In 2008, Dr. Paul Links published a study that ranked the interpersonal “triggers” of emotional dysregulation in people with BPD. In descending order of importance the triggers are:
- Interpersonal Issues
- Daily Life
- Internal Psychological States
- Physical States
- Media Stimuli
- Major Life Change/Stress
This study contains both good and bad news for a loved one of someone with BPD. The bad news first: since “Interpersonal Issues” are at the top of the list, each interaction will be interpreted through a filter of “threat-awareness” based on emotional reactions. That is what causes the “walking on eggshells” behavior of the loved ones. Meaning, if you fear a major blow-up every time you say something, you’re “walking on eggshells.” The good news is that childhood events (memories) are not that triggering, so working with a person in the “here and now” can be effective.