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.
There comes a point when learning to deal with Borderline Personality Disorder (BPD) that a person needs to make a choice whether or not they are going to take their learning seriously, or if they are just going to continue complaining about all of the BPD challenges. It is hard work, for instance, to practice feeling rejection, guilt, shame, worthlessness, and abandonment (all common emotional experiences in BPD), and likewise to keep up with all the thoughts and behaviour that need adjustment. And because of the difficulty, the temptation to insist that others always be supportive, emotionally validating, and so forth, can easily creep into everyday life. The urge to even give up on “practising feelings” and other adjustments (independently) could get very strong.
In my articles, I often speak on behalf of the BPD sufferer because I know very well how hard it can be to struggle alone, and also that a comprehensive knowledge of BPD as a disease process is absolutely necessary to start making adjustments. I also write in this way frequently because opportunities for a BPD sufferer to experience accurate and genuine empathy from significant others can be so rare, or even non-existent. However, in writing from this perspective so much, I become concerned that those reading might get the wrong idea and maybe start believing they are under no obligation to continue healing unless others in their lives are deeply invested in learning about BPD and how to be helpful. In reality, the extent to which significant others will actually take the time to learn about BPD, how hard it can be, how to be helpful, etc., is very low.
For one thing, the real suffering of BPD is invisible to others because no one can see what is happening on the inside of another human. This is why so many “BPD moments” get invalidated… it takes a lot of knowledge, patience, and curiosity to see past the drama and chaos of BPD. Most people don’t have this to offer. For another thing, many people are consumed by many of their own issues, mental health or otherwise. For yet another thing, people are further consumed by their sense of obligation to keeping up with the material world… paying bills, paying tribute, paying to play, paying to get more things, etc. People are very busy indeed, even exhausted, and so what in the way of time for mental health and caring about BPD does this leave?
Hard to hear, right?! But real?
If possible, and depending on who a BPD sufferer is in relationships with there is a place for compassion and understanding from others since it can be so helpful in working through difficult emotions, rearranging the irrational thoughts, and correcting the ineffective behaviours. However make no mistake about it… “this card” (the sympathy/empathy card) can be overplayed, or unrealistically played, by a BPD sufferer for all the reasons mentioned above, and more. The balance between independent and interdependent (with others) emotional work can therefore be hard to find. In many relationships and families, it is sadly unrealistic for a person with BPD to expect any help at all with his condition.
So what happens when a person with BPD chooses to continually fight against reality and refuses to take the level of responsibility needed for his circumstances? In short, things will probably never change for him, and things could very likely get a lot worse (losing relationships, losing opportunities, losing wealth, losing losing, losing…). In any case, when there is a refusal to take serious independent responsibility to learn everything possible about BPD and how to overcome, there is going to be suffering, and probably lots of wondering “why is this happening to me?”. A better question that someone with BPD could be asking himself is: “How hard on me do I want to make this learning process?”
In my face-to-face work with people who suffer with BPD, I recommend that they generally assume they will be going through an independent learning process. In other words, I try to prepare for them for the most common reality… that others will not, or cannot, make the time to help with a complicated condition like BPD. If by some stroke of luck a BPD sufferer knows someone who cares to learn about BPD in order to be helpful, I recommend treating this interest with healthy scepticism and keeping expectations low, simply because treating BPD takes several years of commitment. BPD challenges will no doubt remain over time… having some good days and some bad days… and so it can be hard for the person battling BPD to persist in the learning process. Now consider for a moment how much more challenging it would be for a person who doesn’t have BPD to continue as a helper.
Truly, the best resource you can have in the battle of BPD is yourself. You can always be there for yourself, and you can always take the time to learn more about what to do to take care of yourself. It may be hard to accept that your mental health is such a low priority issue in the lives of many (or perhaps most) of the people you know and live with. Unfortunately, it seems that humans have a very hard time caring about the mental health matters of others, even if that human is living in a human family. And so at the end of this article I stress that taking responsibility for BPD is a highly independent activity and that it is perhaps mostly realistic to believe you are on your own most of the time. The choice as to how much you want to suffer with BPD therefore needs to be made again and again, and so hopefully suffering “big time” does not have to be your reality.