Personality disorders harbor a series of peculiarities that can contribute to the appearance of conflicts within social relationships, being Borderline Personality Disorder (BPD) one of those most commonly associated with it.
Due to everyday frictions (some of them important) it is common that interest arises about how to help a person with BPD pursuing the goal of alleviating one’s own discomfort or that of the affected family member/friend.
In this article we will investigate the specific characteristics of this alteration in the very structure of the personality, since this knowledge is essential to understand how a person who suffers from BPD feels and how he or she acts.
BPD is a clinical entity that is included in cluster B of personality disorders ; along with the antisocial, the histrionic and the narcissistic. Like the rest of those mentioned on the list, its core revolves around the difficulty in regulating emotions and behaviors. People who suffer from it often feel overwhelmed by their emotional life, which leads to notable instability in their relationships with others and with themselves (their internal experience).
These are people who suffer from difficulties controlling their impulses, which leads them to commit thoughtless acts that they may come to regret, feeling guilty and ashamed. They also often think that others are not really interested in their life and that they could abandon the relationship that unites them, a belief that ends up precipitating desperate acts to regain the affection and company that they fear losing.
The mechanisms through which they evaluate others are conditioned, like the emotional experience itself, by instability and unpredictability. They tend to resort to extremes of idealization and devaluation, ignoring the varied spectrum of gray shades that could exist between one and the other. For this reason, they usually react with intense anger, resulting in an emotional response that occasionally lasts for days.
The instability that characterizes the judgments they make about others also extends to the way they perceive themselves, making a constant fluctuation evident in self-image and identity. All of this can be accentuated when, in addition, dissociative symptoms such as depersonalization (a feeling of inner emptiness that translates into the vivid sensation of being an automaton or a kind of hollow shell) occur in the same scenario.
In addition to what has been mentioned, which alludes to a deep experience of suffering, those who suffer from the disorder tend to frequently resort to threats or coercion in an excessive attempt to assume control of the external circumstances that generate pain. The content of these threats may involve the production of harm to themselves, or the worsening of a harmful behavioral pattern in which they had previously been involved (substance use, risky sexuality, etc.).
All of these circumstances, along with others such as self-harm or verbal aggression (insults, provocations, sarcasm, etc.), foster a context of extreme relational tension. Although today there are empirically validated treatments for addressing this mental health problem (such as Linehan’s dialectical behavioral therapy), which should be prioritized over other approaches, they also It is essential for loved ones to learn about how to help a person with BPD
Why happens?
Many studies have been carried out with the purpose of determining the causes of this personality disorder, although currently we only know risk factors that contribute to its appearance in a given individual. Most of them contemplate circumstances that occurred during the years of childhood, since this is the period in which the foundations on which its complete clinical expression will be built (in adulthood) begin to be molded.
One of the most important risk factors is the presence of psychopathology in the parents, including mood disorders and BPD itself. The lack of warmth and explicit rejection of parents towards their children has also been consistently related to a greater probability of suffering from it, as well as inconsistent care. Hostility and high negative emotional expressiveness (from parents to children) also have a role to consider.
The experience of long-term traumatic situations, generally in the form of childhood abuse (physical, emotional, verbal and sexual), is one of the risk factors on which there is currently the greatest consensus by the scientific community. These prolonged stress situations can also be associated with the presence of the dissociative symptoms typical of BPD.
Basic attachment styles have also been the subject of study by researchers, emerging from empirical evidence that insecure attachments (especially anxious ones) contribute decisively to the formation of the disorder in adolescence and adult life. Finally, basic dimensions of personality structure; such as neuroticism, impulsivity and experiential avoidance, may be part of the premorbid profile of those who suffer from BPD.
Below we present some suggestions that can help you deal with the daily friction that arises from living with someone who suffers from this important mental health problem. Putting all these tips into practice may require an effort at first, and they do not replace the psychological or pharmacological treatment regimen. Its purpose lies solely in facilitating moments of greatest difficulty
1. Validate your emotional experience
People with BPD often feel that they are not understood by others, and that they are the recipient of constant criticism for the way they think or feel. It is necessary to remember that people with BPD can experience very intense and long-lasting emotions when they perceive that they are the object of an offense.
It is therefore important learn to validate the experience as it is reported, showing support and listening ; in a context of acceptance, honesty and avoidance of judgment.
2. Offer support
In a situation of emotional overflow, let the person with BPD know that you are available to spend time listening to what they have to say.
The use of yelling, or other negative communication strategies (both verbal and non-verbal), can mean the abrupt interruption of an opportunity for connection and the consequent increase in difficult affects. The rupture of the channels of emotional expression ends in a distancing of both parties that may take time to resolve.
3. Communicate your needs and allow them to be expressed
Convey to the person that you understand how they are feeling, directing the focus of attention to the emotional experience instead of accentuating the supposed relevance of the situation that preceded it.
If you find it difficult to connect with her speech, encourage her to continue delving into it with the explicit purpose of understanding it. Speak clearly about what you do not consider tolerable at this very moment such as insults or disrespect, establishing a pattern for contact.
4. Get involved in the treatment guidelines
Many of the therapeutic guidelines offered to patients with BPD directly involve the family. Be interested in what happens in the context of the intervention, respecting the limits of confidentiality and avoiding attitudes of a paternalistic nature. Shows commitment to the improvement project you have embarked on contributing to the changes that must necessarily be articulated in the daily life of the person who suffers from this disorder.
Many people with BPD learn to manage their own difficulties and lead a completely normal life. However, it is very likely that at certain times (periods of intense stress, specific relational conflicts, etc.) an accentuation of symptoms will occur.
Shows understanding and communicates hope that the emotion you are experiencing will eventually be resolved as may have happened on other occasions in the past.
6. Learn strategies to regulate your own emotions
It is undeniable that living with a person who suffers from BPD can cause suffering for the entire family, since from a systemic perspective, the family is a mechanism in which all the gears are relevant for its optimal functioning.
Learn specific techniques for controlling autonomous activation such as diaphragmatic breathing or Jacobson’s progressive muscle relaxation (always guided by a specialist), can help make difficult moments more bearable.
7. Seek professional help
If the situation you are experiencing with your family member generates a stress response in you that is difficult for you to manage (distress), it is important that you are able to take a break and seek professional help.
Long-term stress can cause a decline in our adaptation mechanisms (even physiological), producing exhaustion that increases the risk of many mental health problems (such as major depression or various anxiety disorders, among others).
What things should we avoid
There are a series of situations that we should avoid when we want to help a person with BPD. The first of them is to develop excessively overprotective or condescending behavior, as well as maintaining the belief that with our actions we will be able to solve all their problems. An important part of the improvement consists of learning to regulate emotions, and to do this, those who suffer from BPD must assume their daily lives with maximum autonomy.
It is also necessary to make an effort to do not personalize the harsh words that the person with BPD may say during a moment of anger since she is dealing not only with the conflict in which you are both, but also with the symptoms of her disorder.
