How Borderline Personality Disorder Impacts Families

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Author: Michael Quinn Medical Reviewer: Morgan Blair Last updated:

Borderline personality disorder (BPD) is a mental health issue that greatly impacts how a person manages emotions. Individuals with this condition struggle to build healthy relationships, fear being left alone, and suffer rapid mood changes. This can cause rash actions and problems with self-worth and communication.

BPD impacts not just those who have it but also everyone in their lives, impacting family environments, friends, and significant others. Building trust and understanding with someone who has BPD means knowing the right ways to communicate with them.

What is Borderline Personality Disorder (BPD)?

Borderline personality disorder is a mental condition that disrupts a person’s emotional regulation. About 1.6% of people in the U.S. are believed to have BPD, and they struggle to manage their actions, face conflicts in relationships, and find it hard to maintain a clear self-view.

Borderline personality disorder symptoms include ongoing feelings of insecurity, sensitivity to being rejected, impulsive actions, and intense, often unstable relationships. [1] People with BPD may feel their emotions much more intensely than others. Some typical feelings include sadness, loneliness, hopelessness, isolation, and emptiness. They might use negative coping strategies to try to avoid the emotional pain they go through.

Borderline personality disorder is part of a set of conditions called “Cluster B” personality disorders, and numerous individuals with this condition may not recognize that they have it. [2] One major aspect is their vague and unfounded sensitivity to perceived rejection or criticism. Hence, they can respond intensely to what others consider trifles.

People with borderline personality disorder struggle to regulate their emotions, leading to large reactions to perceived negative experiences. When people experience extreme emotions, it is hard to rationalize situations, which is why individuals with BPD struggle with black-and-white thought patterns.

Ongoing problems and struggles with interpersonal relationships is another key feature of BPD. Large emotional reactions and black-and-white thinking can negatively impact interpersonal relationships, causing communication breakdowns and ongoing conflicts.

Emotional Impact of BPD on Family Members

When a family member has untreated BPD, the whole family is affected. Some family members have reported that the experience is like being strapped in an emotional rollercoaster that never stops. One minute, the BPD family member is loving and affectionate; the next, they lash out. Their angry outbursts, extreme mood swings, impulsive and irrational behaviors, and fear of abandonment can leave family members and loved ones feeling confused, helpless, off balance, and even abused.

People with BPD tend to compete with other family members rather than cooperate with them. Family members of those with untreated BPD say they feel like they are at the mercy of the person’s moods and emotions. Overall, the emotional impact of dealing with borderline personality disorder family members is enormous. Some of the things families of patients experience include:

  • Guilt: Family members can feel guilt and shame, especially if they feel responsible for their loved one’s mental health and behavior.
  • Fear: When someone in a family has BPD, their family fears for their safety, especially if they have a history of self-harming or have attempted suicide.
  • Stress: Constantly worrying about a family member’s well-being and mental health can leave relatives of patients stressed.
  • Helplessness: Family members may feel helpless when they cannot set healthy boundaries.

BPD can significantly disrupt family dynamics and create tension or conflict. Parents may struggle to balance their caregiver responsibilities with their personal needs. At the same time, siblings of BPD sufferers may feel ignored by their parents and overshadowed by the person with BPD. The condition is associated with instability and unpredictability, making it tough for families to maintain routines and have healthy boundaries and communication patterns. [3]

However, those who undergo treatment and are actively pursuing positive changes are capable of healthy relationships and family dynamics. When regulated, people with BPD can be very empathetic, emotionally intelligent, and loving.

Communication Challenges in BPD Families

The key to any good relationship is communication. Communicating with someone with BPD can be tough, but it’s essential. Some who have family members with BPD have likened the feeling of talking to them to the feeling of arguing with a child.

Depending on their current state of mind, they can twist what you say to confirm their assumptions about themselves or you. An innocent comment can be taken as an attack, even if that’s the last thing you meant. They can overreact to any perceived slight, and their outbursts can be verbal or physical.

Many relatives of patients with BPD don’t have the communication skills to get through to them. So, many relationships suffer. It’s vital to explore better ways to communicate with a child or sibling with borderline personality disorder. When you communicate better with borderline patients, it can defuse attacks, helping you have a closer relationship with them.

Here are some ways you can communicate better with borderline patients:

Be Patient and Empathetic

When talking to someone with borderline personality disorder, be patient and understanding. Don’t interrupt or cut them off. Let them talk while you wait your turn. Try to put yourself in their shoes as you listen. Remember, their emotions are part of their condition and don’t necessarily reflect their feelings toward you.

Listen Actively

Listen without judgment. Remove all distractions so you can give them your full attention. Let them feel heard by offering them space to express themselves and not trying to fix the problem immediately. You can restate and paraphrase what they say and ask questions if necessary.

Validate Their Feelings

Validation is a great communication tool. Saying you understand how they feel helps them feel seen. A BPD patient in an invalidating environment can be constantly triggered, and communicating with them becomes more challenging. Research has shown that validation benefits BPD individuals by increasing positive emotions and reducing negative ones. [4]

Acknowledging how they feel doesn’t necessarily mean you agree with them. For instance, you can say, “It’s understandable that you feel frustrated,” which shows that you accept and understand their feelings without escalating the situation.

Explore Their Interests

A family member with borderline personality disorder has other interests and isn’t just defined by their diagnosis. Find the space to explore their interests and connect with them on a deeper level.

Stay Calm Regardless of the Situation

Don’t lose your head when things get intense. It’s essential to stay calm and collected during intense arguments. Resist the urge to respond in anger or frustration, which may escalate the situation. If the exchange is getting heated, take deep breaths and try to remain as neutral as possible.

Set Healthy Boundaries and Maintain Them

Setting and maintaining healthy boundaries is essential for your mental health and general self-care. Know what your limits are and be clear about them. Reassure the BPD family member that you want a relationship with them, but you have to set certain boundaries to look out for yourself. Setting clear boundaries can provide structure and stability, which can help reduce the fear of abandonment.

How to Cope with BPD as a Family

The diagnosis of borderline personality disorder in a family member leads to one recurring impulse: saving and being saved. Most of the time, people become overwhelmed by the desire to please and begin putting the other person’s needs before their own.

But, as time passes and situations change, this can quickly turn into anger, shame, and sadness. Making incessant efforts to ensure that borderline patients remain stabilized may also lead to developing unhealthy dependencies.

It is important to note that no matter how hard one tries, a relationship with a borderline personality cannot be enjoyed or maintained when one is physically unwell or under too much stress. BPD is a complex mental condition that requires professional care. Seeking the help of a professional will help you cope better as a family.

Having a life away from the person suffering from BPD makes some family members feel guilty. It is essential to remember that life is not limited to a person with BPD. Set some time to do things you enjoy.

How Therapy Can Help Families with BPD

The main form of treating borderline personality disorder is therapy. The treatment aims to uncover the motivation and fears associated with the condition. Here are the types of therapy that can help treat BPD:

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy is considered one of the most effective types of therapy for BPD, focusing on developing four skill sets: emotion regulation, mindfulness, distress tolerance, and interpersonal effectiveness.

By improving these four life skills, they can learn how to tolerate negative emotions and avoid reacting impulsively. They can also learn how to be non-judgemental of themselves and others while learning how to address and change problematic behaviors.

Family Therapy

Engaging in family therapy can be incredibly helpful in preventing parents or children from slipping back into destructive patterns. The professional guidance of a mental health expert can help the entire family learn how to support the BPD family member better, helping the family replace feelings of frustration and helplessness with fulfillment.

Group Therapy

Group therapy is also helpful in treating BPD. It involves a group of people meeting to describe and discuss their challenges under the supervision of a therapist. This therapy benefits emotion regulation, stress management, mindfulness, and family relationships. It may help people with BPD interact with others more positively and effectively express themselves.

Support Groups

Individuals and families of patients may also want to join a support group to connect with others with similar experiences. Meeting with others who know what you’re going through can help you feel less alone with your problems.

References
  1. Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, Salzer S, Spitzer C, Steinert C. (2024, Jan 12) Borderline Personality Disorder: A Comprehensive Review of Diagnosis and Clinical Presentation, Etiology, Treatment, and Current Controversies. https://pmc.ncbi.nlm.nih.gov/articles/PMC10786009/
  2. Chapman J, Jamil RT, Fleisher C. (2020, Nov 30) Borderline Personality Disorder.: https://www.ncbi.nlm.nih.gov/books/NBK430883/
  3. Caluza WN, Poggenpoel M, Chris M, Myburgh C, Ntshingila N. (2023). The Lived Experiences of Family Members of A Sibling with Borderline Personality in South Africa: A Qualitative Study. https://www.sciencedirect.com/science/article/pii/S2214139123000690
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Author Michael Quinn Writer

Michael Quinn is a writer with five years of experience unpacking everything from technology and politics to medicine and telecommunications.

Published: Jan 6th 2025, Last edited: Jan 22nd 2025

Morgan Blair
Medical Reviewer Morgan Blair MA, LPCC

Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.

Content reviewed by a medical professional. Last reviewed: Jan 6th 2025
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