Lisa Bahar Profile Photo Professional IToday we’re talking with therapist Lisa Bahar about Borderline Personality Disorder and how it can affect relationships.

Welcome, Lisa.

BPD makes it difficult to be involved in a stable, healthy relationship. What are some kinds of behaviors that people with BPD have that are a challenge to a relationship?

A person with BPD desires and responds to structure, predictability and communication. When there is lack of predictability, anxiety or fear of abandonment can potentially set in, and disruptive and unstable behavior can escalate into controlling and aggressive reactions.

These reactions can occur when their partner’s behavior even slightly differs from what is expected. For example, if a partner, who is “always” on time is 15 minutes late, breaking a pattern of predictability, feeling of anxiousness increase. These feelings trigger feelings of abandonment, which can then lead to disproportionate reactions.  These feelings are all rooted in fear.

For example, when the partner shows up, the person with BPD might accuse them of cheating, leaving or have a plan to leave them. Or the person with BPD might act out with behaviors used as a way to give the message that the other is being “punished”. These might include not speaking, slamming doors, pouting, and so on. They all communicate I am angry.

Tell us more about what this type of manipulative behavior looks like?

Manipulation is a way to create control.  If it is unconsciously motivated through a conscious act, such as an outward behavior like tantrums, crying, threatening, and attacking, it is what I call sloppy manipulation.

Or, it can be sophisticated manipulation. When manipulative behavior takes the form of crafty questions which are intended to trap the other person into saying something that they really did not know mean to say, or give an answer that they really didn’t realize they were giving.

The individual with BPD does not always use direct and healthy communication skills and instead acts out behaviorally and/or communicates indirectly.

Are people with BPD consciously manipulating others? Sometimes, it seems like these manipulative behaviors are habits or knee jerk reactions rather than conscious emotional manipulation. Can you explain what is really going on?

Exactly, these behaviors can be habits. Generally until awareness sets in, the individual may not know that they are unconsciously motivated. Once awareness sets in, and insight is gained, usually through various mindfulness practices, then there can be an opportunity for behavior change.

Behavioral change is the real test of insight.  Of course, the individual with BPD needs to actually know how to change and that is where the Dialectical Behavior Therapy skills become helpful.

What are the underlying reasons and/or mechanisms driving manipulative behavior in someone with BPD?

Fear of abandonment. Also, a feeling of disconnect particularly with a sense of self. This happens when an individual feels they don’t have an identity without the other there to define them. When the partner demonstrates behaviors that are interpreted as “leaving” by an individual with BPD it can feel like a loss of identity.

Fear of abandonment can feel almost like death to the individual with BPD since it is a kind of “death of self.” That is why some people with BPD have a pattern of jumping from relationship to relationship—they do this in order to sustain sense of self.

How does Dialectical Behavior Therapy help those with BPD resolve these issues?

Dialectical Behavior Therapy is a set of skills that are very concrete and clear. They allow the individual to decrease emotionally intense reactions by providing a way to decrease the symptoms.

DBT teaches a set of skills including:

Core Mindfulness skills which help to calm the mind.

Interpersonal Effectiveness skills which are designed to help you effectively communicate what you want, express feelings and say no clearly.

Emotional Regulation skills which help you manage and deal with emotions rather than emotions controlling you.

Distress Tolerance skills which help you be able to handle crisis situations more effectively and deal with reality and it’s terms, as opposed to resisting what reality is.

What are some suggestions for people who want to overcome manipulative behaviors that drive people away?

The first part is that the person has to want the change—they have to be the one to do the work! Of course, someone else such as the person the client is in a relationship might also want the change, and that is fine—but it can’t be the primary motivation.

Next, there must be a willingness and dedication to learning skills that can help. For example the client must be willing to practice the skills he or she learns from DBT. They have to understand: This is a not a quick fix, but the development of a pattern of life skills.

What advice do you have for family, friends and colleagues who are trying to cope with these behaviors and who, understandably, don’t want to feel attacked or manipulated?

Education is key.

Significant others must be aware of their part in interactions and reactions and must learn how best to respond. DBT is most effective if all family members are involved. Each person involved should practice a self care plan. It is so important for clients and family members to not point the finger at any one person.

Thanks for speaking to this topic.

 

About Lisa Bahar

Lisa Bahar, MA, CCJP, LMFT, LPCC is a licensed marriage and family therapist and licensed professional clinical counselor. In addition, she is certified as a drug and alcohol addiction counselor with the California Certification Board of Alcohol & Drug Counselors.

Lisa is known as a DBT therapist and provides a comprehensive DBT Informed Skills Training groups which provide clients the “How” skills to deal with emotionally reactive behaviors, inability to express feelings and difficulties in managing stress and ability to self calm. Lisa maintains a private practice in Newport Beach and at Southern California Psychiatric Associates located in Laguna Niguel, and is part of the Safe Harbor House Clinical Team.