Tough Love is not an effective approach to BPD
Tough Love is not an effective approach with children and teenagers with Borderline Personality Disorder. Although some therapists and self-help authors recommend tough love as what should be done with BPD, it is ultimately detrimental to the borderline and to your relationship with the borderline. The problem comes in regarding the nature of the disorder. While behavioral therapies can work, those based on reinforcement and shaping, those therapies usually include acceptance strategies and non-judgmental approaches. The nature of BPD is that the individual with the disorder is in deep emotional pain because of the dysregulation of the emotional system. They are exquisitely sensitive to emotional experiences and many of these experiences are physical in nature, especially with children. There is intense physical pain and social rejection (to which borderlines are also intensely aware) causes more pain. The borderline will then seek to end the pain in any way they can, including substance abuse, casual sex, thrill-seeking and other dangerous methods. While these methods will stop the pain temporarily, the pain always comes back.
OK, now back to why tough love doesn’t work. A person with borderline personality disorder wants more than anything to communicate his/her pain with those with whom he/she has an attachment relationship. Understand that BPD is not just a case of the person “behaving badly”. The behavior has a function and generally that function is to either stop the pain or to communicate the pain. If you try to deal with behavior with tough love (rules, contracts, boundaries, punishments, etc.), the person with BPD will feel more rejected, more abandoned and unable to communicate the pain. This causes MORE pain and requires more pain-quelling behavior. It causes more of what made you start using tough love to begin with.
A little while ago, I was speaking with someone about a friend of my daughter’s. This girl probably has BPD. Her behavior was totally off the charts – drugs, turning tricks, running away, cutting herself, suicide attempts, etc. When the person I was speaking with expressed sympathy for the girl’s mother, I responded like this: “I think what happened with [girl’s name] was that she was in a lot of pain and didn’t know why. All she really wanted was for her mother to see her pain. All she ever wanted was for her mother to understand her and her pain. But her mother only saw bad behavior and tried to deal with that. So, the girl tried anything and everything to stop her pain.”
The word compassion actually means “to suffer alongside” (or co-suffering). If you’re a parent of a person with BPD, are you seeing and understanding their pain? Or are you fed-up with their “bad behavior”? Developing non-reactive compassion is the answer, not tough love. Tough love sends a message that the borderline can’t communicate their pain. Are you co-suffering? Or are you punishing the borderline for doing anything to stop the pain?
11 Comments
bnagit
“Non-responsive compassion” is bull shit. If you care, you care, if you don’t. you don’t. I’m a human being. Let’s get real.
Bon Dobbs
I said “non-reactive” not “non-responsive” – there’s quite a difference. When you don’t make the issue about you and your feelings and instead are compassionate, validating and gentle when someone is in emotional crisis, it makes a big difference. That is part of being human as well.
water
Thank You,,,I have bpd and my daughter has it really bad. I have felt guilt over not using tough love with my daughter,,,,everyone said I should,,,i’m glad I didn’t,,,
kevin blumer
I was never loved as a kid so i blame this as a factor to me having BPD i belive if my parents had loved me a bit i would of developed normal i dont know if this is a factor but i belive it is
kitlou88
I found my daughter cutting when she was 15. At first, and I mean at first, I took the soft approach with her, asked her all of the questions a parent should ask to try and understand. I wanted to know what I could do to help her thru her pain. I wanted to know why she was doing it. I offered taking her to a counselor, her reply was, “Why? I will only tell them what they want to hear!”
She was interested in no common suggestions that I offered. Her cutting became worse. I would go into her room to literally clean out the blades, knives, scissors repeatedly.
I finally took what I referred to as the tough love approach. I got mad about her behavior not at her. I drove her to the local ER and told the doctor, either you do something or she will end up cutting too deep and she won’t be with us any longer!! They would not admit her into the hospital for evaluation only because she wasn’t cutting to kill herself. I thought, really, why would anyone cut to draw blood if they weren’t trying to commit suicide? I took her home that night and we talked for hours. She finally agreed to meet with someone. It had to be someone that was a younger female, someone she could relate too. She knew most counselors would preach to her and tell her not to do it, rather than understand why she was doing it.
Needless to say, this approach I took, caused her cutting to only last about 3 months. Her cousin on the other hand, still cuts to this day, 7 years later.
Her parents took the I am so sorry approach and coddled her. It obviously didn’t work!
I realize each cutter is different and each parent is different, but I wanted to relay my story.
Bon Dobbs
Sounds to me as if your daughter knew what she wanted – someone to talk with about the behavior and feelings and for that someone to be of a certain profile such that your daughter knew that this person “got her” and understood. I would say that your “tough love” approach was the magic element that ended the cutting. As for her cousin, I DON’T recommend the ” I am so sorry approach and coddling” approach… no, what I recommend is for the person to be validated EMOTIONALLY (not behaviorally) and for the consequences of the behavior to be explored. I have found the most significant consequence is an emotional one for the cutter herself. I don’t suspect you’re getting mad was what ended your daughter’s cutting. It seems to me that the “talk for hours” and the agreement to go see a counselor who fit a certain profile was more of the cause of your daughter’s ceasing cutting. You’re daughter seems to be quite attune to her own feelings, knowing that she didn’t want “preaching” from most counselors and wanted someone to “get her” and truly understand the motivations behind the self-injurious behavior. In my mind, that’s not “tough love” at all, even if your application of “tough love” kicked off the going in the effective direction. You say, “she was not interested in common suggestions that I offered”. No one who has emotional pain is interested in common suggestions (advice). They need a full six-step application of I-AM-MAD (validation) that includes the analysis of consequences and for them to solve their own problems with the help of someone who understands. Your daughter seems to have instinctively know this or she wouldn’t have made the suggestion about the type of counselor she wished to see.
Melly
It is exhausting to deal with the behaviors . Physically and mentally .. EXHAUSTING …
How can I be compassionate at that point ? After days of hours of being screamed at and verbally beaten to nothing
Diana
Mine is 28 and running over us like a steam engine year after year. She has pain? She is using up everyone around her and cleaning us out of every penny she can steal. We have gone through 20 years of hell while she walks away from every responsibility. Including a granddaughter who she gave up for adoption. Nope. Tough love it is. I think you are doing these adults a disservice to not make them at least partially responsible for their choices. Our daughter is only “hurting” when I ask her to do something she is supposed to be doing as a responsible adult. Then out come the fake tears. Two minutes later she is laughing and running out to party with friends. It isn’t hurt. It is pure manipulation. Stop making abused parents feel guilty for stopping the cycle of insanity.
Sally
Diana I felt as you did, until that so called manipulator killed herself. Perhaps our demanding they live and behave to our standards of what it means to be a responsible adult may be beyond their capabilities. I read my daughters diary after her death. I was amazed to read about what would be simple things for me were torturous for her.
Sally
She hanged herself after years of minor cutting or what some might call attention seeking. We need to step outside our own understanding…
Bon Dobbs
Sally, so sad. I hate to hear this. I’ve heard it too many times. It’s not best to minimize mental illness. Or to tough love it.