The Difficulty In Treating BPD

A common theme in the emails I receive is how to help someone who has Borderline Personality Disorder (BPD) and how do you convince someone who has BPD that they need to get help. Unfortunately there is no easy answer and a good portion of people who qualify for the BPD diagnosis will never go near a doctor for their mental quirks as they will not admit their thought process is faulty. Normally when someone is diagnosed with BPD they were seeking treatment for another mental disorder at the time such as depression or anxiety when the doctor puts the pieces together.

Imagine walking in a room full of family and friends who were all staring at you with a not so pleasant look on their faces. Someone from the group comes up to you and says "Hey Joe we need to have a talk. Do you know how you believe that two plus two equals four? Well Joe two plus two equals five". Poor Joe is trying to wrap his head around this notion that a belief he has had since he was waist high is wrong and either his head will explode or he will. Joe lets off a tirade that can stir the dead trying to hold on to a belief that is part of his core for if he was wrong or disillusioned in that area what else is wrong and it is a choice of protecting this idea or watching the whole package crumble. Welcome to BPD.

Once upon a time I created an illusion to present to others to keep myself safe as my real self was not doing a very good job. I repeatedly put forth an image that would please the other people in my life. They wanted someone who never talked back, who was the perfect child in social settings and basically every parents dream so that is what I gave them. The problem was I was so busy keeping everyone else happy that the real me was lost in the process. It was never about right and wrong but what other people wanted. I knew that when I was angry that other people would not act too pleasant so I figured out how to keep the anger inside and never show it. Any emotion that came up had to go through the filter of "If I present this emotion how will someone else react" and never the thought "To deal with said emotion the right way I need to do this" so my emotional learning curve went straight into the ground. I was so good at presenting this false image that some how it became real in the process and I would go to great lengths to protect it for this is how I survived and if you take that away then I literally have nothing else left.

When I started to really look at my past I went over a variety of situations where I could not figure out my reasoning behind them is when the realization that something was not quite right in the way I thought and behaved. The false self image was made to keep others happy but the thing is it needs constant reassurance so you need to figure out a way to get attention. Some people may resort to using suicidal ideation, sex with strangers or just blowing up when it is convenient for any attention is good attention. The thought process is "Well if I was not important then they would not be reacting the way they are" it doesn't matter how you get the attention all that matters is that you do. The BPD world is very black and white with the grey area holding very little weight.

What borderline people do understand fully is boundaries as their lives are full of them. When person X seems to cross this invisible line then this is the response he/she is going to get to make sure they do not try it again which keeps my core nice and safe for when my core is rocky my entire world is rocky. To me this is also the key to recovery but it is not going to be easy as everyone in the BPD persons world needs to be on the same page for it to work.

If the decision is made that every time the BPD person uses a suicidal gesture then the reaction will be to call 911 and get the person committed for their safety but this has to be done every time by every person or it will not work. For the first thing the BPD person is going to do is find the link that responds the way they are hoping for. If every response comes with a firm reaction the BPD person has no other option but to change and hopefully at the same time realize that their thought process is not so sound as they thought it was.

The substance rate when it comes to BPD is sky high somewhere in the neighborhood of seventy percent and I believe they do so to get rid of the doubt that something might not be right by using alcohol or drugs to hide from the reality. The statistics for suicide and Borderline Personality Disorder is one in ten. Imagine waking up one day realizing none of your life is really yours but has been one very long act your left with a few choices: A) Go to work and basically rewrite your entire thought process B) Continue to go on with the same act but knowing something is wrong C) Giving up completely and throwing in the towel. Most people will live in option B until they hit rock bottom and realize the show is over and it is time for their real self to come back to life playing the main role but for some it is too much and the curtain closes for good.

The best thing that I have ever done to correct my BPD way of thinking is insert a buffer between someone else's words or action and my response. The buffer gives me time to really look at the situation from all angles then decide which one is most appropriate. It has not been easy and there is still a long way to go in some areas but gradually I am finding myself making the choices that are healthy and not self serving on a regular basis. For thirty years I held the belief that my false self image was the real one and when reality hit it was not a fun day to realize my core beliefs were a lie. Mind you it is easier trying to balance one self image then two.

Like everything else on this blog this is my perspective and it makes sense to me. Use this blog as a starting off point and not a final conclusion. Take care.