How do I tell someone I think they have Borderline Personality Disorder?

Borderline Personality Disorder - Winona Ryder and Angelina Jolie in Girl, Interrupted

BPD anyone?! – Winona Ryder and Angelina Jolie in “Girl, Interrupted”

This is one of the questions I get asked a LOT. It’s also a search term that leads people to my blog a lot. “What can I do when I suspect my friend or someone I otherwise care about has BPD?” or alternatively “How do I tell […friend’s name…] that I think s/he has BPD?”.

So I am going to write about that. That said, I do feel a bit overwhelmed with the question, because I feel like it is not my place to give people advice on something that can potentially have an effect on other people who I don’t even know, which is why I put this post together with the help of my mom (not the dysfunctional mother I grew up with, I might add, but the mom who’s my mom now, after adopting). She is a psychiatrist. Not my psychiatrist, obviously, because that would be just weird, but that’s her profession anyway. So she knows what she’s talking about and I feel more confident doing a ‘how to’ piece on this matter having discussed everything with her first.

So here we go: How do I tell someone I think they have Borderline Personality Disorder?

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1. Diagnosing someone is not a layperson’s call. Psychological conditions can be tricky. Symptoms overlap. It can be hard to diagnose someone with the right thing even for trained professionals whose job it is to know ALL the symptoms of ALL the disorders. Unless you are a trained professional who is seeing this person in a professional context, you can not diagnose anything and even if you are convinced BPD is it, you might be awfully wrong. Even professionals can get it wrong – and so you can, too. Always keep that in mind.

2. Before you tell anyone anything, stop and think about yourself for a moment. Why do you want to suggest to someone they might have BPD? Why is it important to you, if you are completely honest to yourself? If the answer to that is anything that comes from a place that is not solely genuine care and concern and love for the other person, then you are about to start off into an unhealthy direction anyway and should not go ahead with it. If there is anything at all that causes you to get own positive feelings out of telling someone, then stop reading right now, get the idea of telling the other person out of your head and start to deal with and take responsibility for your own feelings that put you on this path instead.

3. Keep in mind that self harm is not BPD. I have seriously seen people who thought that everyone who self-harms must automatically have BPD. That is totally not true. If your only clue is that someone self-harms, then you have an extremely thin case to go on and should not go ahead suggesting s/he has BPD at all.

4. Do not drop a label on anyone. If you carefully considered all of the above things and still feel like you want to let someone know you think they have BPD, then consider now that dropping a label on someone can be extremely harmful. Borderline Personality Disorder is a label with a lot of stigma attached. How would you feel if someone suggested you have something that people generally feel strongly and very negatively about? Therefore going ‘hey, I’m quite convinced that you have Borderline Personality Disorder’ is a really bad idea. After all if you come from a place of genuine care, concern and love – which is the only case in which you should still be reading this – you do not want to freak anyone out or harm them, or do you? Therefore you should be extremely cautious with dropping labels. Properly inform yourself instead and learn all you can about what BPD is and what it not is before you proceed.

5. Check if your relationship is one where suggesting someone has a psychological condition is appropriate. That’s a biggie. Are you a concerned friend or partner? Then you’re probably good. Are you just a co-worker, classmate or an acquaintance? Chances are it’s not your business to get so intimate with someone as to suggest they have a psychological problem. Are you a mother, father, sibling or other relative? Please go back to #2 and re-assess it. Carefully. Family – especially family of someone who might have BPD – is often a playground of hidden agendas, underlying power or mind games, wanting to tell someone for the sake of feeling superior or making the other feel inferior, etc. If you feel like you’d get any kind of personal satisfaction out of telling your family member they have BPD in the guise of being concerned, then don’t go ahead. If that is the case it’s quite likely you have just as much of an issue as the person you suspect has BPD and speaking up will only end up in your respective issues playing off of one another in an unhealthy way. Suggest you as a family have things going wrong instead and try to find professional help for the family as a whole – yourself included.

6. Always present what you are suggesting as your own opinion, because it’s not a fact and you might be wrong. If you have come this far and still want to go ahead, before you say anything at all, be aware of the relativity of your perception and thoughts. Even when you feel very convinced that you are right, you might still be wrong. What you are about to say is just a suggestion based on your own impression and opinion. State it as that: a possibility, not a fact.

7. Suggest it in a helpful and respectful way in a suitable moment.Suitable moments are moments where everyone is calm, when there is enough time to talk, even if it should turn into a longer talk, where you feel reasonably close to the other person and where you can make very clear that genuine care, concern and love is the place you’re coming from. Never talk in a place where others could overhear you, because that makes people generally uneasy. Suggesting something in a helpful and respectful way includes asking if the other person wants to hear your thoughts. You could say something like “I noticed you are struggling with a couple of things and I feel sad for you, which is why I am wondering if you would like my opinion/thoughts on it.” If you are actually friends and your friend or partner feels safe and positive about your relationship, chances are s/he will want to hear your opinion or thoughts. If s/he does not want to hear it, respect it, because if your thoughts are not welcome to start with, your thinking they have BPD is probably not going to go down well either.

8. Don’t say it in a way that suggests they have a bad personality or are a damaged person. If your thoughts are welcome, be careful to suggest your suspicion in a way that does not make the other person feel awful about herself. BPD is not a death sentence. It’s not a terminal, unalterable thing. It is simply a pattern of unhealthy ways of relating to people and the emotional issues that cause it are treatable. BPD isn’t the result of someone being a bad person either, but most of the time it’s a perfectly normal person who has experienced things that were really hard on him or her and made it necessary for her to develop these now unhealthy strategies to live their life somehow. Oftentimes they have survived things you have not and that’s something that deserves respect, not making the other person feel bad for themselves. That the ways of feeling and thinking and the behaviour are maladaptive now in normal contexts is all that is wrong, and that can be very hard. But there’s treatment available, people with BPD can be good people. Don’t feed into any misconceptions about BPD. And don’t use judgmental language and vocabulary.

9. Be prepared for the consequences. Even if you suggest it out of concern and love in a respectful, helpful way you might still trigger a response you didn’t want to trigger. The other person might get defensive. Or angry. Or sad. Or desperate. Or discard what you said. That you felt you needed to suggest to them that they might have BPD might temporarily damage your relationship. Or permanently. Be aware of that. If you are right about your suspicion, then the other person having BPD means that her relationship patterns follow their own dynamics to start with and those might include effects you didn’t want to cause. There’s little you can do about it. Knowing your own boundaries, staying calm yourself and not taking the response too personally (if you were actually coming from a place of concern and did not follow a hidden agenda) are the best things you can do. Ask if there is anything you can do for the other person. Be there for them if they want to. Give them space if they want space. You can’t force anything upon them.

10. Leave reacting upon it or not to the other person. You might think the other person should seek help, but whether or not they do it is their decision. Keep in mind that you have been thinking about the whole issue for a good while now, but to the other person your suggestion has suddenly caused a new situation. They might need time to think. They might come to a different conclusion than you. And that’s okay. You can point out options regarding what can be done, but no more. The rest is up to them. Respect their reaction. The only case in which you should intervene is if their reaction poses an immediate danger to themselves or other people. Everything else and they’re good, even if you don’t agree with it.

~ ~ ~

So much for my suggestions about how to deal with telling someone you think they might have BPD. My mom and I did our best to try and consider all the aspects. We hope you find it helpful and wish you all the best. Feel free to let me know what you think.  🙂

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How I Met My Mother

Not many people can remember how they met their mother. Just like them, I can not remember how I met my biological mother either. But I remember how I met MY mother. Mom. And this is what I remember:

I was living at a girls’ residential group at the time. I was sharing a room with another girl who didn’t like me. To be fair, I didn’t like her either. Or rather I didn’t like anyone, period. Everything sucked.

When my social worker knocked I didn’t answer. Didn’t have to because she entered after knocking anyway. No doors were to remain closed to staff. House rule. And when I say no doors, I mean NO doors. Whatsoever. Anyway, she came in and looked at me over the rim of her glasses – but only after she had given the newly-messed-up room a critical once-over.

“They’re here, Lola. They’re waiting for you.”

I remember that I shrugged. So what? So what if I had agreed to check out some family care project? I had changed my mind. I didn’t want to be part of anyone’s research study-crap. I didn’t want to be anyone’s guinea pig. So I looked the other way and pretended she wasn’t there.

The social worker grew impatient. I could tell by the way she inhaled dramatically, held her breath for a second and then let go of it in this sharp puff that said “you’re being impossible!” like that was news.

“If you’re not going to come, Lola, I will send them to your room! They didn’t come all the way out here for fun. You agreed to see them, so that’s what you will do!”

I didn’t care. Like I ignored my social worker I would ignore them. They would leave sooner or later. Being with people who didn’t talk was annoying, after all. They would try to be nice people at first, they would try to make conversation – in vain – and in the end they would look at each other, would realize their mistake and would be happy to leave and never come back.

Little did I know that this was not what was going to happen. At all.

The first surprise was that they didn’t enter together. I expected this middle aged couple, all prim and proper, suburban, well-off, being basically all the things that I was not, coming in to examine me like I was exhibit A at the Museum of Sad Deranged Individuals. That was what I was prepared for. And they would be getting quite a good show, too. Messy room. Girl with long blond hair and way too much dark makeup in skimpy clothes, forearms freshly slashed. To make absolutely sure they would see, I removed the bandages from last night’s wounds as soon as my social worker had left. Now, see, on another day I might have tried to please everyone, covered up nicely to be a pretend version of the ever-smiling good girl next door, but on that day the world was a black place and I was in a fuck-all mood.

It knocked again. “This is her room”, the social worker told them. “She’s waiting for you.” The exaggeration of the year.

Instead of entering together, this lady came in alone. I only glanced at her casually, and she was pretty average looking. A bit older than I had expected, but by far no granny. Shoulder length brown hair with some silver in it. A smile.

Scowling, I looked the other way. She closed the door behind herself.

“Hello Lola. I am Samantha, but most people call me Sam. It’s nice to finally get to meet you.” She looked around the messy room. “Can I sit down somewhere?”

I ignored her and stared out the window. An idiot-proof method to get rid of people.

“Say so if you mind I make room for myself and sit down on this chair”, the woman said and politely waited a moment before she relocated a mess of clothes.

Her nasty little trick hadn’t slipped from my attention. Instead of asking whether she may sit down – to which I would have remained silent anyway – she had put it the other way around: Speak up if you mind. Not too stupid. Which irked me. I kept on ignoring her, knowing this was a game I was better at than anyone else. So I simply waited. For her to try conversation starters. Several if she was persistent. But most of all I waited for her to grow desperate, irritated and finally helpless in the face of my passivity so she would leave.

But instead of saying something, she remained silent as well. I didn’t turn her way, but in the way you notice things from the corner of your eye I could tell that she was looking around the room, studying things. Studying me. Calm and collected.

“Honey, I don’t meant to be intrusive but those cuts on your arms are bleeding. You might want to have them taken care of before sitting here with me.”

As much as I would have liked to ignore her words, I couldn’t. I wasn’t aware the darn cuts had started bleeding again, but stealing a glance down I saw that she was right. So much for my genius idea of taking the dressings off of fresh wounds to go for the shock-effect. Shit. And she hadn’t even sounded particularly shocked. More like it wasn’t a big deal.

I shrugged and there went my resolution not to talk because some switch in me had just been flicked the other way. “So what?! Not like anyone cares what my arms look like around this place.”

Sam had looked at me and smiled a little. Friendly, but I couldn’t tell whether she was buying it or not. In hindsight I know the answer, but back then I couldn’t tell.

“How about we go and get them cared for?”

Have I mentioned that I am a sucker for attention and getting fussed over? Yeah, well I am. So once I had started down this road, I couldn’t resist. I ended up going to the nurse with her. Ended up talking with her. And quite unlike I had planned, I ended up liking her after this first visit. Or rather I ended up thinking she was the only person in the world who was good. My day had turned from black to perfect. Yay for idolization and all that. At least it made coming to live with her and her family a lot easier some weeks down the road.

Of course thereafter it didn’t take long until I got disillusioned. Hated her. Lots of drama. But we solved it. Loved her. Hated her again. Loved her. Hated her. And loved her. But it always ended with loving, even the bigger episodes of drama. And now she’s my mom. The greatest mom I could ask for. In a real way, not an idolizing one. Or maybe a little idolizing. But just because she is.

Mom&lola4

mom and me

Advice for my younger self ~ on BPD, PTSD and life

I have been through a series of ups and down lately (which felt like more downs than ups to me, really) and did a lot of talking with Mom because of it. Now that’s no real news, because we always do a lot of talking . . . but then it kinda felt significant when Mom reminded me of how in the beginning we did nearly no talking of this kind because I’d just scream that she hated me and that I hated her and threaten to do silly things whenever things worth talking about came up. Reminded me that I have come a long way already.

So given my past disinclination to talk about stuff – or listen to people talk about stuff – maybe this post doesn’t make any sense at all, because I probably would have just ignored my older self or told her to fuck off. But even so, here are some things I would tell my younger self if I got the chance:

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 

Hang in there. Life seems horrible right now and it will continue to feel that way longer than you deserve, but you are in for real good stuff later. You will meet real good people. Not the kind of ‘good’ you know, but a REAL kind of good. So hang in there and don’t give up hope. The good stuff is worth waiting for, even when it’s an excruciatingly long wait.

Do not take unhealthy pride in your diagnosis of BPD and do not feel like you are less than anyone else because of it either. It’s just a word. I know you feel like there’s nothing good about you, but even when you don’t know it yet, you are more than a single word or any label can ever convey and lots of who you are has nothing to do with messed up relationship patterns. Try to find the parts of you that are healthy and lovable and work on them.

Do not fuck that guy. Seriously. Just don’t do it. No matter who he is. No matter what reason you think you should do it for. Just don’t do it. It’s not going to accomplish a thing. But don’t hate yourself for doing it either. You have poor impulse control, so it’s not you being a failure if you do it anyway. Just try your best not to. That’s all. And when you fail, try again. You’ll manage, eventually.

Don’t go around hating everybody. I know there are lots of people in your life who don’t get what’s up with you, but they aren’t doing it because they’re malicious or indifferent or because they hate you. They don’t even know you. Not properly. And really, I don’t expect you to love or even just to like them. Just don’t go around hating them is all. The person your hatred is going to hurt the most is yourself. And really, you hurt enough as it is. Don’t add to it in this way. Just ignore them and focus on whatever good stuff here is instead, even when there is not much.

It was not about you. All the shit that went wrong while you grew up, it was NOT about you. It was never about you. You were born right into the middle of a fucked up mess, but that mess has nothing to do with you. Your parents were struggling with and failing at their own life and took it out on you because you were there and you couldn’t fight back. But that’s not your fault. Nothing you did made it happen. You could have been any other way and it would still have happened. It was never about you.

Try your best to see the middle. Whatever there is, things have a middle. I know you slide all the way to one side and all the way to the other side all the time like life were a playground seesaw, but that’s because you haven’t learned to hold your balance yet, not because there is no middle. Nearly nothing is as extreme as it looks and feels to you. You’re like a kid on roller skates on a seesaw, whose roller skates go whichever way the seesaw tips all at once and it will be a while until you learn how to put yourself sideways to avoid the instantaneous skidding, but take my word for it that the middle IS there. Always. Try your best to see it, even when you aren’t able to stay there yet.

People are not their actions. Others aren’t and you aren’t either. Yes, you have done awfully disgusting things, but you are not what you have done. It’s not you who IS disgusting. The disgust you feel belongs with the actions, not with you as a person. I wish there was a way to help you feel that.

Sing. You’re good at it.

When that family comes along who want you to live with them, don’t be so hard on them. That woman who you’ll start out calling Samantha, she is going to be your mom one day and she’ll be the best mom you could ever ask for. Cut the yelling a little when you can. And don’t throw those things at her. Just tell her you’re afraid. She’ll understand. She’ll help you make it better. Just don’t throw all those things. Or at least don’t throw the chair. It’s not going to drive her out of your room. All it will do is hit her and you’ll feel awful for years to come that you did that.

The good stuff is yet to come. Like I said in the beginning. Take my word for it. I promise. It will come with lots of hard work and it does also come with truly hard and painful moments, but it’s going to be worth it.

Persevere. Persevere. Persevere. Learn from your mistakes. Persevere. And don’t forget to laugh at the absurd stuff when it happens. You’ll be in for plenty. Laughing at the absurdities is often the best thing you can do. You’ll do better one of the next times around. Persevere.

With love,
the older Lola 

Borderline and self-awareness, self-confidence and self-esteem

I grew up believing that there is nothing I can do well. The only thing I believed I was useful for was to give other people sexual pleasure. That’s sick, obviously, because I was a child.

Awareness of who we are grows through the kind of feedback we receive about ourselves. As a social species we use others as a mirror to see ourselves. By how they react to us, verbally and through behavior, we draw conclusions about ourselves.

My mother was unable to be a good mother. My needs usually went unmet. She was unpredictable, angry and often aggressive towards me. I concluded I was unimportant, unlovable, unable to do something right and that I deserve punishment just for being there.

My step-father’s interest in me centered solely around the sexual abuse. If I didn’t do what he wanted me to, he became violent. My mother often said that she only kept me around because I had made him “addicted” to me. I concluded that I had to earn my right to exist by making myself available for abuse.

At school I got held back because I did not learn. Teachers used to say that they are not sure that there’s anyone actually at home inside of my head. “The lights are on, but nobody’s home.” I concluded that I must be really dumb.

In the institutionalized years that followed people became annoyed with me very often after what had always looked like promising starts. I concluded that I may look worth saving on the outside, but that there was nothing inside of me that would keep anyone going.

As you may imagine, my self image was real bad. I didn’t like myself. Like, at all. The feedback I had received painted a very unlikable picture of me and I was convinced that it was true. Because as a social species we tend to take social feedback seriously.

Unfortunately we’re also not born with a way to tell whether the person who reflects an image of us back through feedback is a good mirror, or one right out of a fun house. Imagine you had looked into a distorting mirror all your life. How would you like the way you looked? And if you had grown used to always looking a certain, distorted way in the mirror because you never saw yourself in any other mirror, would you believe the reflection if it suddenly were different?

I went through a lot of unhappiness and trouble with the positive feedback I received after I met my family and came to live with them. Lots of fear that once they discover how terrible I really am, they will want to have nothing to do with me anymore. In lots of ways I have tried to force them to hate me and be repulsed by me. Sometimes I could not stand their presence. At the same time I am and always was mortally afraid of losing them. But I wanted to have it happen, because I was convinced that it was what I deserved and what was going to happen anyway. When things don’t match up, when everything is a mess, when you don’t know who or what you really are or are not, that’s what happens.

Lots of tears, tantrums, hugs, yelling, cuddling, passionate hating, ardent loving and most of all lots of patience later, I am pretty sure that my “self” I have been aware of, was really not very realistic but just the reflection of other people’s mental issues. I don’t feel horribly unlovable, useless and dumb anymore most of the time. I am starting to allow the thought that there are things I might be good at, that I can be a kind person who others like and some even love. That this is not just some con act, but actually part of who I am.

At the same time I do not have a lot of practice thinking those things and old habits die hard and I have moments where I get very confused and find it hard to assess who I am. What I am. What I can. That I am important to someone.

It helps that my family are aware. Sometimes my mom sings the Lumineers’ “Ho Hey” chorus to me. You know, the “I belong to you, you belong to me, you’re my sweet-heart” part. She does it just because. Just because she wants to. I really like that because it feels like she means what she sings and wants me to know.

What also helps is actually DOING something useful. I have started volunteering at my mom’s former psychiatric ward. She used to be the head psychiatrist there or something and it’s a kids ward. That they know my mom and trust her judgment is probably the only reason why they agreed to let me volunteer. Anyway, I am going there once a week to just be with a little girl they assigned me to and play. To just do normal stuff with her, so she gets to just play and relax and laugh. We’re friends. She loves my long blond hair and says that when she grows up she wants to be just like me. I always laugh and tell her to pick someone else to be like, not a girl who’s way too old to not have an education and stuff. But deep down I am starting to think that maybe it’s not the worst thing. Being me, I mean. Maybe not by everyone’s standards, but my own standards are modest. Or maybe not modest, but different. But my life is different from that of many other people, so what do I need their standards for, right? 😉

I think finding the right mirrors for myself and the right standards to assess my behavior and my “self” with is one of the keys for a better and more realistic awareness of myself and for becoming more confident and stuff. Also, it helps to actually DO things that I can then assess. After all, staying on the borderline isn’t much fun. Lines are narrow. Borders are boundaries. And while boundaries are not necessarily bad, I don’t want to live ON them, but within them. And maybe sometimes beyond. In a good way. And a feeling good about myself way.

So that’s where I want to get. Slowly but surely.

Clearing out my life

I’m on a boost of good energy lately. Ever since mom came around from being sick again, some things have somehow clicked into perspective. It’s hard to explain, really. I’m still a hot mess here and there and my mood still rollercoasters along, but I’m more aware of it now and more able to distance myself from it and still hold on to the awareness that the rest of my feelings still exist, too, even if I can’t feel them in that moment.

I’m also feeling the need to clear out my life at the moment. I feel less and less attached to most of the things that I’ve had for a long time now. Stuff like clothes that I still have from before I got removed from my birth family, or birthday and Christmas cards I’ve gotten from staff during what I call the “institution time” of my life, or little trinkets and knickknacks that I used to be attached to because I associated them with a certain time of my life or a specific event and felt like I’d be losing a part of myself if I didn’t have those things anymore.

Over the last couple of weeks I’m feeling more and more like I don’t need those things anymore, or don’t even want them any longer. So I’ve parted with quite some things and am amazed how little things I actually allowed my mom and dad to get for me. My room is half-empty all of a sudden. But it’s alright. It means there is room for new stuff when something good comes along.

I also feel like I’m more able to look ahead now, rather than back, and more able to focus on the moment as it IS, not as it appears in the light of the past. Which I have found to free quite some energy. I’ve also started to cook. Like, nothing amazing, and mom helps me, but I can now make pizza from scratch, and salads and yummy desserts.

One more thing is that I have started to meditate. Mom said it would do me good to learn how to give my mind a rest and she said she’d join me, so I’m practising meditation. And I’m really crap at it! LOL. My thoughts haven’t really even gotten a basic idea of resting yet! But I am practicing. And even when it’s probably not meditation like someone who’s actually good at it would go it, it’s kind of fun.

Flower of Life

Life is good at the moment. 🙂

Taking a break

Hi everyone. My mom being sick has rocked me a bit more than I thought. She’s fully well now again, since a week now already, and technically things are back to perfectly normal at our house, but I haven’t found much energy in me to blog. So I’m taking a break for a while and see what happens. I hope you’re all well. Take good care of yourselves! ❤

Situation #1739 I can not cope with

Hello everyone. I have not dropped off the face of the planet. I just haven’t been in any mind to blog. Situation #1739 I can’t cope with is when mom is sick.

Last Thursday my mom came down with a stomach bug, right away, early in the morning. It was nasty. I panic when mom is not her usual, healthy self. Not just feel annoyed or unhappy, but serious panic. I start to worry that she will die. That she will be unable to be there for me. Like, ever again. I feel like I am going to lose her. I know it’s unreasonable, but my emotions don’t care and react anyway.

So when mom started to be unwell, I went into panic mode. Mom said she needed me to be a big girl. And I think I managed, after a fashion. Biggest three year old ever. Crying and refusing to leave mom’s side, unable to focus on anything other than the fact that mom was sick. Helpless, afraid, alone, abandoned, angry, panicky… Not pretty.

Stupid stomach bug is hanging on like for dear life, the fierce fucker. Fifth day now, and mom is still struggling with it, but at least she is better than during the past days. And my sister came home on Friday to help take care of things at home a bit, which helped. But it was still a horrible weekend. Awful bug. I really can’t cope with mom being sick.

PS: thanks for the comments everyone. I’ll reply once mom is better and I am in right mind again. Or in whatever resembles my right mind the closest.

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