Borderline Personality Disorder,  Boundaries,  Treatment

Tough Love is NOT the Answer with BPD

I often peruse the web for articles and posts about dealing with people with Borderline Personality Disorder and what I usually find is incorrect and misguided. I recently stumbled upon a post that can be found here:

http://www.helium.com/tm/339437/individuals-suffering-borderline-personality

In which the author gives some insight and advice about “dealing with” someone with Borderline Personality Disorder. I’d like to look at her advice by excerpting some of her text and then offer a little commentary.

First of all, she says this:

Individuals suffering from borderline personality disorder are very self-destructive and they have great difficulty forming any good relationships. A deep-seeded fear of abandonment is behind every wayward action and prolonged mood swing. It’s [sic] victims are mainly women who show frequent displays of inappropriate anger and who exhibit forms of self-mutilation. They also act on impulse, without regards to consequences and than [sic] hold others responsible for their actions. They are sexually permissive and may indulge in binge eating and drug abuse. Victims of this disorder may shop lift. Hell bent on harming themselves, they live with no discipline or boundary.

While this characterization is generally true, it suffers from what wikipedia calls “weasel words”. Basically, the words that are used slant the information toward being extremely judgmental. What I mean is the use of the words “great difficulty forming any good relationships,” “every wayward action and prolonged mood swing,” “show frequent displays of inappropriate anger,” and “they live with no discipline or boundary” all show us that the author is judgmental toward the sufferer. The idea of “prolonged mood swing” is incorrect as well, since the “moods” of a person with BPD generally last only hours. Also, the idea that “they are sexually permissive” MAY be true for some of the sufferers, but not for all. The idea that a “fear of abandonment is behind EVERY wayward action” is also incorrect. Much of the “actions” are motivated by pain relief and/or shame. Use of the words “no discipline” betrays the authors true feelings about people with the disorder and tells me she doesn’t understand the disorder very well (see below on “Tough Love”).

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The author goes on to say:

Group therapy can resolve self-destructive behaviors. These individuals learn better from their peers because of their resistance to authority. Impulse behavior can be curtailed in this same setting.

Which is basically wrong. Group therapy does work (especially in the context of DBT), but not for the reasons that the author suggests. It is not a “resistance to authority” that drives the effectiveness of group therapy. Instead, seeing that one is not the only sufferer and having the ability to support one another normalizes the disorder. You are not just the broken, shameful person that you feel you are. Interestingly, many people with BPD will criticize others in the group and report that they are not as “crazy” as those people are.

The thing I have the most problem with is this:

Tough love may be needed from family members and loved ones before the person asks for assistance.

This statement is completely false and possibly harmful. Here is the text of a post of mine in the ATSTP group which addresses Tough Love:

Depending on the actual problem with your son(s) the idea of “tough love” might be the worst thing for him (them). While it seems to work for substance abuse, tough love can be an awful mixture for those with ERD-like issues. The problem comes down to the “invalidating environment” as Marsha Linehan puts it. Tough love will invalidate a person’s basic feelings and lead to shame and the feeling of “brokenness”. I have seen this first-hand with one of my daughter’s friends. This friend is 16 now and is a classic BPD/ERD case. She has been kicked out of several “lock down” facilities. Recently her mother sent her to a “tough love”/boot camp. It was a total disaster for the kid and for the family.

A better approach IMO, is emotional validation + a sense of personal responsibility. This combination is built through letting the person know that feelings are not wrong or right, they just ARE. The second half comes through building mastery over their behavior associated with feelings. Bad feelings just exist. This is important because often a person with such issues will use behaviors (like drug abuse or cutting or raging) to make the bad feelings go away as quickly as possible. They need to learn to tolerate the distress and behave in an effective manner. Once this new behavior/reaction to feelings is practiced, they can eventually build mastery over the behaviors. This works backward to help quell the feelings.

It seems that most parents believe that emotional validation = “giving in” (or agreeing with the child or “poor discipline” or whatever). This is NOT the case. It’s difficult for me to express this more firmly. Remember the word “emotional” is important. If you validate invalid behavior, you are enabling. It is important to separate in your mind the emotions (which are natural) from the behavior (which can be painful to all involved). If that separation can be communicated to the person with ERD, it can be worked with. It is difficult, but possible.

Unfortunately, tough love is not the answer.

7 Comments

  • mary

    I have a friend…dear to me for 3.5 years…I was worried about her health due to certain behaviours…I had no one to talk to…I wrote a friend of hers I didn’t know personally. the e mail addresss was included on my e mail forwards from her…this friend of hers was a dear one in her own words…when I contacted her..I was very nervous and felt as though I was betraying her…however I was worried. somehow…my friend found out..a risk I took, but not the wisest on the part of the other person. My friend doesn’t like me now….the latest is that she doesn’t like me because of another person…whom supposedly she doesn’t like, consider a friend, nor talk to….that person has caused problems with our kids by exaggeration and distortions…not a good mix. NOW my friend is siding with this person…I feel to bug me…I am so emotionally whipped….I just never know what manipulation will occur…I’m trying not to react, but that is hard. Right now all I do is wrong…damned if I do or don’t. I haven’t e mailed her in 6 days….for 3 years we wrote every day…..she stopped sending me forwards, won’t say anything nice about me….doesn’t seem to care anymore and this is such the opposite of what our friendship was. she has flloored me. I just cant stand to see her with the other person/friend when the kids plan events…not because i’d normally be jealous, but because it’s an obvious manipulation to anger me. I’m a nice person, but not perfect. FOrtunately I could not make a movie yesterday that the kids were invited to…..I didn’t get off work in time. I dreaded that meeting all day while I was working….my kids are fnally getting tired of it too….I don’t ever encourage them to hate or dislike anyone because of me…although I’ve been falsely accused of it by my friend months ago…I told her the kids don’t understand…she hugged them and said, “this is between your mother and I and not you, you’re just kids” in the mean time…I think she’s turned her son away from us. I just don’t know what to do. I feel like writing a letter to everone at one time and telling my story just to get it over with….not sure that would do any good….just so tired. I am at a point where I feel my validations and kindness are like throwing pearls before swine…I am truly depressed…truly…and I’m having a hard time climbing up. any comments or thoughts would be great.

  • Bon Dobbs

    Mary,

    Emotionally volatile relationships are hard for anyone to deal with. It’s exhausting and painful and takes a lot of energy. On top of that, we are not taught how to deal with emotionally volatile situations. Sounds as if your friend was emotionally wounded by something you did (or she imagined you did and felt the intention was to heurt her) and is angry and attacking you back. That is natural when anger is involved. In the case of someone with BPD, that feeling of anger can quickly become “splitting you black” – which mean she considers you all bad, evil even. When that occurs many people with BPD will burn bridges with former friends. It is a painful situation for the friend (if you value the friendship) and, in time, it mght become a painful, embarrassing situation for the person with BPD. Once the emotional dysregulation and impulsive emotional behavior wears off, your friend is likely to come back to you. It can’t be assured, but it is likely.

    Take care of yourself emotionally and be patient. Sometimes it is the best course of action.

  • Kim

    This is my perspective as some one who has this illness. It does not fit every situation. This is just from experience from dealing with friends of mine and my personal struggle. Please read with an open mind.

    Look I have BPD and let me tell you that if your friend cut ties with you then they will be back. It is all a phase we go through and when we realize that we are being irrational (because deep down we know it is) it sinks in and the cycle continues (the apologies and so on). It is down right manipulation and you have a right to feel the way you do. Asside from the BPD I am not the sweetest person in the world but I would at least try to talk to her, call her out on her crap. Try to get a general sense on what made her feel this way toward you. You ultimately have to decide if this relation ship is worth saving or not. You can be cordial but put down boundaries.

    Boundaries are the best thing you can lay down with this person. Kids are kids and you are right they shouldn’t be involved (guilt trips are a great maipulation tool by the way especially using kids). One day, when you feel up to it you should have a lunch with her (not in a public place maybe a picnic. Public creates more drama and that fules the fires of BPD) Ask her what happen. Make her think about the reasosn why she does the things she has done to you. If you pretty much get the same answer then ask yourself if this is worth it. If it is state that you will be friends and then set boundaries. If not set boundaries and let her know how you feel.

    Idk if your friend has more than one issue i.e. MPD, Bi-polar etc… but it is hard to find people to understand what you are going through when you are going through all of these feelings emotions and phases.

    Having BPD (for me) is like being a caged animal. You don’t really know why you are there in that cage or why you are being punished for rules you didn’t even know you were breaking but everyone that comes to that cage (even the nice person who comes and gives you food or to play with you and pet you) is an enemy because of this one (or sometimes more than one) in humane SOB. So the caged animal becomes paranoid, angry, and explosive. Even though it longs for love it can’t help but to feel betrayal at the front door.

    It is a cycle of ups and downs. I encourge you to read the book I hate you don’t leave me. It is about $8. Your friend needs therapy and support. Idk if tough love is the answer, it isn’t for me anyway. It just makes me want to push my friends away more (a nice way of putting it). Sometimes it is about hurt and making others hurt as much as you do or saying “leave me alone” when they know deep down they need a hug. As a friend, it is a trial and error thing. It all comes down to how commited to the relationship are you willing to be. This is NEVER going to go away but it can be managed. Encourage your friend to talk about their feelings or vent out the frustration.

    I have friends who are BPD and they have jumped off the deepend but I am there when they come back. I text them quite often (about nothing in particular. I.e. about my day or text them call me when you have time).

    Bottom line is that you CANNOT love them back to normal. I have MPD BPD and bipolar; it is not easy living from emotion to emotion and people who try to say that I should just fight doesn’t know anything about fighting. To fight your emotions 24/7 all day long never slipping up once is rediculous. Don’t let your friends emotions take over your life and determine your happiness get them into therapy and ask them about how it is going. Therapy is very personal so they will be a little raw but let them know that you are there for them and in time things will get better.

  • Lucy

    I am a parent of an 18 year old who has just been diagnosed with BPD and I am devasted. I think that the reason I feel this way is because I keep reflecting back on my daughter’s up bringing and my husband and I tried very hard to bring her up like my other 2 children. My daughter though did seem always to be abit different in the sense that she was always clinging onto me and wouldn’t let me go anywhere. I basically had no life. She never played like normal children with toys or other children. All she did was demand attention. She was never one to keep herself occupied. When we would have family gatherings, instead of playing with the other cousins, she would be around the adults (me). We would try to get her to play and interact she would go for abit then she would be back. If I would step out for a quick coffee with my sisters, she would call me at the age of 5 asking where are you why aren’t you home. Alot of times I would have to sneak out and my husband would have to keep her occupied for me to be able to do anything that needed to be done like errand. I am wondering if this is something that she had all along and it just developed more as she became older. All through school I had alot of problems with her in the sense that because she was the smallest in the class and youngest she would get picked on alot. When she went to high school, I thought things would change but it only become worse with all the drama and her hating school. She has was labeled as an IEP student, very bright but had some learning disabilites. She managed to make it to grade 11 but half way I came down with Breast Cancer. I was very fortunate they caught it early. I think this really caved her in. Ever since then she became a total different person. Unfortunately the school and as well as us tried to accomodate my daughter in the hopes of getting her to complete her grade 12 but it did not work. She ended up leaving school with half of grade 12. She has always gone to find jobs and has no problem getting them, but just can’t keep them. She constantly gets anxiety attacks where I have to take her to the emerg. Every job she has had she has has one or 2 eposides where we have to take her in. We have taken her everywhere to see if we can get help and nothing has pulled through. Everyone just passes the buck. Finally this week after seeing 5 psyhrists, he was able to tell us what was wrong with her and is now sending her to theraphy DBT. What I don’t understand is that we as parents have been supportive an have been here for her always. She comes from a very loving and close knit family. I don’t understand why she developed this? What really scares me is the suicidal thoughts she has sometimes and her anger. Even though she gets angry and says crazy things she never follows through thank god. The other things that really concern me as a parent is how do you discipline a person wth BPD without pushing them over the edge. She is so demanding and is constantly asking for things that we just can not give her. Example is constantly wanting to use the family car to go to friends house and the friends are not girls they are guys. She says that girls are inmature and bring on to much drama where as boys don’t care. She has a real hard time keeping herself busy and seems to want to always be around people. Alot of her choices are poor choices so she ends up in messes of drama. She never thinks before reacting. Everything has to be solve yesterday. She had a 1 year relationship that was a horrible disaster and toxic relationship. The Boyfriend had alot of problems and wasn’t helping the issue if anything he was feeding into her problem. Her therapist and crisis centre people advised her to leave him alone and take care of her self first and stay away from him. She did for awhile now she is talking to him again but says they are only friends. When she stopped her relationship with this boy, not more then 3 weeks later she starts seeing someone else who works with her ex. Big mistake but she didn’t listen to anything we said to her. She went ahead mind you the relationship wasn’t a close as her previous one and it only lasted maybe 4 weeks. She is only friends with him now but dealing with the drama between the new ex-boyfriend and the 1 year ex-boyfriend. All I know its a mess. I find that she is always in some sort of drama. She had 1 girlfriend that she was close and then went to school since Kindergarden, but they hardly see each other. They keep in touch and she keeps in touch with alot of people but she just doesn’t seem to be able to have one true friend that sticks around. Even in school was the same thing. There this one boy who she known since Kindergarden and seems to be the only one that has been there always for her. He knows she suffers from BPD but has alot of patience for her. Thank God for him. Also she tends to always interfer with our plans. If my husband and I go away which is rare because we know how she is, she always manages to ruin it for us. My husband and I never have our time alone. We basically now have no life. It feels as though she has consumed our enjoyment of life. Even my other children (2 boys) who are much older then her feel the sadness and distress we are feeling. They now understand that she has this problem but are angry at the same time because of they way she is slowly distroying the family. I don’t even think she realizes she is doing it. She treats me the worse. If I tell her no for something she wants she totally ignores me and tells me off. The good thing about it is it only lasts for a short time. She knows that I am on remission and the stress is killing me but I don’t think she realizes the impact that this disorder is causing on my health and my family. I don’t want to sound like I am crying woe me its just that its so hard to discipline and deal with someone who is hurting and I feel helpless. I so want to make her better but I don’t know how.

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