Borderline Personality Disorder

Five common mistakes made by supporters of people with Borderline Personality Disorder

Based on the book When Hope is Not Enough: a how-to guide for living with and loving someone with Borderline Personality Disorder.

During the past four years, I have been blogging about, providing advice to and consulting with hundreds of loved ones of people with Borderline Personality Disorder (BPD). When loved ones come tome for support and advice, I usually find them confused, angry and at their wits end. People with BPD can be extraordinarily difficult to deal with and typically engage in emotion-fueled behavior such as raging, blaming and risk-taking. This behavior frustrates their partners and parents to no end. I have found five approaches in which the loved ones and family members engage that actually serve to make the environment between someone with BPD and their loved ones much worse. Many of these approaches are natural and seem to make sense. Additionally, many books and Internet resources assert that some of these approaches are effective, even when experience shows that they are ineffective and can make things more conflicted.

Mistake #1: Setting up “boundaries” and “limits” that are really rules for their behavior

Boundaries are the most misunderstood concept in the BPD supporter community (sometimes called the Non-BPD community). The problem with boundaries is that most people do not understand to whom the boundary applies. Boundaries are about you and can only be applied to your own behavior.Your boundaries are for you, the supporter of a person with BPD, not for the person with BPD.  A popular book on Non-BPs uses the example of telling the person with BPD that you will not take phone calls after 9 PM. This “boundary” (or limit as it’s called in this book) is supposed to be “respected” by the person with BPD. However, when emotional dysregulation gets a hold of the person with BPD, it is unlikely that the boundary will be remembered and respected. The problem with this boundary is that it really a rule that governs the other person’s behavior. With BPD, rules are made to be broken. Only you can respect your own boundaries. If you decide not to answer the phone after 9 PM then that is a boundary, because you are applying it to your own behavior, not expecting the person with BPD to comply with your rule. The misunderstanding of boundaries and to whom they apply causes much confusion and leads to frustration. The frustration is born out of trying to control another person’s behavior with a rule, which is impossible. Likely reactions to “boundaries” that are really rules includes rage, saying “you are trying to control me”and impulsive behavior, such as running away at times when it is unsafe or having unsafe sex.

Mistake #2: Judging them as “crazy”

People with BPD are not crazy, despite their reactions and behavior that might indicate that they are. The name “borderline” is a vestige from an earlier time of psychotherapy that connoted that a person with BPD was on the “borderline” between neurosis and psychosis. Today, most researchers consider BPD to be primarily a disorder of emotional dysregulation and impulse control. Unfortunately for the person with BPD, the word “personality” is also in the current name of the disorder. Many supporters of people with BPD interpret that word as one of either a character flaw (just bad behavior) or that the person with BPD has a certain personality that is fixed and cannot change. Neither of these situations is correct.  People with BPD are more emotional sensitive and more emotionally reactive than other people. I like to compare their emotional reactivity to that of a heat sensing control: yours is set to go off at 80 degrees Fahrenheit; a borderline’s is set at 50 degrees Fahrenheit. It is not a question of “crazy,” merely one of more emotional reactivity (or a lower emotional “tolerance” as they say in the controls community). The lower the tolerance, the more times the alarm goes off (even if it’s a false alarm to you).Judging a person with BPD as crazy actually contributes to the disorder. The reason comes down to shame. A person with BPD is likely to carry around much shame (see Mistake #4 below) and labeling them as crazy increases the shame. The biggest danger with shame is the option of suicide. If a person with BPD believes they are a broken/bad person (through shame), then what is the use in going on living? Other possible fallout from shame is the “giving up” on therapy, since shame makes a borderline believe that he/she can never be cured.

Mistake #3: Getting caught up in the content, rather than the context, of a conversation

I see this situation occur in many Non-BPs. Getting caught up in content, rather than seeing emotional context, is common and natural. Most people feel that they have to listen to the words, rather than thefeelings behind a conversation. In the case of BPD, the feelings matter much more than what is beingdiscussed. When I hear Non-BPs saying, “but she said…” or “what she did was…,” it is a sure sign of being caught up in the details, the content, rather than seeking the emotional context of the conversation.  Instead of getting caught up in the details, it is more effective to look for the primary emotional motivation of the words and actions of someone with BPD. Defending against, negating and/or arguing the details and/or accusations of someone with BPD will typically lead to more dysregulation and to an escalation of emotional behavior. Discovering the primary emotional motivations behind the words and actions of someone with BPD can help the person with BPD know that they are understood and heard.This feeling alone helps calm the waters in the interaction. Additionally, understanding and validating the emotional motivations can help facilitate meta-cognition (or thinking about feelings) in someone with BPD, which in itself can build toward self-mastery of his/her emotional states. That is, one can’t be all feelings and perform meta-cognition at the same time. Each time meta-cognition occurs makes it easier for it to reoccur. Developing mastery over the poorly-regulated emotions is a goal unto itself, since, if the skill can be generalized, the person with BPD will almost automatically feel better without the intervention of the Non-BP. If they feel better, the attacks, raging and manipulation that are motivated by feeling badly will subside, since they are no longer need to quell the negative emotional states.

Mistake #4: Invalidating their emotions

Everyone experiences emotions, and people with BPD experience them in spades – that is the very nature of emotional dysregulation. Dr. Marsha Linehan, the inventor of Dialectical Behavioral Therapy (DBT), contends that BPD is caused by the “biosocial model,” in which there are both biological and social factors that contribute to the development of BPD. The social component or “nurture” in this model is called the “invalidating environment.”

When a loved one of a person with BPD invalidates the emotions of someone with BPD, the result is shame and mistrust in expressing their emotions. The shame comes from thinking of the borderline that: “My loved one tells me I shouldn’t be this way, but I feel this way anyway, so I must be broken.” What is invalidation? Invalidation is essentially the expression of the idea that it is not OK to feel particular emotions, especially primary ones, like fear, anger and sadness. One should not do any of the following in an emotional conversation with a borderline at risk of being invalidating:

  • Make it about you. “I hated it when that happened to me.”
  • Try to one-up the person. “Oh, you think you have it bad…”
  • Tell them how they should feel. “You should feel blessed…”
  • Try to give them advice. “What you really should do is…”
  • Try to solve their problem. “I’m going to call that girl’s parents and…”
  • Cheerlead (there is a time for this, but not now). “I know you can do it…”
  • Make “life” statements. “Well, life’s not fair…”
  • Make judgmental statements. “What you did was wrong…”
  • Make “revisionist” statements. “If you had only…”
  • Make it about your feelings. “How do you think that makes me feel?”
  • Make “character” statements. “You’re too sensitive…”
  • Rationalize another person’s behavior. “I bet they were just…”
  • Call names. “You’re such a baby.”
  • Use reason or the “facts.” “That’s not what happened…”
  • Use “always” or “never” statements. “You always get yourself into these situations…”
  • Compare the person to someone else. “Why can’t you be like your sister?”
  • Label the person. “You’re nuts.”
  • Advising to cut ties or ignore the situation. “Just ignore him.”

Instead, learning to validate the person’s emotions is a very powerful tool and essential to relating positively with someone with BPD. More on emotional validation is included (including a step-by-step guide) in my book When Hope is Not Enough.

Mistake #5: Thinking that their behavior is about you

Most Non-BPs come to my support list thinking something along the lines of “how is it possible that thisperson with BPD, who supposedly loves me, can behave toward me in such an abusive and disrespectfulfashion?” In other words, the underlying feeling among “newbie” Non-BPs is: “what about me?”In reality, little of a person with BPD’s behavior is directed at the Non-BP, whatever the appearances. In my book, When Hope is Not Enough, I have developed a concept called “It’s all about his/her feelings”or IAAHF.

Many people misinterpret this concept – they think it has a negative connotation. In other words, Non-BPs think IAAHF means “it is never about my feelings,” yet that is not the intention of this formulation. No, instead, the actual intention for the Non-BP is quite a positive one. What it really means is that all of the behavior, words and actions of a person with BPD are motivated by his/her feelings. In other words: “it’s not about you.” Most of it is instead intended to quell the negative feelings experienced by the borderline. Once this concept is fully understood, it can lead to more freedom for the Non-BP emotionally.  When someone with BPD behaves in a way that seems to be intended to harm you, think IAAHF and realize that the behavior is completely motivated by the desire to stop the negative/stormy emotions experienced by the person with BPD. She/he is doing anything to stop the pain.

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