If you have a confirmed BPD patient around you, if you are a partner, family member, and good friend, I have some suggestions:
1. First of all, please know more about BPD disease, including common symptoms of BPD, pathological models (biosecondical theory), treatment methods (such as dialectical behavioural therapy), rehabilitation, etc. Please do not be biased against the BPD disease and the group of people with BPD, which comes from ignorance and can exacerbate the symptoms of BPD patients (especially self-blame, guilt, shame, etc.). There is also the network information quality is uneven, there are a large number of unscientific, unscientific, no factual basis of “science articles” and “personal experience”, please carefully refer to the network information. For BPD, I can refer to the following answers:
How to get along with borderline personality disorder relationships and cheating 2. It is equally important to give him full support for formal and professional diagnosis and treatment. Only psychiatrists in the country can make a diagnosis, the reality is that many psychiatrists on BPD are not very understanding, there may be misdiagnosis (such as BPD misdiagnosed as bipolar disorder), it is best to find a special BPD psychiatrist to do the diagnosis. (Realistically, no matter how much you read and understand BPD, you’re not a clinical worker, after all, you don’t have professional qualifications, you don’t have systematic training, you don’t have clinical experience, you can’t and shouldn’t “treat” BPD patients around you.) Leave professional things to professional people to do, encourage, support, cooperate with him to receive professional, reliable diagnosis and treatment, in life to provide him with some convenience (such as food and living, transportation accommodation), let him be more attested to treatment, make changes, these are the most we should do. A lot of times, that’s the only thing we can do.
Of course, this is premised on the fact that he is willing to undergo diagnosis and treatment. If he is not willing at present, then do not force him, mental illness treatment must require the patient’s own subjective will, forced not to come. If that’s the case, you may need to be patient.
If the other person has BPD but is unwilling to receive treatment or is temporarily unable to do so, you have to make your own decision. Tolerable, willing to endure, then continue to wait patiently, it can not bear, reality does not support, then good to get together, both sides clearly. It’s like saying that long-distance love, if you can accept it and are willing to accept it, then go on, but if one party can’t accept it, then break up a friendly (not so easy, of course).
It’s important to know your boundaries and the limits of your ability to bear, not that your close relationship with BPD will necessarily fail, but the challenges are certainly there, and if you want to continue, you need both sides to be prepared. Mental illness is not a “flood beast”, according to the incidence of mental illness, one of the intimate relationships in a lifetime of mental illness is a very high probability, the key is whether they are willing, can accept and deal with.
How to get along with borderline personality disorder relationships and cheating 3. If the above two prerequisites are met, then there is one more thing to do, which is to learn more psychological skills and improve your ability to manage your emotions. The opportunity to learn dialectical behavioural therapy skills (DBT) on its own is ideal.
Note: The focus here is on helping yourself manage your own emotions better by learning psychological skills such as DBT, not on managing his emotions. Please don’t “teach” or “coach” the other person how to manage his emotions, you can use these skills to help yourself unless the other person asks you to help him.
The reason for this is that BPD patients themselves are characterized by feelings that are prone to losing control, that there is no way to effectively manage their extreme negative emotions, and that in many cases they express their negative emotions (such as extreme words, language attacks, threats, and even violence) through extreme, extreme behaviour in intimate relationships, which can also cause you to experience extreme negative emotions. When you experience “unprovoked” negative emotions, it’s easy to make emotional behaviours (such as saying something angry to him and making impulsive behaviours) that in turn affirm his negative perceptions (such as “he doesn’t want me”, “it’s all my fault”) and negative emotions (such as anger, insecurity, self-blame, etc.) and then create a vicious circle.
For BPD patients with out-of-control emotions, cognitive loss, behaviour out of control, out-of-control interpersonal relationships, etc., what you need to do most, but also the most basic, is to improve their ability to manage their emotions. Once your own emotional management skills improve, there are two benign outcomes: one is that you don’t experience extreme negative emotions often, you can deal with your intimacy with him more effectively, and the other is that you experience less of the extreme negative emotions that you cause, and you don’t get caught up in a vicious circle. In this way, you are very beneficial to him in this relationship.
Maybe your own emotional management skills are good, think “I don’t have BPD, why do I have to learn emotional management skills”, but if you are in an intimate relationship with a BPD patient, then “normal” emotional management skills and strategies may not be enough, you may need to “open a small stove”, learn more emotional management psychological skills, is very much needed.
I personally recommend you to self-training DBT skills, how to do so, you can refer to my following answers:
4. If you really want to choose a DBT skill to describe here, it should be Validation, which can be translated as “affirming the other person’s emotional experience”. Why Validation was chosen is a small story.
As you may know, BPD’s international authority is Dr. Marsha Linehan, the founder of DBT, who is a “god” in the industry and was diagnosed with BPD when she was young. She was once asked the question in a lecture by the audience:
“If you’re living on an island with a BPD patient at the same time, if you can only choose one of the many DBT skills to bring with you, which one would you choose?”
Dr. Linehan’s answer is “Validation” because recognizing and affirming the emotional experience (or subjective experience) of BPD patients can quickly “fire down” and minimize emotional intensity to prevent the most out-of-control emotions.
What does Validation probably mean? That is to say, we have to affirm, recognize, understand each other’s cognition, emotion, subjective experience, behaviour impulse, that is, we put ourselves in each other’s situation, to understand and affirm why he thinks so, feel, such behaviour, and directly through language to express to each other.
Validation has many levels (there are six levels in DBT), and this can be summed up from the foundation to progress:
1. Focus on the other person
2. Repeat and review what the other person said
3. Pay attention to the other person’s expression, body language, guess the other person’s emotional feelings
4. Start from the other person’s history and understand the other person’s behaviour at the time
5. Normalize the other person’s emotional experience and realize that anyone in the same situation is likely to react the same way
6. Complete sincerity, treat each other as a real, flesh-and-blood person, with an equal attitude, respect, trust, support each other
Validation and “commonality” are a little different, we not only have to understand why the other person has such an emotional experience, but also through our language and behaviour to express it, and let the other person know that we are really sure of his emotional experience. “Absolutely” does not mean that we “consent” or “identify” with the other person’s emotional experience, on the contrary, we can “oppose” or “disagree” with the other person’s emotional experience, but can still “affirm” the other person’s emotional experience. Because the other person does experience a certain emotion, a certain physical feeling, whether true or not, his subjective experience is “real”, it is undeniable.
For example, you may have been too busy recently to forget one of the things you promised the other person, who thought “you don’t care about me at all”, and then experienced a strong sense of insecurity, anger, abandonment, and even a threat to break up. Although the other person’s cognition and emotions do not correspond to the facts, we can understand that if I think the other person is “intentional”, if I have been abused and cheated, if my emotional sensitivity is high, then such an emotional response is understandable. We can confirm each other’s feelings, but that doesn’t mean we agree with each other’s conclusions.
Under such circumstances, if we can do the first time to “affirm” and “recognize” the other person’s emotional experience, we can reduce the other party “not understood” or “no one understands me, care about me”, can avoid our own expression of extreme emotions, make impulsive behaviour, thus preventing the other party from experiencing a stronger negative emotion, get rid of the vicious circle mentioned above.