WOMEN’S SPECIALIST PSYCHOTHERAPIST Private Online Therapy · Worldwide · Brisbane-Based Client resources. Intense love, intense fear of loss. Borderline personality disorder.
Loving someone with borderline personality disorder can feel like riding someone else’s emotional storm. The good news is that BPD is one of the most treatable personality disorders. Here’s what it is, and how to encourage help with care, without getting swept into the crisis.
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PART 1WHAT IT IS
What is borderline personality disorder?
Borderline personality disorder (BPD) is a long-standing pattern of instability in emotions, relationships and sense of self, together with impulsive behaviour. At its centre is an intense fear of being abandoned.
It’s diagnosed more often in women, though research suggests it affects men at similar rates. It has strong links with trauma, and some people prefer to describe it as emotional dysregulation. It belongs to Cluster B, the “dramatic, emotional or erratic” group.
Cluster BDramatic, emotional or erratic
What it can look like from the outside
- Frantic fear of abandonmentDesperate efforts to avoid being left, whether the threat is real or imagined.
- All good, then all badRelationships swing between idealising someone and feeling betrayed by them.
- An unstable sense of selfNot knowing who they are, what they want, or what they value.
- Impulsive and risky behaviourSpending, sex, substances, binge eating, reckless driving.
- Self-harm or suicidal behaviourIncluding threats. Always take these seriously.
- Emotions that hit hard and fastIntense anger, despair or emptiness that can shift within hours.
WHAT’S UNDERNEATH
The agenda that doesn’t change.
Dr Gregory Lester teaches that every personality disorder is organised around an agenda: a core need that stays the same whatever the situation, and drives how the person sees you and responds to you. Once you can see the agenda, the behaviour starts to make sense, and you can stop taking it so personally.
Here’s how I’d sum up the agenda in borderline personality disorder: Not to be abandoned. Holding on to connection, at almost any cost, while feeling at the mercy of emotions that arrive hard and fast.
Where it comes from. The most widely used explanation, from psychologist Marsha Linehan, is a combination of an emotionally sensitive temperament and an environment where feelings were dismissed, punished or unsafe. Childhood trauma and neglect are common, though not universal.
Easily confused with
- Complex PTSDThere’s a lot of overlap, and the two can occur together.
- Bipolar disorderMood episodes in bipolar disorder last days or weeks. In BPD, moods usually shift within hours, often in response to relationships.
- ADHDImpulsiveness and big emotions, without the same fear of abandonment.
PART 2IF YOU SUSPECT SOMEONE YOU LOVE HAS IT
How to raise it without the drama.
Before you say anything
Start with the good news. BPD is one of the most treatable personality disorders, and long-term studies have found that most people diagnosed with it no longer meet the criteria years later.
Your loved one is probably in a great deal of pain, even when it comes out as anger. Lead with care, and pick your moment: never in the middle of a crisis or an argument.
What tends to help
- Choose a calm moment
When things are settled, not during or straight after a blow-up.
- Validate the feeling first
“It makes sense that you’re hurting. That sounded really painful.” You can validate the feeling without agreeing with the story.
- Talk about their pain, not a diagnosis
“You’ve been hurting for so long. You deserve help that actually works.”
- Make it clear you’re not leaving because of this
Suggesting help can sound like rejection. Say plainly that you’re raising it because you care.
- Share real hope
Therapies such as DBT (dialectical behaviour therapy) were designed for exactly this, and they work for many people.
- Keep your limits clear and kind
Calm, predictable boundaries reduce chaos for both of you. Decide them when you’re calm, not mid-crisis.
Drama traps to step around
Most of these traps are a corner of the drama triangle: rescuing, attacking or collapsing. Seeing which corner you’ve been pulled into is the first step out.
The trap
Arguing about who said whatInstead
You’ll go in circles. Validate the feeling, and don’t try to win the facts.The trap
Threatening to leave in the heat of the momentInstead
It confirms their deepest fear and escalates everything. If you need to set a limit, do it calmly, later.The trap
Becoming their only supportInstead
You can’t be their therapist, crisis line and best friend. Help them build a wider net.The trap
Walking on eggshellsInstead
Giving in to avoid explosions teaches everyone that explosions work. Calm, consistent limits are kinder in the long run.
You can offer help. You can’t make an adult take it. For more on staying out of the drama, read Do you suspect someone you love has a personality disorder?
PART 3WHAT HELP LOOKS LIKE
Help for them, and where to start.
The main treatment for BPD is psychotherapy, as recommended in Australia’s clinical guideline. Therapies with strong support include DBT, mentalisation-based treatment (MBT), schema therapy and transference-focused psychotherapy. Medication may help with specific symptoms but isn’t the main treatment.
Their GP can refer them to a psychiatrist or psychologist who specialises in BPD. Project Air, Spectrum and the Australian BPD Foundation have information for the person and for families.
WHERE I COME IN
They need their own help. You deserve yours.
I don’t treat BPD myself. I do work with women recovering from relationships with someone who has borderline traits: the push and pull, the walking on eggshells, the guilt, and the way your own needs disappear. I help women resolve that impact, rebuild their sense of self and set limits they can hold.
I help women who are experiencing abuse from someone with a personality disorder, and women who need help managing a relationship with someone who has one. These relationships often bring a great deal of anxiety, trauma and drama into your life. I don’t diagnose or treat personality disorders. My work is with you: resolving the impact on your nervous system, your confidence and your sense of self, and helping you step out of the drama for good.
You don’t need a referral or Mental Health Treatment Plan to see me. I’m a private practice, so you can book a private 15-minute consultation directly. If I’m not the right fit for what you need, I’ll tell you honestly, and point you to who is.
You can’t calm their storm for them. You can stop living inside it.
THE PERSONALITY DISORDERS SERIES
Read about each type.
What is a personality disorder? · The 10 types at a glance · Do you suspect someone you love has a personality disorder?
WHERE THIS INFORMATION COMES FROM
Sources.
This page draws on Australian health services, the diagnostic manual clinicians use (DSM-5-TR), and Dr Gregory Lester’s training on personality disorders.
- Personality disordershealthdirect AustraliaWhat personality disorders are, the main types, and where to get help in Australia.
- Project Air Strategy for Personality DisordersUniversity of WollongongAustralian information, guidelines and family and carer resources for personality disorders.
- SANESANE AustraliaInformation, peer support and counselling for people affected by complex mental health issues, including personality disorders.
- Gregory Lester, PhD: speaker profilePESIDr Lester’s background, including his 2,000+ personality disorder trainings and his role as an original research site for the DSM-5 personality disorders revision.
- Clinical practice guideline for borderline personality disorderNHMRCAustralia’s national guideline, which recommends psychotherapy as the main treatment for BPD.
- SpectrumSpectrum (Victoria)Specialist personality disorder service with information for families, friends and carers.
- Australian BPD FoundationAustralian BPD FoundationInformation, advocacy and support for people with BPD and the people who love them.
YOUR NEXT STEP · BRISBANE AND WORLDWIDE
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