequential to other people. As you can imagine, these explosions often wreak havoc in relationships and may even result in physical confrontations. People with BPD sometimes end up in legal entanglements because of their outrageous behavior. Road rage is a good example of this symptom of BPD, although not everyone who exhibits road rage has BPD. 5. Worries about abandonment People who exhibit this symptom obsess over the fear that a loved one will leave them. Their terror over abandonment may cause them to appear clingy, dependent, and outrageously jealous. For example, a husband with BPD may check his wife’s cellphone logs, e-mails, and car odometer readings daily, always looking for evidence of infidelity. Paradoxically, the obsession with keeping loved ones close usually drives them away. To reduce anxiety over the possibility of abandonment, those with BPD often seek reassurance from their friends and loved ones. They may ask, “Do you still love me?” numerous times per day. They may feel terror over perceived criticism or slights, assuming it means they’re no longer cared about. If it’s even possible that some action could imply rejection, they’re likely to perceive it as such. This constant fear leads to much unwanted suffering on the part of the person with BPD. 6. Unclear and unstable self-concept This symptom describes a failure to find a stable, clear sense of identity. People who exhibit this symptom may view themselves highly favorably at times, yet, at other times, they exude self-disdain. They often have little idea of what they want in life and lack a clear sense of values or purpose. Frequent changes in jobs, religion, or sexual identity may reflect shifting values and goals. Navigating life without a clear self-concept is like trying to find your way across the ocean with no compass. 7. Emptiness Many people with BPD report feeling painfully empty inside. They have overwhelming cravings for something more, but can’t identify what that something more is. They feel bored, lonely, and unfulfilled. They hunger for something that could give them a sense of purpose or direction. They may attempt to fill their needs with superficial sex, drugs, or food, but nothing ever seems truly satisfying—they feel like they’re trying to fill a black hole. 8. Up-and-down relationships Relationships involving people with BPD resemble revolving doors. People with BPD often see other people as either all good or all bad, and these judgments can flip from day to day or even from hour to hour. People afflicted with BPD often fall in love quickly and intensely. They place new loves on pedestals, but their pedestals collapse when the slightest disappointments (whether real or imagined) inevitably occur. People in relationships with people who have BPD (whether they’re lovers, co-workers, or friends) experience emotional whiplash from the frequent changes from idolization to demonization. As a result, many people find difficulty in maintaining meaningful relationships with those who have BPD. People with BPD can be highly interesting, exciting, creative, and fun to be with. We’re not implying that long-term relationships with them never work out. With work, patience, and understanding, relationships can sometimes be maintained and enjoyed. 9. Dissociation: Feeling out of touch with reality Professionals describe dissociation as a sense of unrealness. People who feel dissociated or out of touch with reality say they feel like they’re looking down at themselves and watching their lives unfold without being a real part of them. When people with BPD lose touch with reality, they usually don’t do so for long periods of time. But sometimes when they lose touch with reality, they hear voices telling them what to do. At other times, they may suffer from intense, unwarranted mistrust of others. As you can no doubt see, these signs and symptoms overlap and feed on each other. Thus, if someone explodes with little or no provocation, demonstrates unusual moodiness, and clings excessively to his loved ones, you can understand why that person’s relationships suffer. And when relationships go poorly, self-concept can plummet.

Article / Updated 03-12-2021

Borderline personality disorder inflicts an amazing toll on sufferers, families, and society. For a long time, experts assumed that about 2 to 3 percent of the general population had BPD. However, some findings suggest that this estimate may have greatly underestimated the extent of the problem and that up to 6 percent of the population may warrant receiving this diagnosis at some point in their lives. This article takes a look at the personal costs, both physical and financial, of BPD for the people who suffer from BPD and the people who care about them. In spite of the bleak topics covered here, many people with BPD manage to have brilliant careers and live long, fairly successful lives. Furthermore, the passage of time typically results in reduced severity of BPD symptoms, and therapy can accelerate this process. In other words, don’t give up, because you have many reasons for hope! Health costs Experts consider BPD one of the most severe mental illnesses. About 10 percent of the people with BPD eventually kill themselves, and many more of them seriously injure themselves in suicide attempts. Multiple studies conducted from the 1940s to the present have consistently found that people with severe mental illnesses (such as BPD) die young — shockingly, studies show that people with BPD live lives that are 20 to 25 years shorter than the lives of people without mental illnesses. Many factors contribute to these premature deaths. First, people with mental disorders, including BPD, often resort to smoking cigarettes — an obvious risk factor — as a desperate coping strategy. Furthermore, people with mental illnesses usually have greater difficulty controlling impulses and, thus, find quitting even more daunting than other people do. In addition, researchers find higher rates of obesity and diabetes among sufferers of BPD — researchers now consider both of these conditions to be almost as bad as cigarette smoking in terms of the health risks they pose. Additional risks that people with BPD carry with them include heightened probabilities of heart disease and stroke. Unfortunately, some of the medications that mental health professionals use to treat mental illnesses make matters worse by leading to additional weight gain (and its accompanying increased risk for heart disease, stroke, and diabetes). Furthermore, people with chronic mental illnesses usually receive inadequate basic healthcare because they lack financial resources. Accidental death rates and death from violence are also significantly higher in people with mental illnesses such as BPD. Risky, impulsive behaviors may result in unintentional deaths because of traffic accidents, drug overdoses, or sexually transmitted diseases. People with mental illnesses are also more likely to be homeless, which in turn creates additional risks due to poor nutrition, lack of health care, poor living conditions, and victimization. Financial and career-related costs BPD can exert a ruinous effect on employment and careers. People with BPD tend to be chronically underemployed — in part, because they may start out idealizing new job possibilities, only to end up disillusioned and disappointed when jobs don’t live up to their inflated expectations. People with BPD often experience problems with knowing who they are, which often causes them to drift from job to job because they don’t know where they want to go in life. Finally, because many people with BPD struggle to get along with other people, they often lose or quit their jobs because of relationship problems in the workplace. On the other hand, some people with BPD are highly successful in their careers. They may be unusually skillful and gifted. Most of these surprisingly accomplished people still relate to their coworkers in problematic ways. For example, they may misinterpret coworkers’ intentions and react to the slightest provocation with oversensitivity and anger. Their successful careers stand in stark contrast to their failed relationships. The toll on family and friends Marriage isn’t as common among people with BPD as it is among people without the disorder. And, when people with BPD do marry, not as many of them choose to have children compared to the general population. Perhaps surprisingly, their rate of divorce doesn’t appear to be strikingly different from the rate among the rest of the population. Family members of people with BPD suffer right along with their loved ones. Watching their loved ones cycle through periods of self-harm, suicide attempts, out-of-control emotions, risky behaviors, and substance abuse isn’t easy. Partners, parents, and relatives often feel helpless. Friends often go from trying to help to walking away in frustration and anger. Furthermore, families of people afflicted with BPD must deal with the frustrations of scarce treatment programs, discrimination, and stigmatization. Even when families do secure treatment, the treatment process is prolonged and costly. Clearly, BPD casts a wide net of anguish that captures a lot of people in addition to its specific victims. The effects of BPD on the health care system BPD costs the worldwide health care system a lot of money, and, surprisingly, BPD possibly costs more money when it isn’t treated than when it is. Some of these costs result from the personal health problems that often accompany BPD. These health problems cause people with BPD to go to the doctor more often, and because of chronic underemployment, a disproportionate number of people with BPD receive their health care at emergency rooms, which is the priciest source of medical care. BPD is associated with at least 10 percent of all mental health patients. We strongly suspect that this estimate is low because many mental health professionals are reluctant to assign this diagnosis to their patients. This reluctance is a direct reaction to concerns about stigmatizing patients. In addition, since BPD often comes with other, co-occurring mental health diagnoses, it’s sometimes is overlooked. Furthermore, BPD accounts for 15 to 20 percent of all inpatients in mental health hospitals. Inpatient mental health treatment tends to be extremely expensive, so costs mount quickly. Politicians often view these costs as prohibitive — a view that results in the underfunding of such services. Because publicly financed mental health treatment programs are woefully inadequate, some people with BPD end up homeless or in prisons and jails rather than in hospitals or outpatient settings.

Article / Updated 03-12-2021

Borderline personality disorder (BPD), arguably the most common and debilitating of all the personality disorders, causes chaos and anguish for both the people who suffer from the disorder and those who care about them. Personalities are the relatively consistent ways in which people feel, behave, think, and relate to others. Your personality reflects the ways in which other people generally describe you — such as calm, anxious, easily angered, mellow, thoughtful, impulsive, inquisitive, or standoffish. All people differ from their usual personalities from time to time, but, for the most part, personalities remain fairly stable over time. For example, consider someone who has a generally jolly personality; this person enjoys life and people. However, when this person experiences a tragedy, you expect to see normal grief and sadness in this generally jolly person. On the other hand, someone with a personality disorder, such as BPD, experiences pervasive, ongoing trouble with emotions, behaviors, thoughts, and/or relationships. The following paragraphs describe the core problems that people with BPD frequently experience. The American Psychiatric Association has a manual that describes specific symptoms of BPD. The manual groups these symptoms into nine categories. In this article, we condense these nine symptom categories into four larger arenas of life functioning that are easier to digest. Although BPD has an identifiable set of symptoms, the specific symptoms and the intensity of those symptoms varies greatly from person to person. Unpredictable relationships People with BPD desperately want to have good relationships, but they inadvertently sabotage their efforts to create and maintain positive relationships over and over again. You may be wondering how they continually end up in rocky relationships. Well, the answer lies in the fact that their desire for relationships is fueled by an intense need to fill the bottomless hole that they feel inside themselves. People with BPD ache to fill this hole with a sense of who they are, a higher level of self-esteem, and high amounts of outside nurturance, unconditional love, and adoration. But no one can fill such a huge personal chasm. Partners and friends may be defeated soon after they enter the relationship. Their attempts to make their friends who have BPD happy too often fail. The people with BPD reflexively respond to their friends’ efforts with surprising disappointment, pain, and sometimes even anger. This intense negative reaction confuses partners of people with BPD because people with BPD typically start out relationships with enthusiasm, warmth, and excitement. New partners may feel entirely enveloped by love and caring at the beginning of their relationships, but, repeatedly, things go terribly wrong. What happens to turn a relationship so full of love and excitement into something full of pain and confusion? Well, many people with BPD fear abandonment above almost anything else. Yet, at the same time, they don’t believe they’re worthy of getting what they really want. They can hardly imagine that another person truly does love them. So, when their partners inevitably fail to fulfill their every need, they believe the next step is abandonment. This conclusion simultaneously fuels the person with BPD with terror and rage. As a result, they push their partners away. Better to push someone away than to be pushed away, right? This series of reactions is extremely self-defeating, but it’s born out of fear, not malice. Acting without thinking Human brains have built-in braking systems, which, in theory, are a lot like the ones that five-ton trucks use to slow down as they roll downhill. These brake systems come in handy when the trucks drive down steep mountains, or, in terms of the human brain, when the intensity of emotions flares up in certain situations. Unfortunately, most people with BPD have brake systems that are adequate for golf carts — not five-ton trucks — which are hardly enough to handle the weighty emotions that often accompany BPD. Brain brakes, as we like to call them, keep people from acting without first thinking about the consequences of their actions. Like rolling dice in a game of craps, behaving impulsively rarely results in winning in the long run. Common impulsive behaviors in people with BPD include the following: Impulsive spending Gambling Unsafe sex Reckless driving Excessive eating binges Alcohol or drug abuse Self-mutilation Suicidal behavior Volatile emotions The emotional shifts of people with BPD are almost as unpredictable as earthquakes. They can also be just as shaky and attention grabbing. After people with BPD unleash their emotions, they usually don’t have the ability to regain steady ground. The rapidly shifting emotional ground of people with BPD causes the people around them to walk warily. In the same day, or even the same hour, people with BPD can demonstrate serenity, rage, despair, and euphoria. Confusing thoughts People with BPD also think differently than most people do. They tend to see situations and people in all-or-nothing, black-and-white terms, with few shades of gray. As a result, they consider events to be either wonderful or awful, people in their lives to be either angels or devils, and their life status to be either elevated or hopeless. Sometimes the thoughts of people with BPD travel even closer to the edge of reality. For instance, they may start thinking that other people are plotting against them. They may also distort reality to such a degree that they may seem briefly incoherent or psychotic. Psychosis entails difficulty understanding what is real versus not, including obviously false beliefs and seeing or hearing things that others do not. Such departures from reality are usually brief. People with BPD also sometimes perceive their bodies as being separate from themselves, which is called dissociation. They describe these occurrences as like looking down at what is happening to them from another vantage point.

Article / Updated 03-12-2021

Here are some tips on what not to do for your Borderline Personality Disorder (BPD). Some of these items are quite harmless and may provide a little relief from pain, depression, or discomfort. However, you won’t find any research that proves that any of the following techniques are comprehensive enough to tackle BPD. BPD is a serious emotional disorder. It’s important to get appropriate help. Do not expect quick fixes We’re sorry if you expected to read articles, do some research, and be cured of your BPD. Effective treatment of BPD takes time. In most cases, treatment takes at least a year and often longer. BPD is a complex disorder that requires consistent hard work. Don’t be fooled by someone who promises a quick fix. You won’t find any ten-day miracle cures for BPD — at least none that actually work. On the other hand, people with BPD who are ready to look at all their symptoms in an honest way and work hard to get better can enjoy significant improvements fairly rapidly. Not surprisingly, however, breaking old habits and permanently learning new, better ways of living usually takes considerable time. Do not stay stuck When people with BPD tell us that they’ve tried everything to get better and nothing has worked, we know they’re stuck. Because so many treatment options have emerged over the years, few, if any, people have really tried them all. Thus, we tell our clients that doing nothing is, in fact, making the decision to stay the same. We’ve never met anyone with BPD who loves having the disorder. If you have BPD, you can find programs that can help you. If you live in a location where no therapists are trained in treating BPD, consider asking a local therapist to request supervision from someone who has knowledge and experience with the disorder so that you can get the help you need. The bottom line: You can find treatment for your BPD, and you can feel better. Do not choose chiropractic medicine for BPD Most chiropractic doctors believe that the spine and overall health are related. People who go to chiropractors report relief from headaches, back pain, neck pain, and other muscular or skeletal pains. Often covered by insurance, this type of health care has gained popularity over time. However, some chiropractic practitioners promise much more than relief from physical pains — some of them promise improvements in mental health. Chiropractic medicine has its place in the care of many health issues; however, no research justifies it as a treatment for BPD. So, feel free to seek this kind of treatment for your body’s physical aches and pains, but don’t expect it to cure your BPD. Do not make acupuncture a primary BPD treatment Imbalanced internal energy is the premise behind acupuncture, an ancient Chinese medicine that many trained acupuncturists still practice today. Acupuncture treatment consists of inserting very fine needles into different places in the body to rebalance energy flow. Many people claim that acupuncture helps decrease chronic mental and physical pain. Limited research supports the use of acupuncture for substance abuse, as well. We advise you not to make acupuncture a primary treatment for BPD because evidence to support acupuncture’s effectiveness in treating BPD just doesn’t exist. However, if you find that it helps reduce pain or stress, or improves your mood, by all means, consider it in addition to your other treatments. Do not find a life coach for BPD We like coaches. Coaches can help you stay focused on your goals and cheerlead your efforts. However, BPD is a serious mental disorder. Treatment requires highly skilled professionals trained in specific therapies for treating BPD. We encourage you to postpone hiring a life coach until you’ve benefited from professional mental health treatment. If you decide you want to have a coach at that time, be sure to talk with your therapist first. Do not fill up emptiness with food or drink One of the symptoms of BPD is a strong feeling of inner emptiness. If you suffer from this symptom, you feel like something important is missing. Often, people experiencing this emptiness hope that food or drink will fill the void. Unfortunately, that approach doesn’t work. Furthermore, after eating or drinking too much, people with BPD add guilt and remorse to their plate of negative feelings. This common feeling of emptiness isn’t a hunger of the body; it’s a hunger of the mind. Working on getting better, improving relationships, and leading a meaningful life will satisfy the hunger — not food or drink. Do not try too hard Most people come to therapy with great anticipations and expectations. Just walking through the door for the first time to get help can set off feelings of optimism and hope. Those positive feelings can be quite strong. We wish we had a magic wand that could instantly fix the people who walk into our office, but breaking old habits and learning new ones takes time — not magic. To get the most out of your therapy, you need to find the balance of learning to accept where you are in the present and where you want to be as you move forward. Trying to go too fast, too hard only bogs down your progression. Pace yourself. Give yourself the space to work through your issues. Remember that the turtle wins the race through persistence and hard work — be the turtle. Do not gaze at crystals to cure BPD Some people believe they can tell the future, solve crimes, and heal people by staring at a crystal ball. Some crystal gazers advertise that they can defeat depression and relieve daily stress. After surfing the web for about an hour, we found out much more than we ever wanted to know about the powers of crystal balls. Apparently, different crystals have different powers. One website suggested putting a particular crystal in a glass of water overnight and then drinking the water the next day as a tonic. Well, if you want to look at shiny rocks, go ahead. But please don’t hope to cure BPD with crystals. You just won’t find any evidence that proves crystal gazing can cure the disorder. Do not get the wrong BPD therapy Psychotherapy for BPD is very important. However, some psychotherapy approaches don’t appear to be effective or haven’t yet been well researched for treating BPD. We recommend that you choose a therapist who conducts evidence-based treatments specifically targeting BPD. Now, we’re not saying that some of these other treatments don’t have benefits, but we are saying that we don’t have enough information to say that they do. Would you buy a new type of furnace to heat your home if it has never been tested in the lab? Or a car that has never been tested on the road? The same idea holds true for therapy. Ask potential therapists how they treat BPD and what therapy they use. If they can’t answer these questions, find someone else. Do not hope medications will cure BPD Researchers are constantly developing new medications. In the future, scientists may find a medication that substantially helps or possibly even cures BPD. But at this time, no such medication exists. People with BPD sometimes benefit from medication for specific symptoms, but you should use medication only in conjunction with psychotherapy.

Article / Updated 03-12-2021

We have great compassion for people with borderline personality disorder (BPD). We know painful emotions permeate their lives. Guilt and regret are two especially powerful emotions that often plague people with BPD. We also know that folks who love people with BPD often feel terribly hurt and confused. Some have endless optimism that their loved ones with BPD will improve. Others give up and move on. Either way, people with BPD feel better when they take personal responsibility for the roles they’ve played in hurting the people who care about them. Part of getting better involves being able to tell the people you have hurt, “I’m sorry.” This list offers ten ways to tell your loved ones that you’re sorry. Say the Words Out Loud A simple but, at times, excruciatingly difficult way to communicate remorse is by speaking the words out loud. For some people, apologizing seems almost impossible. If you feel overwhelmed by this challenge, talk to your therapist about it. Try role-playing in one of your sessions. Then ask yourself the following questions: What does saying I’m sorry mean about me as a person? How can saying I’m sorry help me and the other person? Saying you’re sorry actually suggests that you’re a brave person — someone who can own up to mistakes. Saying you’re sorry can help the one you hurt as well as yourself. Although apologizing won’t negate past wrongs, it’s a move in the right direction — especially if you commit yourself to continuous growth. Ask for Forgiveness Saying you’re sorry is only half of the picture. The other part is asking for forgiveness. Sounds pretty easy, right? “Please forgive me.” People who’ve been hurt by people with BPD have likely been told, “I’m sorry,” or “Please forgive me,” more than once. Asking for forgiveness must come with a spoken or unspoken pledge to work at making life better for both you and the person you hurt. In other words, when people with BPD ask for someone’s forgiveness, they must be starting or getting treatment and learning the skills that will improve their relationships. After all, asking forgiveness is a promise to work on reducing the hurt. Run an Errand You’ve heard the expression, “Actions speak louder than words.” Well, being professional writers, we’re not sure that we agree 100 percent; but, in the quest for making amends, you need to think hard about this concept. For example, consider running an errand for someone you care about and think you may have hurt with your BPD-driven behaviors. This errand can involve picking up the groceries, filling up the gas tank, going to the post office, picking up the kids from school, or taking the tax forms to the accountant. The task doesn’t have to be difficult, but it should be something that your partner, family member, or friend usually does for herself. Send Flowers Almost everyone likes flowers. And getting flowers from someone you care about feels good. You don’t have to spend a fortune. A small bunch from the grocery store can brighten up moods and get your point across. If you can’t afford the cost of a bouquet, buy a single flower. Send a Card A card can also be a thoughtful way to express your feelings, whether you want to ask for forgiveness, say you’re sorry, or tell someone how special he or she is. You can buy a paper card or go online and find an e-card. Make sure you spend some time looking at and reading the card before you send it. You probably don’t want to send your partner a card designed for someone’s third birthday, even if it does look pretty cute. Do a Chore Again, the chore doesn’t have to be a big deal. Just make sure that it involves something that your friend, partner, or family member usually has to do. For example, you can clean the garage, make a special dinner, pay the bills, wash the car, pick up around the house, or file financial papers. Whatever you choose to do for someone you care about, do it without complaining or bragging about what you did. Write your Thoughts Writing out your thoughts can be one of the most meaningful ways to show and explain your feelings. Your loved one will appreciate the time you spent thinking about him or her. Here are a few pointers: Never send anything that you wrote in the middle of the night without proofing it in the morning. Don’t send a letter that’s basically self-defense and justification. Don’t write your letter after you’ve been drinking or getting high. Remember that when you write something, whomever you give it to can save it forever. Find a Poem Sometimes you can’t express yourself in a way that fully describes your feelings or passions. Poetry sings a message. If you haven’t read poetry since high school (okay, that goes for about 90 percent of the population), go to your local library or bookstore and browse for a couple of hours with a cup of coffee. Whether or not you understand everything you read, a few of the poems will surely inspire you. Borrow the book from the library or buy it from the store. Copy the poem in your best handwriting or type it on the computer. Add a few comments about what meaning the poem holds for you and what you think about the person you’re giving it to. Send the poem and your comments to the person you may have hurt. Send a Small Gift Small gifts are another way to express your feelings. In many ways, small is truly better than large. Large gifts generally come with implicit strings attached, whether you intend them or not. Small gifts, especially gifts that may have special meaning to the person you wronged, have much more power and, yet, no strings. If you want to express your regret or sorrow with your therapist, we generally recommend avoiding gifts whether small or large. Many therapists work under ethical codes that discourage accepting gifts, and they aren’t necessary anyway. Simply express your feelings verbally or in writing. Make Amends: Giving or Volunteering Sometimes your past actions from long ago continue to plague your mind with guilt and regret. Often, the person you hurt has moved on, died, or simply isn’t available for you to make amends directly. In these cases, consider designing a plan for making amends. Such plans can entail making a contribution to others. The contribution may be giving money, spending time, or providing a skilled service to someone or a group of people who need help. A few of our favorite charitable activities include becoming a dog walker at the Humane Society, working at a local food bank, tutoring people who want to learn English, and participating in a community trash pickup. You can also donate money to a group that’s important to either you or the person you’re making amends with. Call your local Red Cross or United Way office for more possibilities. You can’t undo the past, but you can feel better about who you are becoming today by contributing to others. Saying you’re sorry, asking forgiveness, and making amends are only useful when you accompany them with a commitment to make things better — not a promise of perfection, but a sincere effort.