Communication Strategies for Borderline Personality Disorder
Medically reviewed by Michael MacIntyre, MD
Understanding how to communicate with someone with borderline personality disorder (BPD) can help improve your relationship with them by focusing on good communication.
Borderline personality disorder (BPD) is a mental health condition that significantly affects a person’s ability to regulate emotions. This, in turn, can lead to impulsive behavior and trouble with self-esteem or self-image. BPD also makes communication and relationships challenging.
To help maintain a healthy relationship, there are several ways to communicate with someone who has BPD including:
Listen with empathy
Validate their feelings
Explore their interests
Set healthy boundaries
Be clear and consistent
Check in regularly
Learn about treatments and support
Change their focus
Offer constructive criticism
Be patient
Keep reading to find out more about how to help someone with BPD, how to communicate with them, and ways you can take care of yourself in the process.
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Symptoms of BPD
Communication may be difficult for people with BPD because they tend to see the world as either all good or all bad. Their moods can be volatile and intense, and it may be hard to control anger.
BPD is often described as chaotic and unpredictable. A person with BPD may go through periods in which they don't show any symptoms of the illness but then become triggered by something. This is known as an episode and is marked by worsening signs and symptoms. Common BPD triggers include:
Being rejected (perceived or real)
Feeling betrayed
Feeling abandoned at the smallest slight (perceived or real)
Being offended
Feeling disappointed
Having one’s self-concept threatened
Being in a boring situation
Being alone
These feelings are very real for them and can lead to:
A distorted and unstable self-image or sense of self
Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance misuse, reckless driving, and binge eating
Self-harming behavior, such as cutting
Recurring thoughts of suicidal behaviors or threats
Intense and highly variable moods, with episodes lasting from a few hours to a few days
Chronic feelings of emptiness
Inappropriate, intense anger or problems controlling anger
Feelings of dissociation, such as feeling cut off from oneself, observing oneself from outside one’s body, or feelings of unreality
It's important to be consistent in your approach and to practice clear communication on a daily basis. That said, it's best to save any difficult conversations for when your loved one isn't having an episode. They'll be calmer and more rational, and the discussion will be more productive.
Takeaway
If an individual is experiencing severe mood swings and you're concerned about them, get help 24/7 by calling the Substance Abuse and Mental Health Services Administration national helpline at 800-622-HELP (4357). Take any threats of self-harm or suicide seriously and don't hesitate to take the person to the emergency room or call the Suicide & Crisis Lifeline at 988.
Communication and BPD Episodes
Being in a relationship with someone with BPD poses some unique challenges, but there are ways you can support them while also taking care of yourself.
Listen with Empathy
Taking active steps to listen with an open mind and hear about what someone is going through shows you care about them. Ways to listen with empathy include:
Listen without judgment
Avoid interrupting or cutting off their sentences; wait your turn to speak
Remove distractions so you can give your undivided attention
Be comfortable with silence
Show your listening with nonverbal messages, such as eye contact and nodding
Restate and paraphrase using the person’s words, ask questions, and clarify comments as needed
Consider what the other person is feeling and try putting yourself in their position while you listen
Validate Their Feelings
Validation—affirming how someone feels—allows them to be seen and gives them hope. An invalidating environment is a major trigger for people with BPD.
You don't necessarily have to agree with the person. Validation simply means you're listening and acknowledging the person's feelings. Research has found that validation helps improve long-term therapeutic outcomes for people with BPD.
Explore Their Interests
It’s not healthy for anyone to make their diagnosis the bedrock of their identity or personality. Your loved one with BPD still has other interests, and their life is larger than the diagnosis. Make the space to explore their interests and plan activities together.
Set Healthy Boundaries
Healthy boundaries are essential for your self-care. Be clear about what your limits are and what the consequences will be if they're ignored. Clear boundaries can provide structure and predictability, helping reduce the fear of abandonment and rejection.
Be honest but kind—reassure the person that you want your relationship to continue, but you have to set some boundaries to take care of yourself. By consistently reinforcing your boundaries, you can help improve your relationship with your loved one, too.
Be Clear and Consistent
Avoid ambiguous statements and ensure your words match your actions to minimize potential misunderstandings. People with BPD can perceive situations or comments in extremes. By communicating supportive messages and boundaries clearly and consistently, your loved one knows what to expect.
Check In Regularly
Since fear of abandonment is a major trigger for people with BPD, checking in with them consistently reassures them that you have not forgotten about them and provides a sense of security.
Learn About Treatments and Support
All the love and support in the world cannot take the place of professional mental healthcare services. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or group settings.
Psychotherapy (sometimes called talk therapy) is the main treatment for people with BPD.
Dialectical behavior therapy (DBT) is the most common treatment for BPD and is highly effective. It teaches mindfulness and skills to help people manage intense emotions, reduce self-destructive behaviors, and improve relationships.
Cognitive behavioral therapy (CBT) can help people with borderline personality disorder identify and change core beliefs and behaviors that come from inaccurate perceptions and problems interacting with others. CBT may help people reduce mood swings and anxiety symptoms and may reduce the number of self-harming or suicidal behaviors.
By familiarizing yourself with DBT and CBT, you can help your loved one practice these skills. You can help your loved one get the care they need by being aware of local inpatient and outpatient treatment programs. Should they threaten self-harm or suicide, dial 988 to be connected to the Suicide & Crisis Lifeline.
Change Their Focus
Using distraction can sometimes be a useful strategy when the person’s emotions are intensifying. Try suggesting activities or tasks, such as watching a film, going out for a walk, or doing chores. Another strategy is to start an activity yourself and encourage them to join you when they feel ready.
It's also important to avoid escalating the situation. Acknowledge their feelings, but avoid arguing or confrontations. Instead, try to de-escalate by remaining calm, patient, and composed.
Offer Constructive Criticism
Constructive criticism involves providing feedback that is meant to help someone improve. It offers specific, actionable suggestions in a kind, caring manner with good intentions. This can be a challenging situation because people with BPD may interpret even minor feedback or constructive criticism as a personal attack, leading to intense emotional reactions. Offering feedback when the person is not having an episode is more likely to be effective.
Be Patient
Remind yourself that BPD is a mental health condition and that your loved one isn't purposely being hurtful. Treatment can be effective in managing the symptoms of BPD, but it takes time. Being patient and supportive while your loved one is developing skills to manage their symptoms can be difficult, but important for a healthy relationship.
Related: Why Do Pathological Liars Lie?
How to Get Support for BPD
A strong support network can help make BPD treatment more effective. Things you can do to support your loved one during BDP treatment include:
Encouraging treatment and learning about the treatment they are getting
Learning about BPD to better understand them
Reassuring them, even when they’re having episodes, and validating their feelings
Realizing that this is a clinical disorder, and their symptoms are part of it
Being a support system for someone with BPD is great, but don't overlook the support you need, too. A therapist or support group can help you work through your struggles and emotions, educate yourself about BPD, and arm you with tools to improve communication.
Summary
Being in a relationship with someone with BPD can be challenging. However many communication strategies can help. These include validating the person's emotions, setting boundaries, communicating clearly and consistently, learning about their treatment, and being patient. At the same time, it's just as important to take care of yourself and get the support you need.
People living with BPD can be very intense; that's the disorder manifesting itself. There are many things you can do to provide support, but don’t take it upon yourself to “fix” anyone. Professional treatment for them—and outside support for you—is a smart approach.
Read the original article on Verywell Health.
