How to Treat a Borderline Personality (with Pictures)

2024 Author: Samantha Chapman | [email protected]. Last modified: 2023-12-17 09:13

Bordeline Personality Disorder (BPD) is a mental disorder defined by the "Manual of Diagnostic and Statistical Mental Disorders" (DSM-5) as an unstable psychiatric condition that affects interpersonal relationships and self-image. Affected people have trouble identifying and regulating their emotions. As with other disorders, these behavioral patterns cause stress or social problems and have certain symptoms that must be diagnosed by a professional who specializes in the mental health sector; it is impossible to do this for oneself or others. It can be difficult to cope with this disorder, both for the person affected and for their loved ones. If you or someone you love has borderline personality disorder, learn ways to manage it.

Steps

Part 1 of 3: Asking for Help First Person

Step 1. Contact a psychotherapist

Usually, therapy is the first treatment solution for those with BPD. There are several types of therapy that can be used to treat it, but the one that has been shown to be most effective is Dialectical Behavioral Therapy, or TDC. It is partially based on the principles of Cognitive Behavioral Therapy (TCC) and was developed by Marsha Linehan.

• Dialectical Behavior Therapy is a treatment method specifically developed to help people with BPD; according to some studies it has been shown to be quite effective. In essence, it teaches people with the disorder to regulate their emotions, develop a greater tolerance to frustration, acquire skills of careful awareness, identify and label their emotions, strengthen psychosocial skills to interact with others.
• Another common treatment is schema-focused therapy. This type of treatment combines cognitive-behavioral therapy techniques and strategies inspired by other therapeutic approaches. Its goal is to help people with BPD to rearrange or restructure their perceptions and experiences to build a stable self-image.
• This therapy is usually conducted directly with a patient and in a group. This combination allows for greater effectiveness.

Step 2. Pay attention to how you feel

A common problem faced by people with BPD is the inability to recognize, identify and label their emotions. During an emotional experience, taking a break to think about what's happening to you is a strategy that can teach you to regulate your emotions.

• Try talking to yourself several times a day. For example, you might take a short break from work to close your eyes, understand what's happening to your body and your emotions. See if you feel tense or have physical pain. Reflect on the persistence of a certain thought or feeling. Taking note of how you feel can teach you to recognize emotions, and thus to better regulate them.
• Try to be as specific as possible. For example, instead of thinking "I'm so angry I can't stand it!", Try to observe where this emotion is coming from: "I feel angry because I got stuck in traffic and arrived late for work."
• Try not to judge emotions as you think about them. For example, avoid saying things like "I'm feeling angry right now, so I'm a bad person." Instead, just focus on identifying the feeling, without judgment: "I feel angry because my friend is late and it hurts me."

Step 3. Distinguish between primary and secondary emotions

Learning to bring out all the feelings you have in a given situation is an important step in regulating emotions. For people with BPD, it is normal to be overwhelmed by a merry-go-round of emotions. Take a moment to separate what you feel first and what you feel later.

• For example, if your friend has forgotten that you should have met for lunch, your immediate reaction may be to get angry. This would be the primary emotion.
• Anger may also be accompanied by other feelings. For example, you may be hurt by your friend's forgetfulness. You may also feel fear, because you fear your friend doesn't care about you. Also, you may feel ashamed, like you don't deserve to be remembered by him. All of these are secondary emotions.
• Considering the source of your emotions can teach you to regulate them.

Step 4. Your inner dialogues should be positive

To learn how to manage your reactions in different situations in a healthy way, fight negative responses and habits with inner dialogues devoted to optimism. Doing it spontaneously or naturally can take some time, but it's helpful. Research has shown that this strategy can help you feel more focused, improve attention, and relieve anxiety.

• Remind yourself that you are deserving of love and respect. Imagine it's a game: identify aspects of yourself that you admire, such as your skills, your generosity, your creativity, and so on. When you experience negative feelings, remember all of this.
• Try to remind yourself that unpleasant situations are temporary, limited and normal: sooner or later they happen to everyone. For example, if your tennis coach criticized you during training, remind yourself that this moment does not characterize every past or future performance. Instead of obsessing over what happened in the past, focus on what you can improve in the future; this gives you more control over your actions, without feeling like you are someone else's victim.
• Re-formulate negative thoughts to turn them into positive ones. For example, if a test didn't go well for you, you might immediately think, "I'm a loser. I'm useless and I'll fail." This is of no use and is not fair to you either. Instead, think about what you can learn from the experience: "This exam did not go as well as I hoped. I can talk to the professor to find out what my weaknesses are and study more effectively for the next one."

Step 5. Before reacting to the words or actions of others, stop and think about it

A person with BPD often naturally reacts with anger or despair. For example, if a friend has hurt you, your first instinct might be to respond by yelling and threatening them. Instead, take a moment to converse with yourself and identify your feelings. Then, try to communicate them to the other person, without threats.

• For example, if your friend is late on a date, your immediate reaction may be to get angry. You want to scream and ask him why he was so disrespectful to you.
• Examine your emotions. What do you feel? What is your primary emotion? What are the secondary ones? For example, you may feel anger, but also fear, as you believe your friend is late because he doesn't care for you.
• In a calm voice, ask him why he is late, without judging or threatening him. Use first-person sentences. Example: "I feel hurt because you arrived late for our appointment. Why did this happen?". You will probably find that the reason for the delay is harmless, for example it got stuck in traffic or could not find the keys. First-person affirmations keep you from blaming the other person. They will therefore allow you not to get defensive and open up more.
• Reminding yourself to process emotions and not jump to conclusions can teach you to regulate your reactions in front of others.

Step 6. Describe your emotions in detail

Try to associate physical symptoms with emotional states that usually occur at the same time. Learning to identify your psychophysical state can help you describe and understand your emotions better.

• For example, in certain situations you have a knot in your stomach, but you may not know what to associate this feeling with. When it comes back to you, think about the feelings you have in that circumstance. This discomfort could be linked to nervousness or anxiety.
• Once you understand that this knotty feeling in your stomach is due to anxiety, you will eventually learn to better control the emotion, instead of letting it control you.

Step 7. Acquire self-assuring behaviors

Learning to calm down on your own can calm you down when you feel upset. These are strategies that you can implement to cheer up and love yourself.

• Take a hot bath or shower. Research has shown that physical warmth has a calming effect on many people.
• Listen to calming music. Research has shown that listening to certain types of music can help you relax. The British Academy of Sound Therapy has prepared a list of songs that, according to scientific evidence, promote feelings of relaxation and tranquility.
• Try using physical contact to calm yourself down. Touching yourself in a compassionate and calming way can help calm you down and relieve stress, as this releases oxytocin. Try crossing your arms across your chest and gently squeezing yourself. Alternatively, place a hand on your heart and feel the warmth of the skin, the heartbeat, the rise and fall of the chest as you breathe. Take a moment to remind yourself that you are wonderful and worthy of affection.

Step 8. Learn to tolerate uncertainty or anxiety better

Emotional tolerance is the ability to endure an uncomfortable emotion without reacting inappropriately. You can practice this skill by becoming familiar with your emotions, gradually exposing yourself to little-known and unpredictable situations in a safe environment.

• Keep a journal where you can write down any feelings of uncertainty, anxiety, or fear you feel throughout the day. Be sure to write in what situation you felt this way and how you responded in the moment.
• Rank your uncertainties. Try to categorize your anxiety or discomfort on a scale of 0 to 10. For example, going to a restaurant alone might be a 4, but letting a friend plan a vacation a 10.
• Practice tolerating insecurity. Start from small and safe situations. For example, you might try ordering a dish you've never tasted before at a new restaurant. You may not like it, but that's not the important thing: you will prove to yourself that you are strong enough to handle uncertainty on your own. You can gradually proceed towards more uncomfortable situations in relation to increasing your confidence.
• Record your responses. When you feel something uncertain, write down what happened. What have you done? How did you feel during the experience? How did you feel afterwards? What did you do if things didn't go as planned? Do you feel capable of dealing with other similar situations in the future?

Step 9. Practice unpleasant experiences safely

Your therapist can teach you to overcome uncomfortable emotions by giving you exercises to do. Here are some you can do on your own:

• Hold an ice cube in your hand until the negative emotion has passed. Focus on the physical sensation of touch. Observe how it becomes more intense, then fades away. The same goes for emotions.
• Visualize a wave of the sea. Imagine it growing until it reaches its apex, then subsides. Remind yourself that just like waves, emotions will subside, then recede.

Step 10. Exercise regularly

Exercise can help you reduce feelings of stress, anxiety and depression. This happens because it releases endorphins, the good mood hormones naturally produced by the body. The US National Institute of Mental Health suggests exercising regularly to reduce negative emotions.

Even moderate exercise, such as walking or gardening, can have these effects, according to research

Step 11. Follow a set schedule

Since instability is one of the main features of BPD, organizing a schedule, such as mealtimes and bedtime, can be helpful. Fluctuations in blood sugar or sleep deprivation can worsen the symptoms of the disorder.

If you have trouble remembering to take care of yourself, for example you forget to eat or don't go to bed at an appropriate time, ask someone to help you

Step 12. Your goals must be realistic

Dealing with a disorder takes time and practice. You won't see a complete revolution in a few days. Don't be discouraged. Remember: you can only do your best, and that's enough.

Remember that symptoms will gradually decline in intensity, not overnight

Part 2 of 3: Helping a loved one with BPD

Step 1. Remember that your feelings are normal

Friends and relatives of those with BPD often feel overwhelmed, divided, exhausted or traumatized by the disorder and all that it implies. Among these people, depression, feelings of grief or isolation, and feelings of guilt are just as common. It is useful to remember that this is normal, it does not mean that you are a bad or selfish person.

Step 2. Find out about the DBP

It is as real and debilitating as a physical illness. And it's not your loved one's fault: while unable to change, they may feel great shame or guilt because of their behaviors. Learning more about the condition will allow you to offer the best possible support to your loved one. Research the disorder and how you can help.

• On the internet you can find a lot of information on DBP;
• There are also online programs, blogs, and other resources that can help you understand what it means to suffer from BPD. For example, you can find tips and other materials on the website of the Association of Cognitive Psychology and the Association for the Study and Treatment of Personality Disorders.

Step 3. Encourage your loved one to go into therapy

However, remember that treatment can take some time to work and that some people with BPD do not respond well to treatment.

• Try not to have an approach that denotes a superior or accusatory attitude. For example, it is useless to make statements like "You worry me" or "Your behavior is not normal". Instead, prefer phrases like "I am worried about some of your behaviors that I have observed" or "I love you and would like to help you get better."
• A person with BPD is more likely to undergo treatment if they trust and get along with the therapist. Nonetheless, the interpersonal instability of these individuals can complicate the creation and maintenance of a healthy therapeutic relationship.
• Consider family therapy. Some treatments for BPD may include family sessions with the patient.

Step 4. Acknowledge your loved one's feelings

While not understanding why he feels this way, he tries to offer him support and solidarity. For example, you can make statements like "It seems very difficult for you" or "I understand why this upsets you."

Remember: You don't have to say you agree with your loved one to show that you listen to them and behave in a sympathetic way. As you listen, try to make eye contact and explicitly state that you are following the thread

Step 5. Be consistent

Since people with BPD are often fickle, it's important that you are consistent and trustworthy, that you act like an anchor. If you have told your loved one you will be home at 5, try to do so. However, you shouldn't respond to threats, claims, or manipulations. Make sure your actions are consistent with your own needs and values.

• This also means maintaining healthy boundaries. For example, you could tell him that if he yells at you, you will leave the room - that's right. If your loved one starts being rude to you, be sure to keep your promise.
• It is important to establish an action plan to implement if your loved one starts behaving destructively or threatens to harm himself. It would be helpful to work on this plan with him, possibly in collaboration with his psychotherapist. Whatever decision you make, stick to it.

Step 6. Set personal boundaries and enforce them

Living with people with BPD can be difficult because they often don't know how to effectively regulate their emotions. They may try to manipulate loved ones to meet their needs. They may not even be aware of the personal boundaries of others, and are often unable to determine or understand them. Implementing personal boundaries according to your needs and convenience can help you be safe and calm as you interact with your loved one.

• For example, you could tell him that you won't answer the phone after 10pm because you need a good night's sleep. If he calls you after that time, it's important to tighten the boundary and not answer. If you do, remind him of your decision, while acknowledging his emotions: "I love you and I know you are having a hard time, but it is 11:30 am and I have asked you not to call after 10. It is important to me. You can call me tomorrow at 4:30 pm. I have to go now. Bye."
• If your loved one accuses you of not loving him because you don't answer his phone calls, remind him that you have established a boundary. Give him an appropriate time when he might call you instead.
• Often you will have to state your boundaries many times before your loved one realizes that you mean it. You should expect him to respond to putting your needs into action with anger, bitterness, or other intense reactions. Don't react and don't get angry. Continue to reinforce and determine your boundaries.
• Remember that you are not a bad or selfish person because you say no. You need to take care of your physical and emotional health to adequately help your loved one.

Step 7. Respond positively to appropriate behaviors

It is very important to support proper behaviors with positive reactions and praise. This may encourage him to believe he can handle his emotions. It can also inspire him to improve.

For example, if your loved one starts yelling at you and then stops to think about it, thank him. Tell him that you recognized the effort he made to avoid hurting you and that you appreciate it

Step 8. Ask for help for yourself

Following and supporting a loved one with BPD can be emotionally draining. It is important to provide yourself with sources of self-help and support as you try to maintain a balance between the emotional support you offer and the creation of personal boundaries.

• On the internet you can find resources in your area;
• You may also find it helpful to see a therapist. It can help you process your emotions and teach you healthier endurance skills;
• Find out if there are programs for families in your area;
• Family therapy can also be helpful. There are training courses that teach family members of a person with BPD the right skills to understand and manage the disorder. The psychotherapist offers support and suggestions aimed at developing specific skills to help your loved one. Therapy also focuses on the individual needs of each family member. It focuses on strengthening the respective skills. Teach each participant to develop approach strategies and acquire resources that will help promote a healthy balance between their own needs and those of their loved one.

Step 9. Take care of yourself

It can be easy to get so involved in treating your loved one that you forget about yourself. It is important to be healthy and to rest. If you sleep little, are anxious and neglect yourself, you are more likely to respond with irritation or anger to your loved one.

• Exercise. Sport relieves stress and anxiety. In addition, it promotes well-being and is a healthy approach technique.
• Eat well and at regular times. Eat a well-balanced diet that incorporates proteins, complex carbohydrates, fruits and vegetables. Avoid junk food and limit caffeine and alcohol.
• Get enough sleep. Try to go to bed and get up at the same time every day, even on weekends. Do not do other activities in bed, such as working on the computer or watching TV. Avoid caffeine before bed.
• Take it easy. Try meditation, yoga, or other relaxing activities, such as hot baths or nature walks. Having a friend or relative who has BPD can be stressful, so it's important to take the time to take care of yourself.

Step 10. Take threats of self-harm seriously

Even if this person has already threatened to commit suicide or harm himself in the past, it is important to always take these words seriously. 60-70% of people with BPD attempt suicide at least once in their life, and 8-10% succeed. If your loved one talks about it, take him to the hospital.

You can also go to a call center like Samaritans. Make sure your loved one has the number too, so you can use it when needed

Part 3 of 3: Recognizing the Characteristics of Borderline Personality Disorder (BPD)

Step 1. Understand the diagnosis of DBP

A qualified mental health professional will use the DSM-5 criteria to diagnose borderline personality disorder. The manual determines that a person must have at least 5 of the following symptoms to be considered borderline:

• Frantic efforts to avoid real or imaginary abandonment;
• Patterns of unstable or intense interpersonal relationships characterized by an alternation between extremes of idealization and devaluation;
• Identity disorder;
• Impulsiveness in at least two areas that involve potential personal risk;
• Recurrent suicidal behavior, gestures or threats, or self-harm;
• Affective instability due to a marked reactivity of mood;
• Chronic feelings of emptiness;
• Inappropriate and intense anger or difficulty in controlling it;
• Stress-related, transient paranoid ideation or severe dissociative symptoms;
• Remember that you cannot diagnose BPD for yourself or others. The information provided in this section will only help you determine if you or a loved one might have it.

Step 2. Look for an intense fear of abandonment

A person with BPD experiences extreme fear and / or anger when faced with the prospect of separating from a loved one. He may exhibit impulsive behavior, such as self-harm or threats of suicide.

• This reactivity could also occur if the separation is inevitable, already planned, or temporary (for example, the other person has to go to work).
• People with BPD generally have a great fear of loneliness, and have a chronic need for help from others. They may panic or get angry if the other person goes away even for a short time or is late.

Step 3. Think about the stability of interpersonal relationships

An individual with BPD usually does not have stable relationships with someone for a significant amount of time. These people tend not to be able to accept the gray areas of others (or often of themselves). The view they have of their own relationships is characterized by an absolute type of thinking, so the other person is perfect or imperfect. Individuals with BPD often jump very quickly from one friendship or romantic relationship to another.

• They often idealize the people they have a relationship with or put them on a pedestal. However, if the other person demonstrates a defect or makes a mistake (even if only presumed), it often immediately loses value in the eyes of the individual with BPD.
• A person with BPD usually does not take responsibility for problems affecting their relationships. She may say that others don't care enough for her or that they haven't made a good contribution to the relationship. Others may think he has superficial emotions or interactions.

Step 4. Consider this person's self-image

Individuals with BPD usually do not have a stable self-concept. For people who do not suffer from personality disorders, the sense of their identity is quite solid: they have a general idea of who they are, what they value and what others think of them. These views are not subject to excessive fluctuations. People with BPD do not perceive themselves this way. They usually have a disturbed or unstable self-image that varies depending on the situation they are in and with whom they interact.

• People with BPD may base their opinion of themselves on what others think of them. For example, if a friend arrives late on a date, someone with the condition may believe it happened because they are a bad person, unworthy of being loved.
• People with BPD may have very unstable goals or values that change drastically. This extends to their treatment of others. An individual with BPD could be very kind one second and hateful the next, even to the same person.
• People with BPD may have feelings of self-loathing or believe they deserve nothing, even if others reassure them otherwise.
• People with BPD may experience a changing sexual orientation. They are significantly more likely to change the sex they prefer in their partners more than once.
• People with BPD usually define self-concept in a way that departs from their own cultural norms. It is important to remember to take these rules into consideration when evaluating what counts as "normal" or "stable" self-concept.

Step 5. Watch for signs of self-defeating impulsivity

Many can be impulsive, but a person with BPD regularly engages in risky and hasty behavior. Usually these actions seriously threaten your well-being, safety or health. This behavior can come on suddenly or as a reaction to an event or experience in your life. Here are some common examples of risky choices:

• Risky sexual behavior
• Driving reckless or under the influence of drugs;
• Substance abuse;
• Binge eating and other eating disorders
• Crazy expenses;
• Uncontrolled gambling.

Step 6. Consider whether self-harming or suicidal thoughts or actions occur frequently

Self-harm and threats, including suicide, are common among people with BPD. These actions may occur on their own or in reaction to real or perceived abandonment.

• Here are some examples of self-harm: cuts, burns, scrapes or picking on the skin;
• Suicidal gestures or intimidation could include actions such as grabbing a pack of pills and threatening to take them all;
• Suicidal threats or attempts are sometimes used as a technique to manipulate others to do what the person with BPD wants;
• People with BPD may be aware of the risk or harm of their actions, but feel completely unable to change their behavior;
• 60-70% of people diagnosed with BPD attempt suicide sooner or later.

Step 7. Observe this person's mood

Individuals with BPD suffer from emotional instability, exaggeratedly vacillating mood and psychic alterations. The mood can change frequently, and often the swings become more and more intense than would be considered the result of a normal reaction.

• For example, a person with BPD might be happy one second and burst into tears or have a tantrum the next. These mood swings could last only a few minutes or hours.
• Despair, anxiety and irritability are very common among people with BPD, and could be triggered by events or actions that people who don't suffer from it would consider insignificant. For example, if the therapist tells a patient that the session is nearly over, the individual may react with an intense feeling of despair or abandonment.

Step 8. Consider whether this person often seems bored

Individuals with BPD report many times that they feel empty or extremely bored. Many of their risky and impulsive behaviors could be a reaction to these feelings. According to the DSM-5, a person suffering from it may be constantly looking for new sources of stimulation and arousal.

• In some cases, this can extend to feelings about others as well. An individual with BPD may very quickly get bored with their friendships or romantic relationships, and seek excitement in a new person.
• A person with BPD may also experience the feeling that they do not exist or fear that they are not in the same world as others.

Step 9. Look for frequent manifestations of anger

An individual with BPD displays anger more often and more intensely than is considered appropriate in their culture. They usually have difficulty controlling anger. Often a person reacts in this way because they perceive a lack of affection or neglect on the part of a friend or relative.

• Anger may come in the form of sarcasm, severe bitterness, verbal outbursts, or tantrums;
• Anger may be a person's automatic reaction, even in situations where other emotions seem more appropriate or logical. For example, an individual who wins a sporting event might focus on hatred of the opponent's behavior instead of enjoying the victory.
• This anger could escalate and result in physical violence or an argument.

Step 10. Notice the signs of paranoia

A person with BPD may have passing paranoid thoughts. They are stress-induced and generally don't last very long, but they may recur frequently. This paranoia is often related to other people's intentions or behaviors.

• For example, a person with a medical disorder may become paranoid and think that the specialist is conspiring with someone else to harm them.
• Dissociation is another common trend among people with BPD. An affected individual with dissociated thoughts may believe that their environment is not real.

Step 11. Check if the person has PTSD

Borderline personality and PTSD are strongly linked, as both can arise after periods or moments of trauma, especially in childhood. PTSD is characterized by flashbacks, avoidance, feeling "on the edge" and difficulty remembering the traumatic moment, among other symptoms. If someone has PTSD, there is a good chance they also have a borderline personality and vice versa.

Advice

• Take the time to take care of yourself, whether you are suffering from the disorder or a loved one has it.
• Continue to be supportive and emotionally available to your loved one.
• Medicines cannot cure the disorder, but a mental health professional can determine whether certain supplemental medications may be helpful in reducing symptoms such as depression, anxiety, or aggression.
• Remember that BPD is not your fault and does not make you a bad person. It is a treatable disorder.