When thinking about people with BPD and the behaviors they exhibit many people will come to different conclusions about them personally as well as the behavior they most often exhibit. They forget the old saying, “Love the person, hate the sin.” If you live with a person who has BPD, you may well view their negative behavior as being highly manipulative. In fact, I have said myself that oftentimes the person with BPD holds their loved ones emotionally hostage by their threats of suicide and self-harm. But underneath all that ranting and raving is a person who is genuinely hurting and, in many cases, filled with utter despair not knowing where to turn for comfort. Inexperienced professionals will refer to their patients as manipulative and highly resistant to treatment when in fact they are almost incapable of responding any other way.
DIALECTICAL BEHAVIORAL THERAPY OFFERS UNCONDITIONAL ACCEPTANCE OF THE PATIENT, NOT THE BEHAVIOR
Dialectical Behavioral Therapy (DBT) is based on the premise that the therapist accepts the patient unconditionally. In my experience, except when it came to my DBT, I never believed that was anything such as unconditional love. I certainly did not receive that from either my children or my husband. With my husband, there were always conditions attached. But DBT is different. There is, however a huge difference between unconditional love and unconditional acceptance.
People with BPD are not intentionally manipulative. Being manipulative requires the intention to deceive. Using the label connotes that the person is inherently bad or evil. Most of the time they are crying out desperately for help and attention but they just don’t communicate their needs and desires in a positive manner. This is why I believe that assertiveness training is paramount for anyone with BPD who is engaged in treatment. Learning to be assertive allows you to communicate your needs, wants and desires without tearing the other person down or impinging on their humanity. If there are no assertiveness training classes in your area, there are loads of resources to be found online. Assertiveness, like all new behaviours for the person with BPD takes practice. I like to compare them to exercise. You start small and build up. No one ever starts bench pressing 350 pounds the first day. It is a slow process. You can not change a lifetime of maladaptive behaviour overnight.
BPD IS A COMPLEX PERSONALITY DISORDER
The person with BPD was created, not born that way. BPD is a complex personality disorder which arises within a family context.. It is no one’s fault that they have it. No one would ever wish to have Borderline Personality Disorder. There is some thought that it may be related to the genetic makeup of a person. Other people believe it is connected to damage to the brain’s pre-frontal cortex.
People who have BPD can not simply ignore their emotional pain and think their way to being better. They can, however, be taught different ways of responding to certain kind of emotional stimuli and learn new behavioral patterns. In my opinion, it is very important for the person with BPD to change the way they think but even after learning different ways of thinking and responding, sometimes the person with BPD can’t help it and simply relapses back to old behavioral patterns. Two steps forward, one step back. It happens and it will continue to happen until they master these new techniques.
IT IS POSSIBLE TO HAVE TOO MUCH EMPATHY
People with BPD are often overly aware of other people’s suffering and will over-empathize with them. This can get them into trouble emotionally because they feel other people’s pain acutely because they understand it so well. This is why people with BPD need to be taught how to establish firm boundaries between themselves and others. Good fences make good neighbors and good boundaries make good relationships.
Change takes time and a boatload of patience. I think this is especially true for people with BPD because they have embraced their negative behaviour for a long, long time and it has, by and large, seen them through multiple storms. In the same way that learning how to tie your shoes takes time, learning how to be a different way takes time. And just because they may learn to change their gut reaction emotional responses does not mean that they are cured. I think that, like a Type I diabetic who receives a stem cell transplant, they will always remain a Type I diabetic. The same holds true for the person with BPD.