hi

Hello, I have BPD myself, and things that help me is being told straight up. We go through time of extreme depression, and then maybe the next week we feel extremely happy and okay. It helps me to be told that even though I'm extremely happy now I will get extremely depressed again if I don't get help. BPD never goes away, we just have to learn to cope with it. Manage our emotions. So just help them understand that when they are starting to get extremely angry or upset that it is probably just their BPD acting up, and they need to walk away from whatever situation it is.

I think it depends on the person, but if your client can handle it ? I agree that just being straight forward is the best option. Because IMO people with BPD are really good at seeing through bull-dust and really don?t like to feel patronised (I think part of this is because we can tend towards being hyper-sensitive/aware of the way others treat us and that then leans towards cynicism or suspicion.)

Consider supporting her with compassion and understanding and clear boundaries ? because a lot of BPD?ers can become extremely needy/vulnerable and will lash out with anger, rage and despair if they feel they are being unfairly pushed away or are at risk of being abandoned ? and a way to avoid this is to make what you can and can do, when you can and can?t be called upon etc. Be clear, honest and upfront before it becomes a problem (because once you?re having a dependency issue ? pulling away for whatever reasonable reason can be seen as abandoning)

Try suggesting journaling, meditation (mindfulness), CBT, DBT, lifestyle changes (exercise and diet) and medication as well as just allowing her to talk, encouraging and prompting her to move away from the habits of blaming herself, feeling guilty, feeling ashamed or defective and towards acceptance and forgiveness. I find my biggest issues are with emotional overloading which leads to a whole slew of bad behaviours, but for the most part if I can ride out the storm within a few hours the worst of the impulses will have passed, so I benefit a lot from distraction.

This biggest thing for me was being told by my therapist that I couldn?t talk with her about my Self Harm AFTER I had done it. If I am at crisis, freaking out, right-about-to-do-it she will do her best to be there for me, support me and will read my journaling and discuss it with me. Anything after the fact we didn?t talk about (apart from bare bones like ?had I SH?ed?? and ?what I had done??) This made a huge difference, just changing my thinking from ?I need help, I?ll SH and GET help? to ?If I SH I can?t be helped? and trying to break the link between SH and crying for help. I still SH, especially when I am struggling with emotional overload ? but breaking the connection between SH and care-seeking has been really, really important for me.(i.e. Moving from ?If I self-harm, then someone will notice I am in trouble. If I self-harm I can rightfully ask for help.? to ?I can just ask for help, if I am thinking about self-harm ? I ALREADY need help.?)

I think everyone who has a friend or knows someone who SH?s has a responsibility to enforce this. You get attention if you don?t self-harm ? not if you do. Because like it or not, reinforcing the idea that SH (or being self-destructive) is the best (or only) way you can be noticed or get help, still reinforces the behaviour. NOBODY should ever have to physically harm themselves so then they feel like they can ask for help.