Loving a person with BPD

I frequently find myself working with people who feels bewildered by the behaviour of their partner/daughter/mother/brother/friend.

When I dig a little deeper, although I am clearly not in a position to diagnose someone who is not in the room, it starts to become clear that the absent loved one has features of personality disorder.  Quite often, that person seems to meet (at least some) of the criteria for Borderline Personality Disorder (BPD).  As described by the National Education Alliance for
Borderline Personality Disorder (NEABPD)
, BPD is “a serious mental illness that centers on the inability to manage emotions effectively. The disorder occurs in the context of relationships: sometimes all relationships are affected, sometimes only one. It usually begins during adolescence or early adulthood.  While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil. Most people who have BPD suffer from problems regulating their emotions and thoughts, impulsive and sometimes reckless behavior, and unstable relationships.  Other disorders, such as depression, anxiety disorders, eating disorders, substance abuse and other personality disorders can often exist along with BPD.

My patient is often bewildered by the behaviour of their loved one – Why do they react so dramatically?  Why do they seem to take everything so personally?  Why do they threaten to hurt themselves over the (apparently) smallest upset.  Having something to read about BPD can be really handy and while there are some GREAT books on this (think “Walking on Eggshells“), sometimes you want to be able to get your hands on some down to earth coping suggestions quickly. So, I was pretty chuffed to find these Family Guidelines published online by theNEABPD https://www.borderlinepersonalitydisorder.com/family-connections/family-guidelines/ 

The guidelines contain some simple, but really helpful suggestions for how to cope with what might feel like very unfair or irrational responses from someone with BPD, and how to make those family/friendship relationships work, despite what can be a tricky set of personality characteristics.  An excerpt below…

Managing Crisis, Pay Attention, But Stay Calm

Don’t get defensive in the face of accusations and criticisms. However unfair, say little and don’t fight. Allow yourself to be hurt. Admit to whatever is true in the criticisms.

When people who love each other get angry at each other, they may hurl heavy insults in a fit of rage. This is especially true for people with BPD because they tend to feel a great deal of anger. The natural response to criticism that feels unfair is to defend oneself. But, as anyone who has ever tried to defend oneself in such a situation knows, defending yourself doesn’t work. A person who is enraged is not able to think through an alternative perspective in a cool, rational fashion. Attempts to defend oneself only fuel the fire. Essentially, defensiveness suggests that you believe the other person’s anger is unwarranted, a message that leads to greater rage. Given that a person who is expressing rage with words is not posing threat of physical danger to herself or others, it is wisest to simply listen without arguing.”