hey there everybody and welcome to this video on supporting a loved one
with borderline personality disorder i'm your host dr dawn elise snipes
there is a lot that i could cover in this video but this is designed to be a short one so i'm
just going to provide you with a few tips that may help you support a loved one with borderline
personality disorder it's important to recognize that borderline describes where the person
teeters where they live pretty much all the time think about walking a tightrope they feel like
they are constantly balancing between safety and danger between acceptance and rejection
between me and you or themselves and you so they're always walking that
tightrope and just like a tightrope it doesn't take much it's not like you can
make an error and not fall so as soon as they make an error they may feel like they're in free fall
borderline personality disorder usually develops in people who have experienced
trauma that resulted in alterations in their brain actual brain structural changes in the amygdala
in the hippocampus happen when people experience trauma now where did those traumas come from
you know that person only knows some people are born wire differently
they may be highly sensitive to stimuli in their environment and there are a lot of issues
like schizophrenia and adhd and autism spectrum disorders that are associated with what's called
sensory gaiting difficulties which means the brain doesn't interpret sensory input the same way so
what feels like a gentle touch to you may feel excruciating to that person well as an infant they
had no way to communicate that so as an infant their environment may have been very traumatizing
and people kept doing it or minimizing or invalidating the way they felt
because they didn't experience the same reaction to that sensation putting a toddler in a bath
that the parent or caregiver thinks is lukewarm well the toddler may perceive if they have sensory
differences they may perceive that water as scalding or on the other hand very very cold
since the caregiver doesn't feel the same difference they think that the toddler
is being oppositional and instead of reacting in a compassionate manner may invalidate that
toddler's experience in the world which is very traumatic because for that toddler they're always
on alert they always feel like they're in danger of pain pain from the people that are our
caregivers and they don't know how to communicate that and they don't know how to stay safe
other people may have had what are objectively considered traumatic experiences there's been a
lot of research on adverse childhood experiences and those can come when there is a caregiver that
is emotionally or physically unavailable because of substance misuse or mental health issues
they can come from experiencing or witnessing violence or abuse of any sort or neglect
so there are a lot of different things that can cause trauma
what's more important is to recognize that the brains of people with borderline personality
disorder or borderline personality type symptoms even if they don't meet the full criteria for bpd
probably experience trauma and or probably have brains that react differently
to stressors than yours does they're not intentionally quote overreacting
their brains and their hpa axis or their threat response system operate differently with stronger
reactions to situations and they require a longer time to re-regulate so instead of dumping a little
bit of cortisol and adrenaline when something happens their brain just opens the floodgates
and as a result it takes longer for them to get back to baseline
telling them to just get over it or let it go only compounds their sense of isolation and unsafeness
people with borderline personality have often been rejected causing their symptoms and or as a result
of their symptoms so when they are rejected it makes them feel unsafe it makes them feel
isolated it leaves them especially if this started happening when they were a child
and they never were able to develop the skills and tools they needed to stay
safe every time they're rejected it makes them feel broken or like something's wrong with them
it's important to understand that prior experiences the person had created triggers
that might prompt dysregulation that seems spontaneous or seems to come from out of the blue
the point is there are triggers there it may be a smell it may be a time of day it may be a place
that you pass or a holiday a particular sound it depends on the person and what the situation was
it's important for the person to recognize that they've been triggered get caught up in the whys
or or the whats for that matter you know what was it that triggered you right now when they are
upset when they are dysregulating when they're spiraling whatever word you want to use for it
it's much more important at that point in time to help them get safe to and to do this
simply consistently respond say okay i can see your spiraling whatever word they they feel
more comfortable using validate their experience they feel terrified they feel um out of control
however they feel validate that experience even if you're not sharing that experience you can
see that they're experiencing so validate it you know i can see you're feeling a lot of pain right
now empathize with how that must feel for them you know if you were feeling that kind of pain
you know what would you want somebody to say to you empathize with them about how awful
it must be or how frustrating or exhausting it must be to feel that intensity of emotion
and support them in tolerating the distress and riding the wave
most of the time these urges will or triggers or emotional reactions will happen the person
may spiral so the wave comes in and it crests and it goes out in about 20 minutes or so now
that doesn't mean they're you know hunky-dory after that but that means the worst part is over
it's important to help them ride that wave until it starts to subside what can you do
and you can ask them what can i do to help you feel safe until you can re-regulate
once they've re-regulated once they are back down into their wise mind as we call it
backward chaining can be helpful saying okay you know that was an exhausting experience let's
look backwards and see what might have contributed to that so we can learn from it
explore with the person situations that make them more vulnerable to dysregulation and
develop prevention and wellness plans if they tend to be more vulnerable to dysregulation
when they are physically tired or if they're sick or they're in pain okay well what can we do about
that how can i help you prevent those things and when you are tired sick or in pain what things
can we do to make help you feel safer and less vulnerable during those periods affectively you
know we all have periods where we're grieving or we're angry or we're stressed about something you
know those are normal emotions but if somebody has that going on already that means their pressure
cooker is already you know wide open and any additional stress could be more than than
the pressure cooker can handle so to speak so it's important to recognize affectively when
you're stressed about something what number one what types of things cause you additional distress
and when you are feeling stress how can i help you feel safer how can i help you feel
more in control same thing with cognitions if they are having unhelpful negative thoughts
you know what things trigger those thoughts and in what ways uh can you best deal with those and each
person is going to deal with their inner critic and their negative thinking styles and pessimism
in slightly different ways environmentally and this is one we don't often consider but what
things make you more vulnerable to dysregulation if somebody is an introvert or has social anxiety
then being in an environment where there's a lot of people even the grocery store or the mall or
you know a work party that you have to go to mandatory fun all of those things can be
extraordinarily stressful and can create the situation where the person is more vulnerable
to dysregulation they're they're already stressed to the brink they're barely keeping their balance
on that tightrope it doesn't take but a little wind to throw them off balance
and relationally what things in relationships in communication styles in non-verbals tend
to make you feel more vulnerable you know what things have you experienced in the past
that may make you feel more vulnerable in relationships now and what's the best way
that we can handle them and it's important to connect with that person and ask them you know
what is most helpful we want to empower them to give us strategies that are helpful for them
journaling prompts that can help you reflect on the times that the person is dysregulated are
there similarities you know sometimes we need help identifying things that make us more vulnerable to
dysregulation even if somebody's been working with on with this for many many years they may still
have some blind spots so reflect on times that you're aware of where the person dysregulated are
there similarities what in those situations might have made them feel unsafe overwhelmed or rejected
mindfulness people with borderline personality are exquisitely sensitive to others feelings and
reactions so if you are feeling frustrated with this person if you are feeling irritated with
this person even if you're trying to hide it they are often going to sense it and it can be
really exhausting for them if you are feeling irritated or frustrated about something else
completely different a lot of times people with bpd overly personalized things so they may assume
that you are angry with them mindfulness is really important checking yourself and effectively
communicating to them you know yes i am really stressed out today but it's got nothing to do with
you i had this thing at the office or i got this letter from the phone company or whatever it is
making sure to openly communicate that what you're what's prompting your feelings
identify warning signs of spiraling in the person with bpd and develop a signal sometimes it can
be helpful to have a support person who notices signs of of of the person with bpd getting ready
to spiral because a lot of times they may notice it sooner than the person with bpd so they can
come over and touch them on the shoulder or they can maybe they have a catch phrase you know maybe
why don't you go get a drink of water or whatever it is that can be used in any kind of situation
that the person's in very discreetly to let the person know hey it seems like you are starting
to become destabilized or getting ready to spiral recognize and i cannot stress this enough
recognize that if they dysregulate when they dysregulate because it will happen it's exhausting
absolutely positively exhausting and like running a marathon will require a recovery period
because their brain instead of going from you know fine to a little bit irritated goes from okay to
terrified or okay to enraged that's exhausting they're they're using a lot of
energy they're having a major shift in their neurochemical balance so it takes longer to
recover and just like a marathon you know some people run marathons in a couple of hours well
kind of about the same thing you want to recognize that if that person has a full out dysregulation
episode it may take them several hours or even the rest of the day or more
to fully recuperate physiologically from what happened work with the person and their
therapist to understand how to set and maintain boundaries people with borderline personality
can have difficulty in relationships because they're torn between wanting to feel safe
and being terrified of being vulnerable so it's important to work with them and their therapist
obviously ask if you can be involved in their therapy to learn how to best
support them a lot of times people with borderline personality have always been told it's your fault
you're the problem you need to go get fixed and nobody else has said how can i help you
how can i support you in this process how can i be a lifeline so by showing an interest
showing a willingness to try to be supportive to try to understand what it must be like to live in
their body you are validating their experience and may help them to feel more supported a couple more
journaling prompts bpd is exhausting for both the person and the people who love them remembering
that what reactions do you have to your loved one that might trigger their fears of rejection
what is the basis of those feelings and how can you own those feelings with your loved one for
example if somebody is going through a bad period and they are disregulating kind of frequently
you may feel very frustrated and it may be important to own those feelings and say
you know i'm really you've been having a lot of dysregulating episodes lately
and i feel really frustrated because i feel helpless or i feel bad for you going through
this so they recognize that you're not angry with them you're angry with the condition
for more information you can go to all ceus.com
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