Part 2: 7 Challenges of Borderline Personality Disorder
Last week I discussed 7 challenges of Borderline Personality Disorder (BPD) such as: dysphoria, attention-seeking, manipulating, controlling, emotional chaos and storms, internal emptiness and loneliness, relational chaos, denial, anger, rage, and progress in some ways and deterioration in other ways. BPD is a complex disorder that requires a supportive family, active treatment, and competent treatment providers. Without these things, recovering from BPD can seem almost impossible.
This article will discuss 7 ways to cope with and deal with the above symptoms of BPD. It is important for me to note that not everyone with BPD exhibits the following behavioral, relational, or emotional characteristics.
One of the most difficult symptoms of borderline personality disorder (BPD) is an inability to relate to others without fear of abandonment, openly communicate, and/or maintain positive and stable relationships for long periods of time. For me, these symptoms are under the broad category of “interpersonal effectiveness.” Interpersonal Effectiveness is a psychological term used to describe a person’s ability to balance priorities and demands, engage healthily in relationships that are balanced and appropriate, and identify emotional needs and wants. You will most likely hear of this term when learning about or reading about Dialectical Behavior Therapy (DBT).
Current research suggests that there are empirically-based, thoroughly researched, and easy to understand and learn treatments available for BPD. DBT is one of those techniques and many of my young clients are in therapy, primarily group therapy, to learn DBT skills. The premise of DBT is to teach emotion regulation and distress tolerance. This includes knowledge of coping skills, triggers, levels of intensity of symptoms, ways to distract oneself when symptoms are out of control, and build awareness of symptoms.
When I work with adolescents who are struggling with BPD, parents often complain about their teenager’s inability to maintain any kind of relational stability. For the loved ones, caregivers, and friends of people suffering from BPD, one main question is often: “why is recovery and treatments so difficult?” That’s a million dollar question that researchers are still trying to answer. But thankfully there are tools available to help sufferers and their loved ones cope.
Below are some of the core symptoms of BPD and suggestions (I often offer my own clients and their loved ones) on how to cope with symptoms:
- Dysphoria: When feelings of deep dissatisfaction with life occur, it is important to try to pinpoint what the trigger is. Is the trigger something you heard or saw? Is it a person, a time of day, or a fleeting emotion with no known triggers? Is the dysphoria or low mood due to thinking errors (erroneous or skewed perceptions) or negative self-talk? It is important to pinpoint what is causing the dysphoria so that healing can begin. Discussing this with a therapist will be very important to recovery.
- Attention-seeking, manipulating, or controlling: As I stated last week, not all individuals with BPD are manipulative, attention-seeking, or controlling. However, if these behaviors are observed, it will be important to seek help or support from someone who can point out the behaviors and suggest better ways of getting needs met. A main reason so many people with BPD are tagged as “manipulators” or “attention-seekers” is because the way in which the person is trying to get needs met is unhealthy. There are healthier ways to get needs met and a therapist or someone experienced with BPD can help.
- Emotional chaos and storms: Emotional storms happen to all of us at some point in our lives. The key to handling them is being able to acknowledge and identify triggers, have a list (literal or mental) of ways to cope when the storm comes, and putting the coping skills to use. Another healthy way of coping with emotional storms is to have more than a handful of coping skills to choose from. Many of my young clients find 1-2 coping skills they absolutely love and will commit to trying during an emotional storm. However, the 1-2 coping skills don’t always work and aren’t always appropriate for the setting (for example, playing basketball at school). Choosing more than 1-2 coping skills for various settings is important.
- Internal emptiness and loneliness: Internal emptiness and loneliness are also emotions many of us will experience at some point in our lives. However, knowing how to deal with it will make a world of difference. Seeking therapy, finding an anchor (i.e., hobby, purpose for living life, God), and eating and sleeping right all matter. It is important to take care of your emotional, psychological, spiritual, and physical needs. Pursuing a holistic doctor, who can recommend healthier eating styles, can also be helpful. Starting a vitamin regimen, exercise program, etc. is all you sometimes need to move forward in a positive mindset.
- Relational chaos: I often recommend that families, caregivers, friends, etc. read books and articles about the relational chaos of BPD. Sometimes a book, an article, an online video, etc. can offer a great deal of knowledge on one of the most difficult symptoms of BPD. “I hate you-don’t leave me” is a great place to start to help you understand patterns of relating.
- Denial, anger, and rage: Therapy is often useful for dealing with denial, anger, and rage. Being able to attend therapy, with a good therapist, on a weekly basis to identify patterns of unhelpful and unstable behaviors is a good way to begin recovery. If you are in denial, are angry, or have unresolved feelings of resentment, coping and surviving with BPD symptoms can feel impossible. Unresolved issues should at least be acknowledged and discussed.
- Progress and then…deterioration: A good therapist or support system can help when deterioration occurs. It is not abnormal or odd for a progressing individual to take a few steps backward. For the most part, many of us do when we are trying to achieve something. For example, you want to lose weight and have been eating healthy for 6 months but somehow you slip and overeat. Recovery includes some errors and mistakes.
What has been your experience with BPD? Do you know someone who (or do you) struggle with the above symptoms? What would make treatment ideal for you? What tools do you feel you need or could benefit from?
Looking forward to your perspective.
All the best
Melton, R. (2014). How a borderline relationship evolves. Retrieved online 8,15,2016 from, https://bpdfamily.com/content/how-borderline-relationship-evolves.
Hill, T. (2018). Part 2: 7 Challenges of Borderline Personality Disorder. Psych Central. Retrieved on February 23, 2018, from https://blogs.psychcentral.com/caregivers/2016/10/7-challenges-of-borderline-personality-disorder-continued/