Understanding Borderline Personality Disorder and its Impact on Relationships
Borderline Personality Disorder (BPD) is often misunderstood, both in its symptoms and the immense challenges it poses for those who live with it and their loved ones. If you have a family member, partner, or friend who tends to explode with intense emotions or has extreme ups and downs within their relationships, you may have wondered if they have BPD. Suicidality and other types of impulsive, dangerous behavior linked to this disorder can worry and even traumatize loved ones.
In a popular episode of “A Little Help For Our Friends,” hosts Jacqueline and Dr. Kibby (CEO of KulaMind) took on this complex topic, offering an enlightening blend of personal stories, clinical insights, and advice for those navigating life with BPD. Dr. Zach Rosenthal, professor at Duke University and renowned expert in emotion regulation and personality disorders, joined the episode to share his wisdom treating this disorder for decades.
What is Borderline Personality Disorder?
BPD is a personality disorder marked by extreme emotional intensity, unstable interpersonal relationships, impulsive behaviors, and a pervasive sense of emptiness or identity confusion. Similar to other psychological disorders, BPD is on a spectrum so showing some of these traits is normal (I mean, who hasn’t had moments when they just lost their cool?). However, when they show up consistently and in destructive ways, that is when someone typically gets a diagnosis of BPD.
The hallmark of BPD is emotional dysregulation—where emotions feel overwhelming, frequent, and impossible to calm. Imagine feeling like every emotion is a tsunami or, as one individual described, as if every nerve ending is exposed to the world. These tsunamis of emotion drive the rollercoaster of intense relationships, self-destructive behaviors, and a persistent fear of abandonment.
Dr. Rosenthal emphasized that BPD doesn’t arise from a single cause. Instead, it results from a combination of genetic predisposition (emotional sensitivity) and environmental factors, such as invalidating or chaotic caregiving environments. In other words, people who tend to have emotion dysregulation are often emotionally sensitive by nature and have been invalidated a lot of over time. This means that when they have felt and expressed intense emotions, caregivers and other people have dismissed or criticized their feelings (i.e. “stop being so dramatic!”). This invalidation then leads to feeling overwhelmed, terrified and out of control when emotions come up, which then leads to desperate attempts to feel relief (i.e. drug use, sex, or self-harm). This nuanced view dismantles harmful stigmas, framing BPD as a disorder of emotion regulation shaped by complex, multifaceted influences. It also highlights the importance of loved ones to understand emotion dysregulation and how their own response to emotions can make a huge difference.
A Firsthand Perspective on Life with BPD
One of the most powerful parts of the episode was the firsthand account of a woman who described her daily struggles with BPD. Her words painted a vivid picture of what it feels like to live with the disorder:
Emotional Tsunamis: Every emotion, good or bad, is overwhelming and all-consuming.
Chronic Emptiness: A constant feeling of a void, as though “life isn’t meant for me.”
Struggles in Relationships: The push-pull dynamic—desperately seeking connection but fearing and sabotaging it—makes maintaining relationships incredibly hard.
Identity Confusion: A lack of a stable sense of self, leading to ever-shifting interests, social circles, and self-perception.
Her vulnerability offered listeners a rare glimpse into the internal world of someone with BPD, highlighting both the pain and the longing for understanding.
How BPD Impacts Loved Ones
The effects of BPD ripple far beyond the individual, deeply affecting their family, friends, and partners. Loved ones often feel caught in a whirlwind of closeness and conflict, admiration and devaluation. This could look like your loved one with BPD “puts you on a pedestal,” treating you as special and the only one they trust, and then suddenly shifts to treating you like the enemy. You may also not know what to expect as sometimes your loved one with BPD may fluctuate between extreme emotions in response to daily events- content one minute and enraged the next. This emotional rollercoaster can lead to feelings of helplessness, frustration, and burnout.
Dr. Rosenthal shared that many loved ones struggle with setting boundaries, feeling overly responsible for the individual’s well-being, or managing the fear that their loved one might harm themselves if they say “no” to them. The emotional toll is immense, but education and support can make a world of difference.
For loved ones of people with BPD who are struggling themselves, KulaMind can offer individual guidance in the science and skills to manage how BPD affects them. The KulaMind community of friends and family of people with BPD also provides a safe space with other people who get what you’re going through. Book a consultation call to find out more.
Treatment and Hope
While BPD is a challenging disorder, effective, evidence-based treatments exist. Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan, is the gold standard, offering individuals tools to manage emotions, improve relationships, and reduce self-destructive behaviors.
However, finding quality DBT therapists or “full-model” DBT programs can be challenging. Loved ones and patients with BPD looking for DBT options should research therapists’ credentials carefully, keeping an eye out for providers who have been trained at an APA accredited graduate program or certified by the Behavioral Tech Institute, the official DBT training program. People seeking treatment should also prioritize comprehensive DBT programs that include individual therapy, group skills training, and support for therapists themselves.
Another evidence-based treatment for BPD is Transference Focused Psychotherapy, a psychodynamic individual psychotherapy for personality disorders. This type of therapy focuses more on identity, personality and attachment and helps patients integrate the different parts of themselves.
For loved ones, Dr. Rosenthal highlighted the importance of self-care. Setting compassionate but firm boundaries, educating oneself about BPD, and seeking support through therapy or family groups can help create a healthier dynamic for everyone involved.
Key Takeaways for Navigating BPD
Understanding is Key: Educate yourself about BPD and its symptoms to better navigate relationships and challenges.
Set Boundaries with Compassion: Know your limits, assert them with kindness, and maintain your emotional well-being.
Encourage Evidence-Based Treatment: Help loved ones access effective therapies like DBT or transference-focused psychotherapy.
Self-Compassion Matters: Loved ones need to validate their own experiences and emotions, recognizing that it’s okay to feel frustrated while still loving someone with BPD.
Final Reflections
As with many serious conditions, loved ones of people with borderline personality disorder face many challenges to their relationships, but education and support can be crucial. To loved ones, symptoms of BPD can be alarming and confusing, but there is a lot of power in knowing that difficulties managing emotions is at the core of the disorder. Loved ones may not fully understand what emotions feel like for the person with BPD, but they can understand that learning how to regulate their emotions can be life-changing. For loved ones and individuals with BPD, there is hope.
For anyone seeking deeper insights or resources, the hosts recommended the book Loving Someone with Borderline Personality Disorder by Shari Y. Manning. It’s a guide filled with practical advice for navigating the complexities of BPD while fostering healthier, more compassionate relationships.
By demystifying BPD and sharing stories of hope, the BPD episode of “A Little Help” as well as the episode on dating someone with BPD are helpful for anyone impacted by this misunderstood disorder. Whether you’re living with BPD, supporting a loved one, or simply looking to learn, this episode is an inspiring step toward greater empathy and understanding.
