{June 6, 2012}   National Education Alliance: BPD hurting

I’m not sure I have any “advice” for family members. I can only admit that I have hurt many, many people due to my illness. I have hurt both of my parents, my cousins, aunt and uncle, boyfriends and unfortunately my own daughter. 

I did not hurt them because I have a character disorder or that I am a bad person. Quite the contrary, I am known as a very kind, caring and loving person. My hurtful behaviors towards others had less to do with who I really am, my own real personality, than my illness which is borderline personality disorder.

It is important to remember that someone who is actively suffering from this disorder is working VERY hard on a moment to moment basis JUST TO SURVIVE. Being in our skin, or walking in our shoes is EXTREMELY painful and may not make much sense to someone looking from the outside. We feel everything much deeper than you do. Some “little” upset can put us over the edge into feeling suicidal. Our emotions are not regulated like yours are. It is not our fault. We experience malfunctions in our brains. Many times, as Dr. Heller puts it, our “brains fire out of control.” We can’t help it but we do anything we can to make it stop.

We experience dysphoria a lot…that some people people feel is a seizure. I don’t know the answer tot his.

Many times, knowing fully what was happening in my brain etc.,…and I did everything I could do to survive it. I went outside and walked around. I kicked things that couldn’t be damaged. I TRIED.

This guideline is a reminder of the central message of our educational program: The person with BPD is handicapped in his ability to tolerate stress in relationships (i.e., rejection, criticism, disagreements) and can, therefore, benefit from a cool, calm home environment. It is vital to keep in mind the extent to which people with BPD struggle emotionally each day. While their internal experience can be difficult to convey, we explain it by summarizing into three handicaps: affect dyscontrol, intolerance of aloneness, and black and white thinking.

 Lower your expectations. Set realistic goals that are attainable. Solve big problems in small steps. Work on one thing at a time. 

Although the person with BPD may have many obvious strengths such as intelligence, ambition, good looks, and artistic talent, she nonetheless is handicapped by severe emotional vulnerabilities as she sets about making use of those talents.

Affect Dyscontrol:

A person with BPD has feelings that dramatically fluctuate in the course of each day and that are particularly intense. These emotions, or affects, often hit hard. We have all experienced such intense feelings at times. Take for example the sensation of pounding heart and dread that you may feel when you suddenly realize that you have made a mistake at work that might be very costly or embarrassing to your business. The person with BPD feels such intense emotion on a regular basis. Most people can soothe themselves through such emotional experiences by telling themselves that they will find a way to compensate for the mistake or reminding themselves that it is only human to make mistakes. The person with BPD lacks that ability to soothe herself. An example can also be drawn from family conflict. We have all had moments in which we feel rage towards the people we love. We typically calm ourselves in such situations by devising a plan for having a heart-to-heart talk with the family member or by deciding to let things blow over. The person with BPD again feels such rage in its full intensity and without being able to soothe himself through the use of coping strategies. It results in an inappropriate expression of hostility or by acting out of feelings (drinking or cutting).

Intolerance of Aloneness:

A person with BPD typically feels desperate at the prospect of any separation – a family member’s or therapist’s vacation, break up of a romance, or departure of a friend. While most of us would probably miss the absent family member, therapist or friend, the person with BPD typically feels intense panic. She is unable to conjure up images of the absent person to soothe herself. She cannot tell herself, “That person really cares about me and will be back again to help me.” Her memory fails her. She only feels soothed and cared for by the other person when that person is present. Thus, the other person’s absence is experienced as abandonment. She may even keep these painful thoughts and feelings out of mind by using a defense mechanism called dissociation. This consists of a bizarre and disturbing feeling of being unreal or separate from one’s body.

Black & White Thinking (Dichotomous Thinking):

Along with extremes of emotion come extremes in thinking. The person with BPD tends to have extreme opinions. Others are often experienced as being either all good or all bad. When the other person is caring and supportive, the person with BPD views him or her as a savior, someone endowed with special qualities. When the other person fails, disagrees, or disapproves in some way, the person with BPD views him or her as being evil and uncaring. The handicap is in the inability to view other people more realistically, as mixtures of good and bad qualities.

This review of the handicaps of people with BPD is a reminder that they have a significantly impaired ability to tolerate stress. Therefore, the family members can help them achieve stability by creating a cool, calm home environment. This means slowing down and taking a deep breath when crises arise rather than reacting with great emotion. It means setting smaller goals for the person with BPD so as to diminish the pressure she is experiencing. It means communicating when you are calm and in a manner that is calm. It does not mean sweeping disappointments and disagreements under the rug by avoiding discussion of them. It does mean that conflict needs to be addressed in a cool but direct manner without use of put-downs. Subsequent guidelines will provide methods for communicating in this fashion.

Listen. People need to have their negative feelings heard. Don’t say, “It isn’t so.” Don’t try to make the feelings go away. 

When feelings are expressed openly, they can be painful to hear.

Do not rush to argue with your family member about her feelings or talk her out of her feelings. As we said above, such arguing can be fruitless and frustrating to the person who wants to be heard. Remember, even when it may feel difficult to acknowledge feelings that you believe have no basis in reality, it pays to reward such expression. It is good for people, especially individuals with BPD, to put their feelings into words, no matter how much those feelings are based on distortions. If people find the verbal expression of their feelings to be rewarding, they are less likely to act out on feelings in destructive ways.

Feelings of being lonely, different, and inadequate need to be heard. By hearing them and demonstrating that you have heard them using the methods described above, you help the individual to feel a little less lonely and isolated. Such feelings are a common, everyday experience for people with BPD.

Family members may be quick to try to talk someone out of such feelings by arguing and denying the feelings. Such arguments are quite frustrating and disappointing to the person expressing the feelings. If the feelings are denied when they are expressed verbally, the individual may need to act on them in order to get her message across.

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