Supporting Loved One with BPD: Quickstart Guide

Hey there, everybody, and welcome to this video on supporting a loved one with borderline personality disorder. I'm your host, Dr. Donnellice Snipes. There is a lot that I could cover in this video, but this is designed to be a short one, so I'm just going to provide you with a few tips that may help you support a loved one with borderline personality disorder. It's important to recognize that borderline describes where the person teeters, where they live pretty much all the time. Think about walking a tightrope. They feel like they are constantly balancing between safety and danger, between acceptance and rejection, between me and you or themselves and you. So they're always walking that tightrope and just like a tightrope, and it doesn't take much. It's not like you can make an error and not fall. So as soon as they make an error, they may feel like they're in free fall. Borderline personality disorder usually develops in people who have experienced trauma that resulted in alterations in their brain, actual brain. Structural changes in the amygdala and the hippocampus happen when people experience trauma. Now, where did those traumas come from? You know, that person only knows. Some people are born wired differently. They may be highly sensitive to stimuli in their environment. And there are a lot of issues like schizophrenia and ADHD and autism spectrum disorders that are associated with what's called sensory gating difficulties, which means the brain doesn't interpret sensory input the same way. So what feels like a gentle touch to you may feel excruciating to that person. Well, as an infant, they had no way to communicate that. So as an infant, their environment may have been very traumatizing, and people kept doing it or minimizing or invalidating the way they felt because they didn't experience the same reaction to that sensation. Putting a toddler in a bath that the parent or caregiver thinks is lukewarm. While the toddler may perceive, if they have sensory differences, they may perceive that water as scalding, or on the other hand, very, very cold. Since the caregiver doesn't feel the same difference, they think that the toddler is being oppositional and instead of reacting in a compassionate manner, may invalidate that toddler's experience in the world, which is very traumatic because for that toddler, they're always on alert. They always feel like they're in danger of pain, pain from the people that are caregivers, and they don't know how to communicate that, and they don't know how to stay safe. Other people May have had what are objectively considered traumatic experiences. There's been a lot of research on adverse childhood experiences and those can come when there is a caregiver that is emotionally or physically unavailable because of substance misuse or mental health issues. They can come from experiencing or witnessing violence or abuse of any sort or neglect. So there are a lot of different things that can cause trauma. What's more important is to recognize that the brains of people with borderline personality disorder or borderline personality type symptoms, even, even if they don't meet the full criteria for bpd, probably experience trauma and or probably have brains that react differently to stressors than yours does. They're not intentionally, quote overreacting. Their brains and their HPA axis or their threat response system operate differently with stronger reactions to situations and they require a longer time to re regulate. So instead of dumping a little bit of cortisol and adrenaline when something happens, their brain just opens the floodgates and as a result it takes longer for them to get back to baseline. Telling them to just get over it or let it go only compounds their sense of isolation and unsafeness. People with borderline personality have often been rejected causing their symptoms and or as a result of their symptoms. So when they are rejected, it makes them feel unsafe, it makes them feel isolated, it leaves them. Especially if this started happening when they were a child and they never were able to develop the skills and tools they needed to stay safe. Every time they're rejected makes them feel broken or like something's wrong with them. It's important to understand that prior experiences the person had created triggers that might prompt dysregulation that seems spontaneous or seems to come from out of the blue. The point is there are triggers there. It may be a smell, it may be a time of day, it may be a place that you pass or a holiday, a particular sound. It depends on the person and what the situation was. It's important for the person to recognize that they've been triggered. Don't get caught up in the whys or the what's for that matter, you know, what was it that triggered you right now, when they are upset set, when they are disregulating, when they're spiraling, whatever word you want to use for it. It's much more important at that point in time to help them get safe. To and to do this, simply consistently respond, say okay, I can see your spiraling. Whatever word they they feel more comfortable using, validate their experience. They feel tough, terrified, they feel out of control. However, they feel validate that experience. Even if you're not sharing that experience, you can see that they're experiencing. So validate it. You know, I can see you're feeling a lot of pain right now. Empathize with how that must feel for them. You know, if you were feeling that kind of pain, you know, what would you want somebody to say to you? Empathize with them about how awful it must be or how frustrating or exhausting it must be to feel that intensity of emotion and support them in tolerating the distress and riding the wave. Most of the time, these urges will or triggers or emotional reactions will happen. The person may spiral. So the wave comes in and it crests and it goes out in about 20 minutes or so. Now, that doesn't mean they're, you know, hunky dory after that, but that means the worst part is over. It's important to help them ride that wave until it starts to subside. What can you do? And you can ask them, what can I do to help you feel safe until you can re regulate. Once they've re regulated, once they are back down into their wise mind, as we call it, backward chaining can be helpful saying, okay, you know, that was an exhausting experience. Let's look backwards and see what might have contributed to that so we can learn from it. Explore with the person's situations that make them more vulnerable to dysregulation and develop prevention and wellness plans if they tend to be more vulnerable to dysregulation when they are physically tired or if they're sick or they're in pain. Okay, well, what can we do about that? How can I help you prevent those things? And when you are tired, sick or in pain, what things can we do to help you feel safer and less vulnerable during those periods? Affectively, we all have periods where we're grieving or we're angry or we're stressed about something. You know, those are normal emotions. But if somebody has that going on already, that means their pressure cooker is already, you know, wide open. And any additional stress could be more than the pressure cooker can handle, so to speak. So it's important to recognize affectively, when you're stressed about something, what, number one, what types of things cause you additional distress and when you are feeling stress, how can I help you feel safer? How can I help you feel more in control? Same thing with cognitions. If they are having unhelpful negative thoughts, you know, what things trigger those thoughts, and in what ways can you best deal with those? And each person is going to deal with their inner critic and their negative thinking styles and pessimism in slightly different ways environmentally, and this is one we don't often consider. But what things make you more vulnerable to dysregulation? If somebody is an introvert or has social anxiety, then being in an environment where there's a lot of people, even the grocery store or the mall, or you know, a work party that you have to go to, mandatory fun, all of those things can be extraordinarily stressful and can create the situation where the person is more vulnerable to dysregulation. They're, they're already stressed to the brink. They're barely keeping their balance on that tightrope. It doesn't take but a little wind to throw them off balance. And relationally, what things in relationships, in communication styles, in nonverbals tend to make you feel more vulnerable? You know, what things have you experienced in the past that may make you feel more vulnerable in relationships now? And what's the best way that we can handle them? And it's important to connect with that person and ask them, you know, what is most helpful? We want to empower them to give us strategies that are helpful for them. Journaling prompts that can help you reflect on the times that the person is dysregulated. Are there similarities? You know, sometimes we need help identifying things that make us more vulnerable to dysregulation. Even if somebody's been working with with this for many, many years, they may still have some blind spots. So reflect on times that you're aware of where the person dysregulated. Are there similarities? What in those situations might have made them feel unsafe, overwhelmed or rejected? Mindfulness. People with borderline personality are exquisitely sensitive to others feelings and reactions. So if you are feeling frustrated with this person, if you are feeling irritated with this person, even if you're trying to hide it, they are often going to sense it. And it can be really exhausting for them. If you are feeling irritated or frustrated about something else, completely different. A lot of times people with BPD overly personalize things so they may assume that you are angry with them. Mindfulness is really important. Checking yourself and effectively communicating to them, you know, yes, I am really stressed out today, but it's got nothing to do with you. I had this thing at the office or I got this letter from the phone company or whatever it is, making sure to openly communicate that what you're what's prompting your feelings. Identify warning signs of spiraling in the person with BPD and develop a signal. Sometimes it can be helpful to have a support person who notices signs of, of, of the person with BPD getting ready to spiral. Because a lot of times they may notice it sooner than the person with bpd. So they can come over and touch them on the shoulder or they can, maybe they have a catchphrase. You know, maybe you, why don't you go get a drink of water or whatever it is that can be used in any kind of situation that the person's in, very discreetly to let the person know, hey, it seems like you are starting to become destabilized or getting ready to spiral. Recognize, and I cannot stress this enough, recognize that if they dysregulate when they dysregulate, because it will happen. It's exhausting. Absolutely, positively exhausting. And like running a marathon will require a recovery period because their brain, instead of going from, you know, fine to a little bit irritated, goes from okay to terrified or okay to enraged. That's exhausting. They're, they're using a lot of energy. They're having a major shift in their neurochemical balance. So it takes longer to recover. And just like a marathon, you know, some people run marathons in a couple of hours. Well, kind of about the same thing. You want to recognize that if that person has a full out dysregulation episode, it may take them several hours or even the rest of the day or more to fully recuperate physiologically from what happened. Work with the person and their therapist to understand how to set and maintain boundaries. People with borderline personality can have difficulty in relationships because they're torn between wanting to feel safe and being terrified of being vulnerable. So it's important to work with them. And their therapist obviously asks if you can be involved in their therapy to learn how to best support them. A lot of times people with borderline personality have always been told, it's your fault, you're the problem, you need to go get fixed. And nobody else has said, how can I help you? How can I support you in this process? How can I be a lifeline? So by showing an interest, showing a willingness to try to be supportive, to try to understand what it must be like to live in their body, you are validating their experience and may help them to feel more supported. A couple more journaling prompts. BPD is exhausting for both the person and the people who love them. Remembering that what reactions do you have to your loved one that might trigger their fears of rejection? What is the basis of those feelings, and how can you own those feelings with your loved one? For example, if somebody is going through a bad period and they are dysregulating kind of frequently, you may feel very frustrated. And it may be important to own those feelings and say, you know, I'm really. You've been having a lot of dysregulating episodes lately, and I feel really frustrated because I feel helpless or I feel bad for you going through this. So they recognize that you're not angry with them. You're angry with the condition. For more information, you can go to allceus.com bpd.