Loving someone with borderline personality disorder (BPD)
By March 27, 2021, my partner, Matt, and I were utterly flattened by Toronto’s quarantine. We were struggling individually, which was also impacting our relationship. We hadn’t seen anyone but each other in months and we share a small living space that we’re also working from full-time. Fed up and at the end of our rope (fuck you, Doug Ford), we bubbled with another couple who were facing similar circumstances for an indoor meal on a wintry evening.
A key feature of BPD is having “disturbed relationships,” or relationships that the DSM-IV & DSM-5 characterizes as, “intense and unstable, marked further by abandonment fears and by vacillating between idealization and devaluation.” Studies have shown that those with BPD have a lower probability of experiencing enduring romantic relationships, and are more likely to experience low satisfaction or distress within a relationship. However, well-functioning relationships actually work as a protective factor for people with BPD, which can lead to mental health stabilization and a reduction of symptoms.
I’ve been with Matt for over six years, while George and Neill have been together for over a year. We’ve proved that, though challenging, stimulating and fulfilling relationships are possible with partners with BPD. That being said, in our respective relationships, we’ve primarily learned through trial and error. Our collective aim for the evening, besides some badly-needed social connection, was to demystify the BPD relationship and share perspectives that might be helpful to others by recording our conversation, guided by questions I wrote ahead of time.
In addition to a pattern of unstable relationships, BPD is also defined as a pervasive instability in self-image and emotion, as well as marked impulsivity. People with BPD experience chronic feelings of emptiness, frantic efforts to avoid abandonment, dissociative symptoms, and recurrent self-harming behaviour. Though the cause of BPD is still unknown, it’s thought to be a combination of genetics and an exposure to trauma or invalidating environments. Unfortunately, many people with BPD grew up in households that ingrained maladaptive habits into them, so they don’t always react to situations the way a person without BPD would.
“A big thing I wish I was aware of when we started our relationship] is not to take things personally,” Neill said. “I didn’t know that sometimes George just has to let the emotional experience happen… It’s about listening.”
Since many people with BPD grow up in households where they aren’t allowed to have feelings, or don’t have their feelings validated, they learn it’s safer to keep everything inside. As much as a partner might want to “fix” an emotion in a partner with BPD, validating and witnessing that emotion can actually be much more helpful.
“Sometimes, I read wanting to fix things right away as invalidation,” George said.
“I think people with BPD carry a lot of shame around our feelings. It’s a really hard balance,” I said.
“I find the same with mistrust,” George said. “When my feelings are happening, my initial reaction is I can’t trust these feelings. I know my feelings are crazy because everyone has told me they’re crazy… I know that, naturally, I assume the wrong thing.”
A person with BPD might also have trouble communicating their needs in a relationship. In the same way it wasn’t safe to express feelings growing up, setting boundaries or vouching for personal needs is an area where people with BPD have limited experience. When they do find themselves in healthy and respectful partnerships, it can be incredibly overwhelming.
“I think it took Miranda two years to let me know that she dislikes it when I leave yogurt containers in the kitchen—like hatred with the fire of a thousand suns,” Matt said.
“I thought asking you to clean up your containers would make you leave,” I said. “It felt like such a monumental ask.”
We took periodic breaks in the conversation to eat the delicious meal Neil prepared—chicken for the boys, and “chik’n” for me, refill our beer glasses, and cuddle with Neill’s adorable fluffy grey cat, Smokey.
When we returned to the conversation, we focused on the symptom that creates the most friction in our relationships: emotional instability, or what I call a BPD emotional storm. People with BPD are extremely sensitive to emotions—their own and others’—which can make interpersonal conflicts daunting. As Marsha Linehan, psychologist and leading expert on BPD, explains, “People with BPD are like people with third-degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”
“For me to navigate these emotional storms, it takes Matt seeing, understanding, and not reacting to where I’m coming from. That can be really frustrating for the person without BPD, because they get into a position where they can’t react when we’re in the throes of our emotion,” I said.
“People with BPD are able to pick up on emotional cues,” Matt said. “I think partners of people with BPD, if they are present, can see things coming too. If you’re not present, if you’re somewhere else, something big can come and knock you off your feet.”
Matt, who participated in a three-month support group, Family Connections, for loved ones of people with BPD at the Centre for Addiction and Mental Health (CAMH) in Toronto in 2018, learned about the importance of caring for oneself when a partner with BPD is experiencing emotional instability. “It’s the idea of the plane is going down and there is a crisis. The oxygen masks drop from the ceiling. If you’re the person who’s meant to help somebody else, you have to put your own mask on first.”
Watching someone with BPD struggle with emotional instability and the reactions it can provoke—panic attacks, depression, self-harm—can be challenging for partners.
“I don’t think it’s something that’s in my nature, but I want to hurt the people who hurt you,” Matt said. “When I see you in pain, I know that your present current pain is probably about something that happened a long time ago.”
“You can’t help that,” Neill agreed. “You see the aftermath of years of whatever it may be… I’m not a violent person, but if I could take away the pain, I would do anything to take it away.”
“I was raised in an environment where I learned I could be abandoned at any time, so I had to behave a certain way to prevent that abandonment,” I said. “Nothing I am doing during times of emotional instability is because I think you’re the person that hurt me, but it’s because it’s how my brain has been conditioned to operate.”
“Another nice way to put it is, ‘I don’t think you will do this. But my body does,’” George said.
As the evening progressed and the empties piled up, the fire crackled along with our conversation, which had turned to relationship history. A tough subject to tackle, Neill and George periodically took each other’s hand for support. Studies show that people with BPD are more likely to have had physically abusive partners and report having been raped multiple times. I plowed ahead with my signature pragmatism and turn to Internal Family Systems (IFS), an evidence-based therapy effective in treating trauma, to explain why this might occur.
“People from trauma environments tend to pick people that are also from traumatic environments who can’t give them the things they need to fulfill themselves. It’s until they break from that cycle and get to that point of self-fulfillment where they find someone who does have baggage but can manage it, and they can manage theirs—”
“—Someone with secure attachment,” George added.
“Exactly,” I said. “It’s this whole idea of you get into these habits because it’s how you were raised as a kid.”
“That’s why we pick partners that are essentially the worst possible partner for us, and it’s really not even our fault. This is what’s in our head,” George said. “As uncomfortable as the chaos is, we have gotten used to it. Sometimes that’s the only place that feels safe.”
“What’s so great about being with Matt, is I finally broke my dysfunctional dynamic.”
“In a dynamic like this—Matt and Neill—it’s extremely rare to find,” George said.
Though our relationships may be challenging at times (and let’s be honest, what relationship isn’t?), our partners consider us rare finds too.
“You have the qualities that will challenge us,” Neill said. “We have extremes, but we fire each other up.”
“I think people with BPD are a little more in touch with what it means to be alive, what it is that is necessary from life, and focused on getting it, which is a bit atypical for the human experience,” Matt said. “There are a lot of people who are just resigned to shades of grey and not really trying to paint with colour. Sometimes, people with BPD only want to paint in colour. To be that person’s partner, you just stand back and revel.”
We left George and Neill with full bellies and warm hearts. Though by that point I was a few beers deep, I fell asleep with the hope that our conversation would benefit not just our relationships, but ease the journey of others in our position.
Mad History
This issue: History of the term “borderline”
In recent times, there’s been a movement within the therapeutic and psychiatric community to rename borderline personality disorder to something more accurate and less stigmatizing. In 2010, Thomas R. Insel, former director of the National Institute of Mental Health (NIMH), was already advocating for reclassifying the disorder; however, in the latest edition of the DSM, the name remains the same.
The term “borderline” was coined by Adolph Stern in 1938, and was used to describe patients who were “on the border” of psychosis and neurosis. These were individuals who displayed specific symptoms under stress, but soon became relatively functional again. By the 1970s, psychoanalyst Otto F. Kernberg’s theories on personality organization classified what was then known as, “borderline personality organization,” as patients who suffered from identity diffusion, primitive defense operations, and reality testing. By 1980, due to work of John Gunderson and Margaret Singer, borderline personality disorder was added to the DSM-III as a psychiatric diagnosis.
Today, suggestions for a revised name for BPD range from emotional dysregulation disorder, to Linehan’s disorder, to emotional intensity disorder; however, until the name of BPD is changed, research has found that those who suffer from it are more likely to face high levels of stigma.
Recommended Reading
Borderline Personality Disorder: An Information Guide for Families
By: The Centre for Addiction and Mental Health
CAMH has published a comprehensive resource guide for family members or loved ones of those with BPD. The guide covers the basics of understanding BPD, treatment options for people with BPD, how to support a loved one with BPD, what to expect from recovery, and how to care for oneself when a loved one has BPD. The resource is free to access.
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