How to Help a Person with BPD: 7 Tips

Several tips to support a person with Borderline Personality Disorder.

Personality disorders harbor a number of peculiarities that can contribute to the emergence of conflicts within social relationships, being Borderline Personality Disorder (BPD) one of the most commonly associated with it.

Due to the daily frictions (some of them important) it is frequent that interest arises about how to help a person with BPDin order to alleviate one's own discomfort or that of the affected family member/friend.

In this article we will inquire about the specific characteristics of this alteration in the very structure of the personality, since this knowledge is essential to understand how a person with BPD feels and acts.

Borderline Personality Disorder (BPD)

The BPD is a clinical entity that is included in the cluster B of the personality disorders.together with antisocial, histrionic and narcissistic personality disorders. Like the others mentioned in the list, its core revolves around the difficulty in regulating emotions and behaviors. Sufferers often feel overwhelmed by their affective life, leading to considerable instability in their relationships with others and with themselves (their inner experience).

They suffer from difficulties in 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 lives and that they could abandon the relationship that unites them, a belief that ends up precipitating desperate acts to regain the affection and companionship they fear losing.

The mechanisms through which they evaluate others are conditioned, as well as their own emotional experience, by instability and unpredictability. They tend to resort to the extremes of idealization and devaluation, obviating the wide spectrum of the emotional experience of others.They tend to resort to the extremes of idealization and devaluation, ignoring the varied spectrum of shades of gray that may exist between the two. For this reason they tend to 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 evident a constant fluctuation in self-image and identity. All this can be accentuated when, in addition, dissociative symptoms such as depersonalization (feeling of inner emptiness that translates into the vivid sensation of being an automaton or a kind of hollow shell) concur in the same scenario.

In addition to the above, which alludes to a profound experience of suffering, sufferers of the disorder tend to resort frequently to threats or coercion in an inordinate attempt to take control of the external circumstances that cause them pain. The content of these threats may involve the production of harm to themselves, or the recrudescence of a harmful behavioral pattern in which they had been in which they had previously engaged (substance use, risky sexuality, etc.).

All these circumstances, together with others such as self-harm or verbal aggression (insults, provocations, sarcasm, etc.), foster a context of extreme relational tension. While there are now empirically validated treatments for addressing this mental health problem (such as Linehan's dialectical behavioral therapy), which should be prioritized over other approaches, it is also essential for those close to the person with BPD to learn about how to help the person with BPD. it is also essential for relatives to learn how to help a person with BPD..

Why does it happen?

Many studies have been carried out with the purpose of determining the causes of this personality disorder, although at present we only know of risk factors that contribute to its appearance in a given individual. Most of them contemplate circumstances that occurred during the childhood years, since this is the period in which the foundations on which its full clinical expression (in adulthood) will be built 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. Also poor warmth and explicit parental rejection of children has been consistently related to increased likelihood of BPD, as well as inconsistent caregiving. Hostility and high negative emotional expressiveness (from parents to children) also play a role.

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 in the scientific community. These situations of prolonged stress may also be associated with the presence of dissociative symptoms characteristic of BPD.

Basic attachment styles have also been the subject of study by researchers.The empirical evidence suggests that insecure attachments (especially anxious attachment) contribute decisively to the formation of the disorder in adolescence and adulthood. Finally, basic dimensions of personality structure, such as neuroticism, impulsivity and experiential avoidance, may be part of the premorbid profile of BPD sufferers.

How to help a person with BPD

Here are some suggestions that can help in dealing with the daily frictions that arise from living with someone who suffers from this major mental health problem. Putting all these tips into practice may involve some effort at first, and they are not a substitute for psychological or pharmacological treatment. Their purpose is only to facilitate the most difficult moments..

1. Validate your emotional experience

People with BPD often feel that they are not understood by others, and that they are the receptacle 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 offense.

It is therefore important to to learn to validate the experience as it is reported, showing support and listeningin 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 take the time to listen to what he/she has to say.

The use of yelling, or other negative communication strategies (both verbal and nonverbal), can result in the abrupt interruption of an opportunity for connection and the consequent escalation of difficult affect. The breakdown of avenues of emotional expression results in an estrangement of the two parties of the two parties that may take time to resolve.

3. Communicate your needs and allow them to express themselves.

Convey to the person that you understand how he or she is feeling, directing the focus of attention to the emotional experience rather than accentuating the supposed relevance of the situation that preceded it.

If you find it difficult to connect with her speech, encourage her to delve deeper with an explicit purpose to understand it. Speak clearly about what you do not consider tolerable at this very moment, such as insults or insults to the person.If you find it difficult to connect, encourage her to go deeper with the explicit purpose of understanding.

4. Get involved in the treatment guidelines.

Many of the therapeutic guidelines offered to BPD patients directly involve the family. Take an interest in what happens in the context of the intervention, respecting the limits of confidentiality and avoiding attitudes of a paternalistic nature. Show commitment to the improvement project on which you have embarked.contribute to the changes that must necessarily be articulated in the daily life of the person suffering from this disorder.

5. Shows understanding in the face of the recrudescence of symptoms.

Many people with BPD learn to manage their own difficulties and to lead a completely normalized life. However, it is very likely that at certain times (periods of intense stress, occasional relational conflicts, etc.) there will be an accentuation of symptoms.

Show understanding and communicate hope that the emotion they are experiencing will eventually resolve itself.as has occurred on other occasions in the past.

6. Learn strategies to regulate your own emotions

It is undeniable that living with a person with BPD can involve suffering for the whole family, because from a systemic perspective, the family is a mechanism in which all the gears are relevant for its optimal functioning.

Learning specific techniques to control autonomic activation, such as diaphragmatic breathingsuch as diaphragmatic breathing or Jacobson's progressive Muscle relaxation (always guided by a specialist), can help to 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 to manage (distress), it is important that you are able to take a break and seek professional help.

Long-term stress can lead to a decline in our coping mechanisms (including physiological), resulting in a burnout that increases the risk of many mental health problems (including physiological), resulting in exhaustion that increases the risk of many mental health problems (such as major depression or various anxiety disorders, among others).

What to avoid

There are a number of situations that we should avoid when we want to help a person with BPD. The first of these is to develop a behavior of excessive overprotection or condescension, 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 in learning to regulate the affections, and for this the BPD sufferer must assume his daily life with the maximum autonomy.

It is also necessary to make an effort to not to personalize the harsh words that the person with BPD may utter during a moment of angerThe patient is dealing not only with the conflict you are both in, but also with the symptoms of her own disorder.

Bibliographical references:

• Stepp, S.D., Lazarus, S.A., and Byrd, A.L. (2016). A Systematic Review of Risk Factors Prospectively Associated with Borderline Personality Disorder: Taking Stock and Moving Forward. Personality Disorders, 7(4), 316-323.
• Stone, M.H. (2019). Borderline Personality Disorder: Clinical Guidelines for Treatment. Psycodynamic Psychiatry, 47(1), 5-26.