**The ideas contained in this post are the opinions of the writer and communicated without reference to supporting documentation. The writer also recognizes that BPD is a disorder that affects both males and females, and uses of “she” or “he” in the communication of ideas are not intended to covey sexual bias. Breakaway MHE Disclaimer
Much of the ongoing problem when Borderline Personality Disorder (BPD) is an active condition for a person, and also for those who are in a relationships with that person, is not understanding what is actually going on.
Most people living out their lives in western culture start out with minimal (if any) knowledge about mental health, and the natural consequence of this is to make errors of attribution. In other words, whenever there are problems with human functioning and human relationships, a typical first approach is to try and establish what is “cause” and what is “effect” WITHOUT having any mental health frame of reference. However without having a mental health frame of reference, chances are very good that the suffering person (and those around him or her) will start out by attributing the problems of BPD to things like attitude or character.
When attributing problems in human emotion and behaviour to attitude or character, people are likely to believe and say things like… “she just likes to create drama”… “he just refuses to grow up”… “she is just attention seeking again”… “he is just trying to manipulate us”. When a person with BPD starts attributing problems experienced to his own attitude or character, he may say things like… “I am such a screw-up and I always will be”… “I can’t do anything right”… “I hate myself for being me”. None of these beliefs and wordings take available information about human biology and the brain into consideration, and most assuredly do not consider the specifics of BPD.
When complex neurological issues (such as BPD) are incorrectly reduced to issues of attitude or character, the first thing that happens is that NO corrective actions are taken to start resolving the issue. In other words, the state of disorder remains exactly as it is or otherwise gets worse and worse. How could it possibly be any other way? The next thing that happens is that all involved, again being without a mental health frame of reference, may start to come up with plans and schemes to try and change or improve the situation… things like punishments and consequences that have no potential whatsoever to address the complex neurological issues taking place.
The punishments and consequences – if coming from someone who doesn’t suffer with BPD – could include things like yelling, or avoiding, threatening to end relationships, or threatening to take things away. The punishments and consequences – if coming from someone who does suffer with BPD – could include frequent self-judging or self-shaming or self-harming.
These types of actions taken by people with and without BPD do nothing more than possibly add to the difficulty of disorder, even though they may SEEM to produce some temporary changes to behaviour and situations. And sadly, because of the temporary changes to behaviour and situations that punishments and consequences may produce, all those involved in using these approaches may simply increase the amount of punishments and consequences the next time the BPD pattern gets activated. Talk about a recipe for destruction – both for the suffering person and for relationships!
If you really want to adjust the BPD pattern, then the approach to problem-solving must include recognizing that parts of the brain are not working as they need to. For instance… memory areas, emotion regulation areas, impulse control areas, and reasoning areas. The approach to problem-solving must also include recognizing how certain types of interacting and responding (words used, phrasing, tones, etc.) can make a big difference to the ways the brain areas of someone with BPD tend to misfire, or not. The approach to problem-solving must finally include recognizing that certain brain chemicals may need adjustment through the proper use (the opposite of overuse) of medications in order to help the suffering person stabilize.
When someone with BPD gets sicker and sicker to the point of not being able to function in relationships and other life areas, it is because faulty beliefs about human functioning and disorder prevailed. It is also because a state of ignorance has prevailed… a refusal to learn new things (or a lack of access to learn things) and take approaches that actually work.
As a therapist and someone who has suffered with BPD, I insist that it is essential for ALL involved to learn how to reduce the catastrophe that BPD can unleash on the lives of ordinary people. There is no way to get around the fact that BPD is a condition that gets activated in the context of relationships, and therefore, can’t simply be “fixed’ by the suffering person alone in therapy. The combination of learned skills in therapy, appropriate medications, and more constructive (mental health informed) interactions between those with BPD and their loved ones, is the surest way to address the neurological issues of this very treatable condition.