How to help a person with BPD: 7 tips

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 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 someone with bpd, pursuing the purpose of alleviating their own discomfort or that of the affected relative/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 have BPD.

• Related article: "Borderline Personality Disorder: causes, symptoms and treatment"

Borderline Personality Disorder (BPD)

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 nucleus revolves around the difficulty in regulating emotions and behaviors. People who suffer from it often feel overwhelmed by their affective life, which leads to notable instability in relationships with others and with themselves (their internal experience).

These are people who suffer from difficulties to control their impulses, which leads them to commit thoughtless acts that they may come to regret, feeling guilty and embarrassed. They also often think that others don't really care about their life and that they might leave the relationship. that unites them, a belief that ends up precipitating desperate acts to recover the affection and company they fear lose.

The mechanisms through which they evaluate others are conditioned, just like the emotional experience itself, by instability and unpredictability. They tend to resort to the extremes of idealization and devaluation, obviating the varied spectrum of shades of gray that could exist between one and the other. For this reason they usually react with intense anger, becoming an emotional response that occasionally lasts for days.

The instability that characterizes the judgments they issue about others also extends to the way in which that they perceive themselves, becoming evident a constant fluctuation in the self-image and in the 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).

In addition to what has been described, which alludes to a deep experience of suffering, those who suffer from the disorder tend to resort with frequently to threats or coercion in an excessive attempt to assume control of the external circumstances that they generate pain. The content of these threats may imply the production of harm to themselves, or the resurgence of a harmful behavioral pattern in which they had previously been involved (substance use, risky sexuality, etc.).

All 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 to address this mental health problem (such as Linehan's dialectical behavioral therapy), which should be prioritized over other approaches, also it is essential for loved ones to learn how to help a person with BPD.

Why happens?

There are many studies that have been carried out with the purpose of determining the causes of this disorder of personality, although we currently only know of risk factors that contribute to its appearance in an individual given. Most of them contemplate circumstances that occurred during childhood years, since this is the period in which the bases on which its full clinical expression will be built begin to take shape (in the adulthood).

One of the most important risk factors is the presence of psychopathology in the parents., including mood disorders and BPD itself. Also, the lack of warmth and the explicit rejection of the parents to the children have 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 events, usually in the form of childhood abuse (physical, emotional, verbal and sexual), is one of the risk factors on which there is currently greater consensus among the community scientific. These situations of prolonged stress can also be associated with the presence of dissociative symptoms typical of BPD.

Basic attachment styles have also been studied by researchers., emerging from the empirical evidence that insecure attachments (especially the anxious one) contribute decisively to the formation of the disorder in adolescence and adult life. Finally, basic dimensions of the personality structure; such as neuroticism, impulsivity, and experiential avoidance, may be part of the premorbid profile of those with BPD.

How to help a person with BPD

Below we present some suggestions that can help to deal with the daily frictions that arise from living with someone who suffers from this important mental health problem. Putting all these tips into practice can be an effort at first, and they are not a substitute for psychological or pharmacological treatment. Its purpose is solely to facilitate the 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 their way of thinking or feeling. 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.

That's why it's important learn to validate the experience as it is reported, showing support and listening; in a context of acceptance, honesty and avoidance of judgment.

• You may be interested in: "The 8 types of emotions (classification and description)"

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 suppose the abrupt interruption of an opportunity for connection and the consequent increase in affection difficult. 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 express themselves

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 an 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 treatment guidelines

Many of the therapeutic guidelines offered to patients with BPD 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. 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 suffering from this disorder.

5. Show understanding in the face of worsening symptoms

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 the symptoms occurs.

Show understanding and communicate hope that the emotion you are experiencing will eventually resolve itself, as it could 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 mean 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.

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 relative generates in you a stress response that is difficult to manage (distress), it is important that you are able to take a breath and seek help professional.

Long-term stress can cause a decline in our coping mechanisms (even physiological), producing exhaustion that increases the risk of many mental health problems (such as major depression or different anxiety disorders, among others).

What things should we avoid?

There are a number of situations that we must avoid when we want to help a person with BPD. The first of these is to develop excessively overprotective or condescending behavior, as well how to maintain the belief that with our actions we will be able to solve all their issues. An important part of the improvement consists of learning to regulate the affections, and for this, those who suffer from BPD must assume their day to day with the maximum autonomy.

It is also necessary to make an effort to not personalizing harsh words that the person with BPD may utter during a moment of anger, since she is dealing not only with the conflict in which you both are, but also with the symptoms of her disorder.

Bibliographic 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.