Coping Skills for Families with Loved Ones Who have Borderline Personality Disorder

Coping Skills for Families with Loved Ones Who have Borderline Personality Disorder

Borderline Personality Disorder (BPD), is a difficult disorder to deal with for both the individual who has it and for the loved ones of that individual. It takes a great deal of patience for the whole family (including the individual with BPD) to get through the trials and tribulation the disorder brings. It is necessary to stay strong and use effective coping skills together as a family, in order to keep the family united. Effective coping skills for the family can keep the peace and the emotional dysregulation of the individual with BPD at bay for longer periods of time. The following are a few techniques that can be used in order to help the individual with BPD to progress in treatment and to help the family to keep the environment calm.

Validation 

An individual who suffers from BPD goes through several emotions daily that are intense and quickly changing and these frequent mood changes can bring on several types of negative behavior. When this happens it is necessary for the family to validate how the individual with BPD feels. Just because the family validates the individual does not mean they are telling them that their negative behavior was acceptable. They are simply saying that they understand where they are coming from and understand why they may have done what they did, even though it was not right. 

Ways of Validation 

 An easy way to validate is just by using body language that shows the individual with BPD that they are being heard. This can be by using eye contact or gesturing to the individual to continue (Linehan, 1997). This type of validation has all to do with showing the individual with BPD that you are there for them without saying anything at all. 

Another way of validating is having an accurate reflection (Linehan, 1997). If the individual with BPD looks upset, a statement such as, “You seem down today…” can ignite a conversation about why the patient maybe down. These types of statements can help to have a open line of communication which can help the individual with BPD emotionally and therefore this would reduce the emotional dysregulation. 

Another simple way of validating is using the individual’s history to help them see the cause of their behavior (Linehan, 1997). An example of this can be, “I understand why you may have interpreted the situation in such a way that you responded so explosively, given your history of being abused at a young age”.  This helps the individual to realize why they may be acting in such a way and also to realize that they are being understood by someone else, Which will also calm their negative emotions a bit. 

Why Provide Validation?

Family and Individual Counseling

Family and individual counseling is a pivotal part of helping the family and the individual with BPD. It is necessary that the family supports the individual with BPD while that individual is going through therapy, as well. Ways to do this are stated during the family counseling sessions, and are extremely helpful in keeping a peaceful environment in the home. It is necessary that the family makes small goals that add up to a big picture for an individual with BPD. Small goals are much more helpful rather than trying to jump to a big goal in general and especially with someone with BPD. When trying to jump to a big goal, failure is a lot more likely than with doing small goals slowly. Since an individual with BPD is emotionally dysregulated, it is likely that they will take this failure a lot worse than someone who does not have BPD. This may make them ruin all the progress they had made, and go back to step one, where the explosive behavior is at (Gunderson & Berkowitz, 1991). 

It is also important for the family to realize that the process of change is difficult to start and scary to maintain. Therefore it is better not to emphasize that the patient is doing so good and getting better so fast and so on, because this may lead to the individual with BPD to completely relapse out of fear (Gunderson & Berkowitz, 1991). While the individual with BPD is getting treatment, they have a lot of support from others and are consistently with someone else. Individuals with BPD frequently are afraid of being alone, and therefore may feel that as soon as they get better they will be isolated and left alone to fend for themselves completely. Therefore, many times just this thought may make an individual with BPD relapse and end up needing urgent medical attention. Therefore, it is better if the family say something along the lines of,  “You’re doing a little better, but there will be new obstacles that you will need to conquer on this journey.” 

Family Members Need to be Aligned with One Another and Consistent

It is necessary for family members to be united when dealing with BPD in the family. This is especially necessary for the parents, because if the adolescent has BPD traits he or she will consistently change who is the “good and bad” parent. It is necessary that the parents work through this together and be consistent no matter how the adolescents moods and views on his or her parents change. It is also necessary for the parents to come to a conclusion together on how to deal with the negative behaviors that BPD brings with it. After the conclusion is figured out, it is necessary that the parents are consistent. Therefore, if the adolescent threatens that they will take many pills, it is necessary that the parents come to a conclusion if after taking the pills out of their mouth or hands if they will call the ambulance or take the adolescent to an inpatient facility. It is necessary for the parents to think of these types of things before hand, and to stick with a plan, so the adolescent is cognizant that there are consequences to his or her actions. This same planning and consistency should go for all other negative behaviors, as well.

Gunderson, J., & Berkowitz, C. (1991, January 25). Family Guidelines. Retrieved April 04, 2016, from http://www.borderlinepersonalitydisorder.com/family-connections/family-guidelines/

Linehan, M. M. (1997). Validation and psychotherapy. In L.Greenberg (Ed.), Empathy reconsidered: New directions in psychotherapy (pp. 353–392). Washington, DC: American Psychological Association.