How to Help Someone with Borderline Personality Disorder

· January 15, 2018

Few personality disorders are as complex and debilitating as borderline personality disorder (BPD). We could talk about treatment, biology or psychology, but there’s also the psycho-social environment of the patient.

Often, his or her family and friends don’t know what to do, what not to do, how to help and care for them. Hence the question of this article: how can we help someone with borderline personality disorder?

A lot of times when we talk about mental illnesses and  psychological disorders, we just list the symptoms, origins, and triggers. However, we’re forgetting one key aspect.

We forget to consider the personal and relational world of the person with the disorder. While it’s hard to think about, they may feel lost, suffocated, and imprisoned by their own mind.

“Borderline personality disorder is still poorly understood. We meet people who are misunderstood and who go from therapist to therapist, getting more and more confused and desperate.’

-Dolores Mosquera-

Every expert in psychology knows that nothing is as challenging to evaluate and treat as personality disorders. There is much symptomatic overlap, many false positives (bad diagnoses), and the immense psycho-pathological labyrinth is often overlooked.

True, manuals like the DSM-V help clarify some of the features. But it’s easy to see how it can be so hard to know how to help someone with borderline personality disorder.

Families of people with this condition know that not everything that their loved one does or suffers can be found in a book. Most of the time the targets and direct victims of their instability, paranoid thoughts, existential emptiness, and dichotomous thoughts are the people closest to the sufferer: their loved ones.

That’s why it’s important to consider the family environment of someone suffering from BPD.


how to help someone with borderline personality disorder

General characteristics of people with borderline personality disorder

People with BPD are most often characterized by instability in their personal relationships and self-esteem.

They…

  • Have extreme mood swings.
  • May idealize their loved ones just to devalue and humiliate them later.
  • Have chronic feelings of emptiness and abandonment.
  • Have paranoid thoughts or…
  • Suffer from self-harm or suicidal tendencies.
  • Utilize a wide variety of defense mechanisms, both negation and projection. These make it even more difficult for them to become aware of their illness and take responsibility for themselves.

It should be noted that, like many other psychological conditions, there is no “magic cure” for borderline personality disorder. There’s no infallible therapy to deactivate the roller coaster of mood swings, the fears and emptiness.

However, what we do have at our disposal are treatments that can bring emotional stability and improve relationship quality. This is the first step in knowing how to help someone with borderline personality disorder.

There is one essential aspect of caring for someone with BPD that we cannot ignore: family support. This is the most basic tool for mental illness. We must offer adequate coping strategies within their personal environment and learn to live together and help them.

an upset man with a headache in bed

How to help someone with borderline personality disorder

People close to the patient often feel guilty. They have doubts, they feel responsible for relapses, self-injury. They feel they should’ve known better, said something sooner. When we have a loved one with BPD, we must take these three aspects into account:

  • We have not caused the disorder.
  • We can’t cure it.
  • And we can’t control it.

Once these aspects are clarified, we can start to help our loved one. Let’s continue with some practical guidelines:

  • Nothing is more important than understanding what is happening and why they’re acting how they are.
  • As we said at the beginning, this disorder is both complex and devastating. Sometimes, along with the disorder itself, the loved one will experience depression, bipolar disorder, anxiety disorders, eating disorders, and substance abuse.
  • It’s essential to know all the symptoms and characteristics.
  • Despite the fact that BPD is treatable, patients often avoid getting help or skip treatment.
  • Therefore it’s essential that we encourage them to keep with the therapy and any medication.

How to help someone with borderline personality disorder: Communicate

People with borderline personality disorder can say cruel and irrational things. They fear being abandoned and left out, so they erupt in fits of rage and verbal abuse.

  • Specialists say it’s like having “auditory dyslexia.” They hear disordered words without context.
  • When they’re verbally aggressive, they should say that “now is not a good time to talk.” Then we should make sure they know they’re important to us and we want to communicate when they’re more relaxed
  • When they’re calm, we should focus on their emotions more than their words in order to make them feel validated. 
  • It doesn’t matter if what they say doesn’t make sense or is irrational. We must make them feel heard and supported.
  • If, at any time, they fall back into aggression, it’s best to give them space rather than get sucked into an argument with them.
support in tough times

Set healthy limits

One of the most effective ways to help someone with borderline personality disorder is to help him control his behavior. To do so, we must set limits and ask him to comply with these limits. To self-regulate and, above all, to understand the importance of sticking with treatment.

  • All family members must agree to the limits and rules.
  • What is and what is not permissible should be determined and communicated.

We have to say what’s not permissible clearly but with affection. “We love you and we want this to work. To do this, you must understand that if you talk to us like this or do these things, you hurt us and yourself. We can’t accept these things and ask that you make this change for all of us.”

What we should not do with a person with BPD

  • Threaten or give ultimatums
  • Tolerate abusive behavior
  • Allow them to stop treatment
  • Ignore suicide threats

In order to help someone with BPD, we must take care of ourselves

We can take care of ourselves by:

  • Not isolating ourselves or building our entire lives around the person with borderline personality disorder.
  • Not neglecting our health.
  • Going to support groups with others who are in the same situation.
  • Learning techniques to manage stress.

To conclude, this collaboration between the patient, his family, and the professionals treating him isn’t easy, but it’s possible. It’s a daily challenge to help someone with borderline personality disorder. A bumpy but rewarding path when we can minimize impulsivity and sow the seeds of rational decision making.