Talking to a Loved One with Borderline Personality Disorder

1. Understand BPD: Recognizing the Challenges and Complexities

BPD is characterized by a number of defense mechanisms, or basic emotional reactions. The primary, animating defense mechanism of BPD is splitting, the need to divide contradictory perceptions.

Splitting shapes perception. This defense mechanism leads individuals with BPD to view people and situations in extremes - all good or all bad. This black-and-white thinking results in idealization or devaluation, making relationships challenging and unpredictable.

Emotional instability is pervasive. People with BPD experience intense and volatile emotions, rapidly shifting between euphoria, anger, anxiety, and depression. This emotional rollercoaster can be exhausting for both the individual and their loved ones.

Identity confusion is common. Many with BPD struggle with a fragmented sense of self, leading to:

• Uncertainty about personal values and goals
• Frequent changes in career plans, friendships, and romantic relationships
• Difficulty maintaining a consistent self-image

2. Master SET-UP: Support, Empathy, Truth, Understanding, Perseverance

SET-UP is not a way to cure a borderline individual but, rather, a technique to help you, the individual's communication partner, relate to her.

Support forms the foundation. Express your concern and commitment to helping the person with BPD. Use "I" statements to convey your personal investment, such as "I care about you and want to help."

Empathy builds connection. Acknowledge the pain and conflicted feelings of the individual with BPD. Focus on their experience, not yours, with statements like "This must be incredibly difficult for you."

Truth introduces reality. After establishing support and empathy, gently present a realistic assessment of the situation. Emphasize the individual's responsibility in addressing issues, while offering your help.

Understanding and Perseverance are overarching attitudes that guide the entire interaction:

• Maintain perspective on BPD's challenges
• Commit to weathering storms and setbacks
• Recognize progress, even when small

3. Navigate No-Win Dilemmas: Balancing Contradictory Demands

The no-win situation is often your most frustrating challenge in addressing borderline paradoxes.

Recognize the trap. People with BPD often create situations where any response seems wrong. This stems from their black-and-white thinking and fear of abandonment or engulfment.

Avoid defensive reactions. When faced with a no-win scenario:

• Don't argue logic or try to prove yourself right
• Resist the urge to become defensive or retaliatory
• Focus on validating emotions while maintaining boundaries

Seek middle ground. Use SET-UP to navigate these dilemmas:

• Express support for the person's feelings
• Empathize with their struggle
• Gently introduce truth about the situation
• Propose compromise solutions when possible
• Be willing to postpone resolution if emotions are too high

4. Manage Borderline Anger: De-escalation and Emotional Regulation

Fighting the fire of rage with more fire will usually not extinguish the blaze.

Stay calm in the storm. When faced with intense BPD anger:

• Lower your voice as they raise theirs
• Slow your speech and movements
• Avoid accusatory language or defensive posturing

Validate without agreeing. Use empathy statements to acknowledge their emotions without necessarily endorsing their perspective. For example: "I can see how upset you are about this situation."

Redirect and refocus. Once the initial surge of anger has passed:

• Shift attention to less volatile topics
• Emphasize shared goals or concerns
• Propose constructive actions to address the underlying issue
• Delay major decisions or discussions until emotions have settled

5. Address Abandonment Fears: Building Trust and Security

Just as borderline anger may push you away, the BP's fears of being left may pull you crushingly close.

Understand the root cause. Abandonment fears in BPD often stem from:

• Early experiences of neglect or instability
• Difficulty trusting others' commitment
• An unstable sense of self-worth

Provide consistent reassurance. While you can't completely eliminate abandonment anxiety, you can:

• Offer regular verbal and non-verbal expressions of care
• Follow through on commitments and promises
• Explain absences or changes in routine in advance

Encourage healthy independence. Paradoxically, addressing abandonment fears also involves:

• Supporting the development of the person's own interests and relationships
• Celebrating their accomplishments and growth
• Setting appropriate boundaries to prevent unhealthy enmeshment

6. Foster Identity Development: From Emptiness to Selfhood

Borderline identity is like malleable, soft clay that can be sculpted into any shape, that can squeeze into any prefashioned mold, but without a model, it remains amorphous.

Recognize identity struggles. People with BPD often experience:

• A chronic feeling of emptiness
• Rapid shifts in self-image, values, and goals
• Difficulty maintaining a consistent sense of self

Encourage self-exploration. Help the person with BPD develop a stronger identity by:

• Supporting their pursuit of interests and passions
• Validating their emotions and experiences
• Gently challenging distorted self-perceptions

Provide a stable reference point. While avoiding becoming their sole source of identity:

• Offer consistent feedback on their positive qualities
• Remind them of past accomplishments and growth
• Help them connect current behaviors to long-term goals and values

7. Confront Victimization: Encouraging Resilience and Growth

Thus, sometimes it is your loved one who feels guilt-ridden and self-blaming, who feels punished. But at other times you may feel you are the one being pummeled, as the perpetrator of the BP's unhappiness.

Recognize the victim mindset. People with BPD may:

• View themselves as perpetually wronged or mistreated
• Struggle to take responsibility for their actions
• Use victimhood as a defense against change or accountability

Validate pain without reinforcing helplessness. Use SET-UP to:

• Acknowledge past hurts and unfair treatment (Support, Empathy)
• Highlight strengths and resilience demonstrated (Truth)
• Encourage focus on present choices and future possibilities (Understanding, Perseverance)

Promote agency and problem-solving. Guide the person towards:

• Identifying specific, changeable aspects of their situation
• Developing coping strategies for managing difficult emotions
• Setting small, achievable goals to build confidence and momentum

8. Handle Self-Destructive Behaviors: Compassion and Safety First

It is important to understand that this self-harming tendency is a result of the BP's unhealthy attempts to cope with anxiety and emotional pain.

Prioritize safety. When confronted with self-harm or dangerous impulsivity:

• Remain calm and non-judgmental
• Assess the immediate risk and seek professional help if needed
• Create a safe environment by removing potential hazards

Understand the function. Self-destructive behaviors often serve to:

• Relieve intense emotional pain
• Provide a sense of control
• Punish oneself or others
• Communicate distress when words feel inadequate

Develop healthier alternatives. Work with the person to identify:

• Less harmful ways to express intense emotions
• Coping skills for managing distress (e.g., mindfulness, physical exercise)
• Professional resources for ongoing support and skill-building

9. Maintain Boundaries: Protecting Yourself While Supporting Others

Examining your own need to rescue and be a hero. Sometimes, despite your best efforts, the relationship may not work. The BP may not molt and cast off the armor of illness that obscures the beauty inside. You may not be the one who can rescue the victim in distress.

Recognize your limits. Supporting someone with BPD can be emotionally draining. It's crucial to:

• Identify your own emotional and physical boundaries
• Communicate these limits clearly and consistently
• Seek support for yourself through therapy, support groups, or trusted friends

Avoid enabling destructive patterns. While offering support, be cautious not to:

• Take responsibility for the person's emotions or actions
• Sacrifice your own well-being to meet unreasonable demands
• Ignore or excuse abusive or manipulative behavior

Encourage professional help. Recognize that your role is supportive, not therapeutic:

• Validate the challenges of BPD while emphasizing the benefits of professional treatment
• Offer to assist in finding appropriate resources (therapists, support groups, etc.)
• Be prepared to set firm boundaries if the person refuses to seek necessary help

Last updated: October 18, 2024