By Martha McLaughlin
If someone you love has been diagnosed with borderline personality disorder (BPD), you may be grappling to understand the condition and how it affects your loved one. Let’s take a closer look at what BPD is and ways you can provide support.
What Is Borderline Personality Disorder?
Unlike anxiety or depression, the term “borderline personality disorder” doesn’t immediately provide clues to the nature of the condition. The name was originally given to the disorder because patients were thought to be on the border between neurosis and psychosis. Although our understanding of BPD has evolved and changed, the name, so far, has stuck.
Some alternate names that have been proposed for BPD — including emotional dysregulation disorder, impulse spectrum disorder and complex post-traumatic stress disorder — indicate that the heart of BPD is difficulty managing emotions. These emotions are felt intensely and lead to impulsive actions, which can include risky and harmful behaviors.
What Causes Borderline Personality Disorder?
Environmental and biological factors may both play a role in the development of BPD. Sometimes, BPD develops after increased stress or trauma, especially in childhood. And twin studies suggest genetics are involved: People who have first-degree relatives with BPD are about five times more likely than others to develop it themselves.1
There may also be differences in the brain’s function and structure in people with BPD, especially in areas related to impulse control and emotional regulation. Communication between the emotional and decision-making parts of the brain seems to be impaired.1
Helping Your Loved One
Living with BPD isn’t easy, whether you struggle with the condition yourself or love someone who does. It’s important to be patient but remain hopeful.
1. Educate Yourself
The more you learn about BPD, the less likely you are to take your loved one’s behavior personally and react in ways that are ultimately counterproductive. The words you hear and actions you see may seem irrational to you, but they’re likely a response to intense, overwhelming feelings your loved one is experiencing and trying to manage.
Feelings of abandonment are particularly common in people with BPD, as is the tendency to swing from extreme closeness to extreme distance in relationships. Your interactions may be complicated and often painful, but understanding the complex emotions behind your loved one’s behaviors can help shed light on the situation.
2. Encourage Treatment
While various treatment options for BPD exist, Dialectical Behavior Therapy (DBT) was developed specifically to treat BPD and has been shown to be particularly helpful. In fact, a 2014 study of DBT found that, after a year of treatment, 77 percent of patients no longer met the criteria for a BPD diagnosis.2
“Dialectical” means to balance or synthesize opposing forces. In DBT, the forces that are balanced are acceptance and change. The message is both that individuals with BPD are doing the best they can and that they need to learn new skills in order to do better.
A loved one with BPD may be reluctant to try treatment or even to accept the diagnosis. People who feel this way may be open to a therapy approach that doesn’t put the focus exclusively on themselves, such as couples or family therapy.
It can also be helpful for you to receive counseling on your own, in order to manage the emotions created by your family situation. A support group can be another source of both emotional and informational help.
Part of what makes DBT different from other therapy approaches is its attention to validation. But validation isn’t limited to the therapist’s office. You can use this technique at home with your family member too.
In an interview with PsychCentral, Shari Manning, the author of Loving Someone with Borderline Personality Disorder, explains that validation involves acknowledging some part of what your loved one is saying as valid, while refraining from validating what isn’t true or helpful. She gives the example of an underweight person saying, “I’m fat.” Validation wouldn’t involve saying, “Yes, you’re fat,” but rather saying, “I know you feel fat.”
She notes the importance of not letting tone and manner contradict the words. Stressing the word “feel,” for example, may communicate that the feeling is understood but unwarranted.3
4. Set an Example
It’s normal and natural to respond to your family member’s outbursts with anger and distress. But regulating your own emotions in the situation can help calm things down, as well as provide a model to follow.
You can also set an example for healthy, proactive stress management by incorporating positive mental health habits into your life. These may include meditation, breathing exercises or journaling.
Recovery Is Possible
The challenges of BPD are real, but so is the hope of change and recovery. Take care of yourself, be patient with your loved one and get as much help for both of you as you can. You can get through it together and come out stronger and closer on the other side.
1 “Borderline Personality Disorder.” National Alliance on Mental Illness, Accessed January 11, 2018.
2 Stiglmayr, Christian, et al. “Effectiveness of dialectic behavioral therapy in routine outpatient care: the Berlin Borderline Study.”Borderline Personality Disorder and Emotion Dysregulation, December 18, 2014.
3 Tartakovsky, Margarita. “How to Help a Loved One With Borderline Personality Disorder, Part 2.” Psych Central, July 17, 2016.
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