- I believe my family member has BPD, but they refuse to believe me/seek help. If they will not agree to therapy, what are some ways I can live with their destructive/hurtful behavior(s)? **Allow me to apologize in advance. This answer got very lengthy very fast. I hope it still helps.**
BPD is difficult to deal with when you are in therapy. Not believing you are ill or need help makes it 10x harder, not only on yourself, but also on those around you. If you’re dealing with a loved one who refuses to seek help, this is the best advice I can give.
First, you need to know that your mental well-being is as important as theirs. It can be exhausting dealing with someone who is untreated, or even someone who is in treatment but not responding or refusing to cooperate. It is okay to take a step back and leave them alone for a little while. If you need time to yourself, please take it. If you’re worried about your loved one, see if there is another family member/friend who can hang out with them while you have some down-time. You cannot be an effective help to someone who needs you if you are not functioning at full capacity.
Second, it is okay to be upset by what someone else does. You may feel like you don’t have the right to be angry or hurt by your loved one because it is their mental illness that causes them to behave this way, and they may not “mean it” when they say or do things. YOUR FEELINGS ARE VALID. Just because your loved one is struggling, that doesn’t mean that your feelings are discounted and thrown aside. You are a human being, and you have feelings, and despite the fact that your loved one may not be “acting like themselves,” the feelings you are experiencing still matter. It is okay to express those feelings. However, if you don’t feel you can do so in a healthy way (in the “heat of the moment,” for example), then I suggest waiting until things have calmed down to rationally discuss it with your loved one.
As far as BPD is concerned, there are several things you can do to help “soften” the outbursts from your friend/family member, and make it less painful on them as well as yourself. The thing to remember with mental illness, although it can be hard when a person is actively seeking to harm you, is that the mentally ill person is also being harmed. It can be difficult to empathize with someone who is being abusive or mean, but trying to remember that the person is struggling can help you to approach the situation in a calm manner and employ some of these steps/skills to alleviate the mental turmoil they cannot explain to you, as well as the emotional damage they are attempting to do to others. Here, I’m going to list some major symptoms/behaviors of people with BPD, and how you can help/combat each specific one. I asked my husband for some help on this, so hopefully I’m not biased or sugar-coating anything. 🙂
Splitting. Splitting is also known as “Black-and-White Thinking.” Borderlines have issues with what would be considered by most as “gray areas.” We tend to see things as all-or-nothing, good-or-bad. There is no in-between for us. Sometimes, this isn’t an issue. So what if I think that grape jelly is the only thing permissible to eat on a peanut butter sandwich? That doesn’t have any effect on anyone or anything else in the world. You are still free to put honey, bananas, marshmallow fluff, or anything else that pleases you on your sandwich, and all it will do is disgust me. I can rationalize that other people like different toppings on sandwiches, and move on with my day. It is when we begin to have this “No Gray Area” manner of thinking toward others and/or ourselves that things get destructive.
In BPD patients, black-and-white thinking isn’t (usually) focused on things as trivial as sandwich toppings. BPD is an extremely “relational” disorder, meaning that it is affected by/affects our relationships with other people. We tend to “split” on ourselves and other people. This causes us to see someone as “all good” or “all bad.” We cannot rationalize the two and create a “whole” or “well-rounded” person. If I do something to disappoint myself, I am bad. There is no alternative in my BPD mind. I cannot sit and “think of my good qualities” to combat the feelings that I am a failure, idiot, waste, etc. If my friend or family member does something to disappoint me, the same line of thinking occurs. This is not something we can stop when it is happening, and that is where we lose a lot of people.
Things you can do to help when a person is splitting. It is important to remember that the way a Borderline is thinking and feeling during one of these episodes is not the way that they normally think. My husband always tells me that “what he thinks and what he believes are not always the same thing.” He can believe that I am not manipulative, but sometimes I behave in such a manner, and that causes him to momentarily think that I am manipulative. This is how BPD patients work all the time. We may express a temporary displeasure or conflict with ourselves or someone we love, but it doesn’t mean that is our permanent idea of the person. The main way to combat splitting is to validate, not contradict, the person. The things I am thinking or feeling in a splitting episode may not be true, but they feel like 100% truth to me, and if you try to rationalize with me and “prove me wrong,” it only makes the episode worse. I cannot reconcile the good and bad traits of a person, and giving me conflicting views of myself or the person I am splitting on makes me feel even more confused than I already am, and makes it harder to come out of the episode. I will struggle to mash the two images of a person together, and it will make me feel out-of-control and chaotic. The best thing to do here is to validate, or legitimize the BPD person’s feelings. If it is something that is entirely untrue, even if it is hurtful and you want to lash out, saying phrases like, “I’m sorry you feel that way” and “I see why you think that” and “I would be upset too if I thought ______” make Borderlines feel that it is “okay” to have feelings. The most helpful thing for us is to put feelings before facts. This is backwards from the way you would converse with a normal (I will refer to non-mentally ill people as “normal” or “neuro-typical” occasionally) person, where facts would come first and they would influence feelings. For BPD sufferers, our feelings dictate the facts, and this is where the problems come in.
Another extremely helpful tactic with splitting is distraction. Getting my mind off of the obsessive thinking that has taken over my brain is going to be one of the best ways to “snap me out of it.” Physical activities are best, such as leaving the house and going to eat or shop or whatever you know your loved one likes to do outside of the home. For me, mental distraction also works when I am not with a friend that can help me get out of the house. Random facts like, “Did you know penguins have knees?” are good examples of mental distraction techniques. Another tactic similar to distraction is redirection. For me, it helps to get me to focus on my cats. They are living creatures, so they need attention, food, water, etc. Asking how they are/what they are doing, if they’ve been fed, etc. will redirect my focus from myself or someone else to them, causing me to lose the “splitting” train of thought.
That’s all for tonight, folks. Check back tomorrow for more!