“Borderline Personality Disorder”

Clients who’ve been diagnosed as “borderline” often know very well what it feels like to be misunderstood, to feel abandoned by their treatment providers, and to feel confused by their own strong emotional reactions. There is true help for borderline personality disorder.

I see BPD as a big, long, agonized cry to have deep needs for connection and validation met. See my video on this:

Contact me if you’d like to learn more about the commitment it takes a therapist and a client to move through BPD symptoms and into healing. It’s work. And it’s worth it!

Looking for a way to counter splitting right away, and want a taste of how I conceptualize this stuff? Here’s my video on “How to Counter Splitting and Understand Relationship Triggers”:

Here’s a story that’s much like the stories of clients I’ve worked with.

She comes into me after abruptly leaving other therapies. She says those therapists started out okay (sometimes they even seemed wonderful.), but none of them really understood her in the end. . One therapist told her to “just quit being so emotional,” and another kicked her out of therapy after she showed up with cuts on her arms right after the therapist had tried to help her.¬†

She’s good at her job, but her home life feels impossible to manage. She locks herself in her room most of the time, and when she interacts with her husband at all, she very often screams at him.

She says she doesn’t know what comes over her, can’t seem to control these outbursts.

She’s attempted suicide multiple times, usually right after a boyfriend mentioned breaking up with her. She admits, with shame, that sometimes she’s even lied to keep a boyfriend from leaving. She would pretend to be pregnant or injured.

She’s lost most of her friends, and is afraid to reach out again. She feels like no one understands her, and why should they? She fears that if someone did understand her, they’d hate her just like she hates herself.

After our first session, she feels understood and starts to have an inkling that I won’t judge her. I talk straight with her early on, telling her that I know that I run the risk of her walking or running away, because she’s gotten so used to leaving before someone else can leave. I tell her that I sometimes make mistakes, and I will, at some point, probably inadvertently hurt her feelings. We discuss what we can do differently so that she can stay even when I don’t get everything right. And I help her to “pace” her sharing with me, and she learns that she can walk out of a session feeling good, feeling strong in herself. This is different from past therapy where she would sometimes blurt out so much information that she’d leave feeling raw with exposure and shame. She remarks on the feeling of safety she gets by knowing that I’ll encourage her to slow down her sharing if I see her getting overwhelmed.

In future sessions, I help her to focus on her body, on her sensations, and to build a sense of solidity and feeling grounded.

Throughout it all, we’re talking about her high sensitivity, how being so sensitive can feel like both blessing and curse. We do some guided imagery. We talk about some strategies she might use in her communications. And we help her to get in touch with a feeling of safety and confidence more easily.

Several weeks into therapy, she tells me that she’s quit screaming at her husband, and sometimes leaves her room and enjoys herself. We work more on other anxieties or anger she has.

Several months in, her life is looking much better and she’s gaining a sense of having options in how she acts.

Sometimes, she doesn’t feel like showing up to therapy. But because we made an agreement with each other, she shows up anyhow. We talk about what it’s like to run away, what it’s like to show up when she feels like running away, how difficult it can be for her to express her feelings directly. We talk about the things she’d like to tell me, the kinds of things she used to hide from saying by running away or hurting herself or raging. I ask, can she experiment with telling me openly how she feels, or maybe just a piece of it?

We together come to understand different pieces of herself, including a childlike part of herself who needs nurturing.

After getting in touch with herself more, she starts to explore other relationships. And to grieve the relationships she never enjoyed fully until now.

She starts to take up some hobbies she used to enjoy.

As therapy goes on, we walk together through the grief, rage, anger, and ultimately, sadness and sense of aloneness she’s experienced for so much of her life. This time, she feels like someone’s here with her, like she doesn’t have to endure these feelings alone anymore. With increased space to be herself and feel her feelings, she’s able to open up more with her husband as well.

She tells me, “I lost so much. I never knew that I could be like I am now. I thought I was evil inside. But now I feel beautiful. I understand why I did those things. But I don’t have to do them anymore.”

Sound good? Schedule your consultation with me here.

Some of the folks I’ve talked with who have been diagnosed with borderline personality disorder were dismissed by therapists and loved ones — They may have been told that their reactions and their feelings were “just being borderline” — A devastating thing to hear if you are highly sensitive, as folks with BPD are.

You may have learned to discount your own emotions while feeling immense shame at being “different” — and sometimes feeling rage at people who don’t seem to understand you. Rage, shame, chaos, numbness — the despair can seem inescapable. But there are ways out.

So what does this diagnosis really mean?

You can find the objective criteria by looking up those characteristics, so I’m not going to rehash the dsm definition here.

I’m going to speak about what I’ve seen this mean for people I’ve worked with.

Marsha Linehan, who’s done research on borderline personality disorder, likens the emotional experience of having borderline personality disorder to what it might feel like physically to “live without skin” — the lightest touch or contact can feel unbearable.

It means that your feelings may alternate between numbness and rage.

It means that you can feel super close to someone one moment, and the next, wonder why you ever wanted to know them.

It means that you may have a fear of abandonment that is truly frightening, and that, when someone leaves, you may feel abject terror — which can lead you to doing and saying things that you later just don’t respect. And you wonder, “Why did I do that? Why do I push the people I love away?”

It may mean that you get into relationships with people you’re not sure if you even like. Or that you feel like you create a new identity for yourself around each new relationship. You blend and become what you perceive other people want — often very skillfully. You may be charming, empathic, and give endlessly to others or just become what you sense they want. And at the end of the day, you may go, “But who am I?”

You may have hurt yourself or done some very impulsive things. Sometimes, it may have been because you felt you had no other way to express your pain. Sometimes, it may have been because parts of you felt so numb, and doing something intense helped you to feel yourself and your body again.

Many people who have borderline traits or experiences have not had many experiences with compassion and help working their way through their keen sense of sensitivity. Helping folks with this diagnosis, in my experience, involves a few different things:

1. Helping you to calm any crisis in your life. Safety first!

So we will want to develop ways for you to get through the day, ways to help ensure that you’ll stick with therapy so that we can make real progress.

We’ll work on helping you to feel a sense of stability and safety.

And we’ll work on helping you to establish a commitment to therapy, because if we’re going to work together, we need to get our relationship expectations and any concerns about safety sorted out. Working through struggles that come up in the therapy relationship is one of the fastest ways to change, and to move into true healing that extends to your other relationships.

Because the potential for change through this relationship is so important, and because you might be used to walking away before that can happen, I also require that, once you choose to work with me, you pay for several sessions in advance. Why? Because I know that feelings that come up in therapy can be tough, and I know that, in the past, you may have learned to walk away when you feared someone else would. You’ve likely abandoned yourself and your feelings so many times that it’s become automatic. We break that cycle in therapy right away by establishing a commitment.

2. Helping you to develop a sense of self. That means that I want to help you to connect with who you really are. Sometimes, folks with intense feelings end up living lives that end up being run by the chaos of just trying to manage or get away from those feelings — but beneath any chaos you may be experiencing is a deeply sensitive person with deeply felt values. Good therapy can help you to get in touch with who you are so that you can have a sense of yourself in the midst of relationships, and so that you can live from a place of integrity and solidity.

Some folks come into therapy actually needing to work through the sense of trauma of being abandoned so many times by people who couldn’t understand and couldn’t stay around the chaos.

3. Helping you to learn ways to soothe yourself and calm your own feelings and your own body. You may have been dealing with so much feeling and so much chaos, and it may be that you’ve never learned how to comfort yourself, how to calm yourself down. If your brain is screaming, “Danger!” when it looks like someone is about to leave you or when someone does something to trigger that sensitivity, it’s hard to even function in day-to-day life. You need help to develop resiliency, and we can work on that through helping you to develop ways to notice your feelings and calm them. You may have spent so much time trying to stifle your emotions or to get someone else to understand you that you haven’t yet learned how to identify your emotions and soothe yourself. We can work with that until it’s second nature for you to realize your feelings and to reach out when that will work, and to learn to self-soothe too. (Lots of clients tell me that my compassion for them becomes an internal presence for them quite quickly — and how rewarding it is to self-soothe through feeling the presence of someone else who cares for them!)

4. Helping you to build a life worth living. “Building a Life Worth Living” is a phrase I’m borrowing from Marsha Linehan, who developed dialectical behavioral therapy. DBT offers lots of ways for you to ground, cope, and navigate complex feelings and relationships so that you can do the work of learning who you are and you can build a life that you love to wake up to every day. Some of my clients find that they need tools to cope with trauma and emotional flashbacks. I offer tools for those too.

5. Helping you to heal from trauma. Many “borderlines” grew up in homes where their feelings were denied. You may have been much more sensitive than your parents were, and they may not have known how to teach you how to handle those emotions and express them in useful ways. You may have heard, “Toughen up!”, or “Stop crying,” or, “Why do you have to make such a big deal out of nothing?”

That, in itself, is a deep trauma that struck at the core of who you were, so you may have developed a “tough veneer” to avoid looking like things mattered — but beneath that veneer is still so much feeling that you’re not sure how to stand it.

Other traumas include outright abuse — sexual, physical, verbal, spiritual. This can occur in families, but also out on the school playground, or in churches — or in dating relationships or marriage.

Another trauma is that of the “borderline” label, which, while it can put some pieces together, can also be done in ways that are damaging. I’ve heard stories of counselors who waved off someone’s intense pain as okay to overlook because it was “just borderline manipulation.” I will take you seriously, and we’ll identify together where and why any “manipulation” comes in and how we can be direct with one another.

There’s hope of deep healing of BPD traits!

Many of the folks I work with start out with traits of this disorder, and I like working with people who struggle in these ways. Progress is often much faster than they expect once they have a relationship with me and some tools they can put to use right away. Most often, people feel like I really understand them and respect them in the first session.

People with bpd can overcome these symptoms. And when they do, they get in touch with that sensitivity and richness that was always there, and embrace them as gifts and traits to nurture. And they live lives full of purpose, joy, and deep emotion.

If you want to explore the possibility of working together for that, schedule a consultation with me today.

 

Author: Michaela Lonning

I'm a counselor in Corvallis, Oregon, and I work mostly with intelligent and sensitive people who are struggling with a sense of connection to themselves or in their relationships. Near Corvallis? Come see me. Not near Corvallis? I work with clients around the world via Skype: Come see me.