Please Note: The ideas contained in this FAQ are the opinions of the writer and are communicated without reference to supporting documentation in most cases. Other inspiration and influence for the writing came through consultation with other mental health professionals but the writer “Peter Quintano” is also fully qualified in DBT making him qualified to talk about the things discussed in this article.
It is interesting to observe that people are quite often willing to provide various types of support to others when they recognize those others as having a genuine need. For instance, opening doors when it appears hands are full, helping with changing a tire, helping to lift something heavy, helping to clean up a mess, etc. On the other hand, when it comes to helping others with working through emotional distress that is hard to understand, the willingness of others to provide support can be drastically less.
This lack of willingness to provide emotional support might be related to not knowing how to offer this kind of support, but it can also be connected to misguided values, morals, and beliefs about emotions and mental health, such as “you should act like a grown-up if you are an adult” and likewise “there is never a good reason to over-react or act irrationally” – As if people could somehow be perfectly emotionally balanced at all times, regardless of condition.
Unfortunately it is very common for people suffering from Borderline Personality Disorder (BPD) to become unbalanced or “de-regulated” in their emotional experience, and therefore, to appear as though they are trying to be disruptive and difficult in the way they express themselves and interact with others. For instance, becoming extremely and unnecessarily defensive, or becoming extremely and unnecessarily demanding/controlling. When other people observe these types of behaviors, it can be very easy for them to believe that the struggling person isn’t struggling at all, but instead has premeditated every word and action and just wants to make life hard.
If a person truly has Borderline Personality Disorder then he or she does not want to make things hard or lose relationships, but instead has NO IDEA how to manage all the emotions going through his or her body and so is continually “over-reacting” to the emotions (very often with no insight, awareness, or understanding that skill development is needed).
When you need emotional skills that you don’t have and that others believe that you should have, the recurring consequence can be conflict with others, being avoided by others, and sometimes even being punished by others who believe this kind of response is necessary to “help a person grow up”. The problem with all of these types of responses towards a person who has not yet developed the emotional awareness and skills necessary to successfully navigate life is that emotional skills remain undeveloped. In fact, with others remaining uncompassionate, unforgiving, and unaware of mental health, the struggling person is more apt to believe that his irrational thoughts and related emotions are all completely sensible, and likewise that there is no other way of looking at things.
One of the primary areas of mental health that a person with BPD needs to strengthen is recognizing multiple viewpoints for every life event, but this area remains weak when nobody realizes what is happening in moments of difficulty.
To be an effective emotional support to someone who struggles with BPD, it is important to realize that there is a serious impairment happening with regards to processing thoughts and feelings and that the struggling person did not ask for this problem. If this one aspect of BPD can be realized, then there is a chance for offering some compassion. To refuse to acknowledge the reality of stunted emotional awareness and skill development in a struggling person is to refuse to accept reality as it is.
It is much more common than people realize to be unequipped in the regulation of emotions going into adulthood, especially when the emotions are of the large/intense variety, and therefore to also develop BPD. When the struggling person and those around him accept the reality that more strength and capacity for tolerating and processing emotions is needed, and that misguided beliefs or punishing types of responses will not help matters, chances of making changes to the BPD pattern improves greatly.
If able to accept the struggling person as having real neurological issues that can’t be corrected easily, and likewise that hard-to-understand emotional expressions are not what they seem, more can still be learned to be a helpful support. For instance, learning to remain curious about interpretations and inquiring about the struggling person’s ways of thinking, plus using validating language to help the struggling person identify emotions and become more mindful of his felt experience, are all excellent ways to be a support.
An excellent analogy for being a supporter of someone with BPD is to imagine working out with someone in a gym, and that you are available to be a “spotter’ and therefore to help lift the weight when it has become too much for the person doing the actual lifting. This is a good analogy because living with BPD means being faced with difficult emotional challenges on a daily basis, and so “the weight” of the emotions can become both exhausting and overwhelming.
Experiencing even small acts of support from others in the ways mentioned above can mean the difference between functioning and not functioning for a person with BPD, so please do consider your willingness and the overall benefits it might bring to the relationships you are in with the people who live with these struggles day in and day out.
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