Any thoughts or suggestions? We are thinking about CBT and/or DBT but have yet to find someone in our area.

Thank you for your time.

My current interest is in moving beyong boundaries and communicating to a borderline, fairly and non-judgmentally, about their behavior, and trying to influence it. I like the DEAR MAN GIVE FAST tool from dialectical behavior therapy as a means to do so. I just wanted to add these to this discussion, because they are different from boundaries in that they are focused not on our own behavior but on our request for someone else to behave in a certain way, but using a non-judgmental, compassionate, empathetic, validating approach.

My one current frustration with this set of tools is that they feel daunting!

I like your approach and I think you and I agree on a lot of things. The reason I wrote this as “Tough Love Reconsidered” is I think at some point AFTER emotional closeness and trust is established, some boundaries – like you mentioned (“I don’t feel comfortable…”) work effectively to protect both a person with BPD and the loved ones. I have also found when a person (any person) is impaired by alcohol or drugs (or both) that that is not the time to be judgmental or to be “effective” – I “just say no” (haha). Afterward, IMO the “boundary” can be explained, effectively and non-judgmentally. I certainly never want to spur shame in anyone that struggles with shame issues. I always try to make this “enforcement” about my feelings and not hers. Sure, during the intoxication, the rage is likely to happen, but I know what it is really about – avoiding shame and pain. That, in me, breeds compassion, even when I have to say “no”.

Yes, we’re on the same page.

Bon

You used the example of not going out with your wife if she’s over-medicated. It’s not practical to imagine that you’ll never do or say something that isn’t upsetting but you do have control over how you say it.

In the mind someone with BPD, there’s a huge difference between the invalidation of saying, “I can’t believe that you took so much medication. Now we’re going to have to call the babysitter and cancel our plans for dinner!” and “You know, I’m not feeling comfortable with the amount of medication you took earlier. Let’s plan on going out to dinner on Wednesday instead.” One response can be seen as potentially hostile while they other is more gentle and validating.

Knowing you, I suspect that you took the kinder approach.

I think that the old adage of getting more flies with honey than with vinegar almost always applies to persons with BPD. Some may see this as “walking on eggshells” but I think that it comes down to giving the non-BP tools to be effective given a difficult situation.

Sorry I have been not around – I was traveling quite a bit. I wanted to follow up on this. You say “punitive boundaries” – I say those are RULES and should not be used as well. The only boundaries that I encourage are for oneself and sometimes (after trust is established) using those boundaries can still feel punitive to others (especially those with BPD); however, it is important to me that, after trust is established, a loved one of someone with BPD can (and should) use their own personal boundaries – this can be seen as a form of “tough love” but it is not really that at all, because once trust si established, it is not really “tough” any more. Instead, it is usually respected. I have a boundary with my wife that I will not go out with her if she is over-medicated. Once I refused to go some where with her in this state, which upset her at the time. Later when asked about it I told her why and she said “oh” and that was that.

Bon

I think that tough love or punitive boundaries (i.e., a long list of don’ts) are things that families feel like they are expected to utilize in an effort to control the behavior of someone diagnosed with borderline personality disorder. Unfortunately, I cannot think of any instance where I have heard this was effective.

You’re right; if there is to be any change in the behavior of someone with BPD, it must start within an atmosphere of trust, safety, and acceptance. For someone with BPD, it may take years to build this level of trust. It certainly doesn’t happen in a few short weeks.

Thanks, Bon, for getting the word out that tough love, inflexible boundaries, and ultimatums simply do not work with this population.