May is Borderline Personality Week and an opportunity to reflect and learn more about this condition.

What is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder is a mental health disorder officially recognised in the 1980’s.  Clinical criteria as published by the American Psychiatric Association in the Diagnostic and Statistical Manual (DSM) IV used to make a diagnosis of BPD are:

A pervasive pattern of instability of interpersonal relationships, self-image and moods. Very impulsive behaviour is common with the disorder generally beginning in early adulthood.

This video goes through 9 traits.

Someone with Borderline Personality Disorder will have five or more of the following:

  1. frantic efforts to avoid real or imagined abandonment;
  2. a pattern of unstable and intense interpersonal relationships;
  3. identity disturbance;
  4. impulsivity in at least two areas that are self–damaging;
  5. recurrent suicidal behavior, suicidal gestures, threats or self-mutilating behavior;
  6. mood instability;
  7. chronic feelings of emptiness;
  8. inappropriate, intense anger; and
  9. short-term stress-related paranoid thoughts or severe dissociation from reality.

Everyone may display some of these symptoms from time to time. To know if you or someone close to you has Borderline Personality Disorder it is important to see a suitably qualified mental health professional. There are ways to treat the condition and reduce the symptoms.

Borderline Personality Disorder and High Conflict Personalities

Interact Support strongly supports the work of Bill Eddy and the High Conflict Institute in helping families to resolve conflict and avoid becoming High Conflict Legal Cases by learning conflict resolution skills.  His work is based on the High Conflict Personality theory which looks at ways to help and work with people who have a high conflict personality.

High Conflict People have the following traits:

  • unmanaged emotions
  • extreme behaviours
  • inflexible thinking
  • lack of self-awareness and self-control
  • identifying “targets of blame” who they believe are responsible for all their problems

Interact Support hosts the New Ways for Families course and training New Ways for Families Coaches in Australia.

The New Ways for Families course is a post-separation parenting program designed to teach 4 big skills to parents to manage co-parenting better as well as current and accurate information about children’s developmental needs and strategies to help children to be more resilient, even if they have a difficult parent.

Visit the New Ways for Families site for more information – Https://newways.interact.support

People with Borderline Personality Disorder may be High Conflict People but only if they have a target of blame that they focus all of their frustrations and anger on.

The fact that someone has Borderline Personality Disorder doesn’t automatically mean they are a High Conflict Person but their behaviour is generally very challenging for others to deal with.

People with Borderline Personality Disorder and high conflict people in general often have wide mood swings, from being very friendly to being very enraged, especially at those closest to them.

Our mediators, coaches and other professionals are taught methods to stay calm while showing the person empathy, attention and respect. This often helps a person who is feeling upset to calm down and more effectively focus on problem-solving. Without this knowledge, many professionals typically get angry back at such clients and make things worse.

People with BPD also have difficulty with interpersonal boundaries and seek to avoid feeling abandoned by alternately clinging or going into a rage. Therefore, we teach the professionals we work with to give extra explanations of how they work with clients (phone calls, emails, in-person meetings, crisis management, etc.) at the beginning of a working relationship in order to develop better boundaries and realistic expectations. We encourage them not to get too close or be too rejecting of the person, but rather to remain stable in a moderate and clearly professional relationship.

When coaching clients and in preparation for Family Dispute Resolution our practitioners engage with potentially high conflict clients to focus on the future and positive participation in dispute resolution by asking questions, making agendas and making proposals for resolving their conflicts. We make it clear that professionals are not responsible for the outcome of their clients’ cases, but rather as assisting their clients in resolving their conflicts.

Often those with BPD and other high conflict people will blame their professionals for things beyond the professional’s control, so it must always be clear what the professional can and can’t do.

The same applies if your partner or former partner has high conflict tendencies. It is very important to establish clear boundaries and be very clear about what you can and will not do. In the New Ways for Families course we teach the BIFF response to deal with irate or irrational communication from a high conflict person in a way that de-escalates and neutralises the conflict.

The goal is to change the way you behave in order to get better results rather than try and change someone who may or may not have a personality disorder or other issues. The reality is that the only person you have 100% control over is yourself. Trying to change someone else, especially if they have a personality disorder, is not something within your power.

Avoid Labeling

Unless you are a qualified professional you can’t diagnose personality disorders. If you recognise a number of the traits in someone it might be helpful to bear in mind the difficult behaviours and learn some of the strategies we teach to help deal with them but telling them that they are borderline or high conflict is only going to upset them and make their behaviour worse. It’s fine to have a “Private Working Theory” about them but keep it private.

This quiz comes from an article on the High Conflict Institute website.  To find out more about the High Conflict Institute visit https://www.highconflictinstitute.com/free-articles/2018/5/17/borderline-personality-disorder-bpd-revisited-fact-or-fiction?

A Quiz of Your Knowledge of BPD

Take this true/false quiz to see if you may have some misinformation about BPD:

1.      T / F       Only a qualified mental health professional can diagnose BPD.

2.      T / F       Anyone with BPD will be a high-conflict person.

3.      T / F       BPD is an unrecoverable disorder. If you have BPD, you’ll always have BPD.

4.      T / F       Those with childhood trauma, especially sexual abuse, are certain to develop BPD.

5.      T / F       A parent with BPD behaviors cannot parent successfully.

6.      T / F       People with BPD know that they’re behaving badly.

Answers:

1.      Only a qualified mental health professional can diagnose BPD.

True. It’s never a good idea to suggest that anyone has BPD or label them as “a borderline”. It’s like telling someone they have cancer or they are “a cancer” just because they have a red patch on their forehead. Leave the labeling and diagnosis to the trained professionals.

2.      Anyone with BPD will be a high-conflict person.

False. Of those who do have BPD, only a small percentage focus on a target of blame, and these are the folks who are most likely to be involved in high-conflict disputes. The others are regular people who deal with a lot of pain and who struggle to keep their heads above water but may, in fact, be conflict avoidant.

3.      BPD is an unrecoverable disorder. If you have BPD, you’ll always have BPD.

False. Thousands or hundreds of thousands of people across the globe are accepting and acknowledging that they have BPD and are seeking treatment. Society is gradually accepting the idea that BPD does not have to be viewed as a scary disorder with no hope of recovery. Many people have worked through therapy to recover and live happy, fulfilled lives with successful relationships. Many have outgrown the diagnosis completely, after working hard on their own patterns of behavior, usually in some form of counseling. And many still continue to struggle. Just remind yourself that it’s a marathon for them – not a sprint – with a little help from people who understand and can give a little empathy.

4.      Those with childhood trauma, especially sexual abuse, are certain to develop BPD.

False. While many people with BPD did experience childhood trauma (sexual abuse, physical abuse, neglect, etc.), not everyone with this disorder has a trauma history. For some, it may be a genetic tendency and/or extreme behavior patterns they copied growing up. For others, an “insecure attachment” with or without abuse may be a factor. So, don’t assume or waste time wondering why some people have it while others don’t, or secretly diagnosing someone just because they have an abuse/trauma history. Instead, focus on using empathy with everyone, even those with BPD traits.

5.      A parent with BPD behaviors cannot parent successfully.

It depends. Some people with BPD have been harmful or provided insecure attachments as parents, while others have been generally effective. Parenting success depends on the severity of the disorder and other factors, such as temperament at birth, nearby support systems, openness to learning parenting skills and/or some good therapy to help them calm themselves and learn new relating skills. Think of it this way: a person who loses a leg through amputation has to undergo therapy/treatment to learn new ways of walking.

6.      People with BPD know that they’re behaving badly.

BPD is a disorder that usually starts in early childhood so that it becomes part of the person’s personality and therefore not obvious to themselves. People with BPD (and any personality disorder) generally have a severe lack of social self-awareness—that’s a key characteristic of these disorders.

They truly believe their problems are all caused by outside events or other people, and that their behavior was normal or necessary given what other people did or said. Even the most learned, skilled professionals sometimes secretly believe that those with BPD know they’re behaving badly and choose it. The reality is that this person is actually quite miserable, through no fault of their own. What comes out can be kind of ugly, sometimes vicious and hurtful, but they truly aren’t intentionally being hurtful and hateful. They are simply stuck for a brief period in the defensive brain with little to no access to their logical brain – in those moments/minutes. We need access to both to relate well with other humans. They are in full fear mode much of the time, which makes them feel like someone outside of them is a threat.

Conclusion

Personal relationships and even working with people with Borderline Personality Disorder can be very difficult. This is especially true if they are also have a High Conflict Personality where they identify individuals as targets of blame to focus all of their anger and frustration on.

Difficult doesn’t mean impossible. There are strategies that people who need to work with someone who has Borderline Personality Disorder can adopt to make the relationship easier and less stressful. If the person is willing to get help and engage in treatment there are very successful methods to help them to deal with their difficulties and improve their interpersonal skills and internal feelings.

Resources

Shehrina Rooney – Recovery Mum – http://recoverymum.com/  A mother who video blogs about her experiences as a person with Borderline Personality Disorder

Book by Shehrina Rooney – https://www.unhookedmedia.com/stock/bigbookbpd

Borderline Personality Disorder Australiahttp://www.bpdaustralia.com/

Amanda Smith – Hope for BPD www.hopeforbpd.com

Books by Amanda Smith – http://www.hopeforbpd.com/borderline-personality-disorder-books/

Jeff Riggenbach

Book by Jeff Riggenbach – Borderline Personality Disorder Toolbox: A practical evidence based guide to regulating intense emotions

Help to resolve family disputes

If you are ending a relationship with someone who is high conflict you may find the process difficult to navigate. Interact Support has a number of services available to help.

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