Do non-BPDs have enough compassion for people with Borderline Personality Disorder? A few months ago, Dr. Kristalyn Salters-Pedneault, PhD, About.com’s BPD guide, posted a message entitled “Have Compassion” in which she said: “Many times each week I receive reader comments, forum posts, and personal emails that are incredibly hateful toward people with BPD. I do understand that many people have been hurt by individuals with BPD, and that usually these comments are written from a place of pain and anger. But, I am often shocked by the level of vitriol in these comments.” She went on to implore non-BPDs to have compassion for those suffering from BPD saying: “People with BPD deserve your compassion. I am not saying that people with BPD do not behave in ways that are hurtful, nor that they should not have to accept responsibility for these actions (and, by the way, you may not realize it, but they usually do, after the fact, and with a deep sense of shame, guilt, and remorse).”
In January, Randi Kreger, the author of “Stop Walking on Eggshells” and “The Essential Family Guide to BPD”, responded to this message on her “Stop Walking on Eggshells” blog. She responded: “Yes, Family Members Are Compassionate! In fact, family members (FM) of people with BPD are some of the most compassionate people out there. Those who know about BPD are aware their BPD FM didn’t ask for the disorder.”
I have been thinking about both of these posts for months. I have noticed that when non-BPDs “wash up on the shores of the ATSTP list” they are generally NOT compassionate. I also have found that just telling them that their borderline loved ones “deserve their compassion” does not work. There has to be a period of learning, skills application and understanding the mechanics of the disorder before they begin to develop compassion for their loved ones with BPD. So, I asked myself: why?
When reading The Lucifer Effect: Understanding How Good People Turn Evil (a book about how “normal” people behave in evil ways), I stumbled onto two concepts that I believe explain why non-BPDs do not have compassion for their borderlines at the beginning. These concepts are: Emotional Burnout and Compassion Fatigue.
Burnout (or emotional burnout) is characterized by three basic building blocks. Those are (with an explanation of each with respect to non-BPDs):
Emotional Exhaustion – the emotional intensity of the interactions with a borderline are exhausting. As I indicate in “When Hope is Not Enough” the emotional tolerance of someone with BPD is set far lower than a person without BPD. Therefore, emotional crises are much more likely to occur. I know from experience with my family members that have emotional regulation issues, I get very tired when there’s an EDM (emotionally dysregulated moment). Some of these “moments” can last a while, thirty minutes or longer, and it’s very difficult for me to have compassion when I am emotionally exhausted.
Cynicism – unfortunately, because the emotional tolerance of a person with BPD is set so low, I have found that many non-BPDs are quite cynical about the reactions of a borderline to “trivial” things. Often, non-BPDs express that their borderlines are “freaking out” over “nothing” or that the borderlines are just inherently evil (in fact, my post about “demonic possession and BPD” is one of the most popular and most commented upon on this blog). BPD is often thought to be a “character flaw” or a case of the borderline just “behaving badly”. These attitudes lead to more cynicism on the part of the non-BPDs. Additionally, the non-BPD’s compassion is often conditional. It seems to be a case of “I’ll have compassion for you when you start to behave better (or go into treatment or get out of the fantasy world you’re living in)”. This leads to more cynicism, because the borderline is not “keeping up their end of the bargain.”
Inefficacy – I have written about learned helplessness on this blog before. I feel that the non-BPDs try to control that over which they have no control. This leads to inefficacy (and learned helplessness). The idea that nothing they try has any effect on the situation.
Compassion Fatigue is a condition that generally health care professionals (such as nurses) or charity donors develop when they have just “seen too much pain and suffering” to extend their compassion. I think with respect to non-BPDs, it begins to develop when (through cynicism) the non-BPD begins to feel that the borderline is “crying wolf” too many times (i.e. they are getting “overly upset” about things that are “trivial” and that the intensity of the reactions are “too much” for the situation as the non-BPD sees it). Non-BPDs then begin to withdrawal their compassion. I once had a therapist tell me and my wife that we couldn’t continue to “live at the intensity level that we were living at.” I believe that because of “psychic equivalence” (when the borderline gets into “feelings = facts” mode, or that their mind actually reflects the environment, even when it is misaligned with how the non-BPD sees things), the non-BPD develops more and more cynicism about the behavior of the borderline, gets emotionally exhausted by the frequent emotional crises and gets discouraged when all that they’ve been taught to do (boundaries, tough love, behavioral contracts, talking sense to the borderline, etc.) don’t have any effect, the non-BPD develops compassion fatigue and begins to feel that the borderline is just “dramatic” or a “lost cause”. Interestingly, compassion fatigue is also referred to as secondary traumatic stress disorder, which seems to apply to the situation with non-BPDs.
So, do non-BPDs have enough compassion for borderlines? At the beginning, before they begin to behave effectively and before they adjust their attitudes about BPD, I’d have to say “no”. However, emotional burnout and compassion fatigue CAN be combated. How? I’ll cover that in a subsequent post.