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BPD Family Members and Loved Ones: Managing Expectations

BPD Family Members and Loved Ones: Managing ExpectationsShantel’s family had been extremely happy with her progress as the result of a new therapy as well as renewed dedication on Shantel’s part. In the last 11 months, she hadn’t had a single crisis and had truly seemed positive. She’d become much more independent, going to and from therapy sessions on her own and even acquiring a new job. She really seemed proud of herself. But as her family became familiar with the new status quo, they began to back off their usual vigilance. Her mom and sister’s constant calls became less constant, and her father suggested that it may even be a great time for Shantel to consider moving out on her own again; she’d been doing so well. They wanted to see their daughter living a normal, happy life.

But this didn’t go as the family expected; Shantel relapsed into her previous behaviors. She became irate, claiming that her family was being “abusive,” that they intended to kick her out on the street. After screaming profanities at the family, she locked herself in her room and refused to come out. She missed work two days in a row without calling in and subsequently lost her new job. She became suicidal again.

Shantel’s family had backed off only because they were encouraged by her progress. Their BPD family member was actually a bright, funny, talented girl, and they truly believed in her. But she had interpreted their behavior through the lens of her disorder; she’d seen it as abandonment—the pivotal trigger for people with BPD. It was not that Shantel would not continue to progress; only that there would be fits and starts along the way and that her loved ones would need to come to expect them or, at the very least, not be caught off guard by their occurrence.

What BPD Looks Like

Having borderline personality disorder (BPD) does not preclude a person from having great strength; wit, wisdom, charm, ambition and creative talent are common traits of sufferers. Unfortunately, BPD is a mental disorder that greatly impacts emotional regulation, showing up most directly through the sufferers’ interpersonal relationships. People with BPD suffer with intense mood swings; have a deeply unstable sense of identity; tend to dramatically idealize then swiftly devalue themselves and others; experience impulsive behaviors like problems with spending, overeating, reckless driving and/or high-risk sexual behavior; have frantic fears of abandonment; and may struggle with self-harming behavior or suicidal thoughts or threats. Having BPD can be incredibly difficult, and loving someone with the disorder can feel heartbreaking at times.

But BPD gets better. Despite its volatile nature and the difficulties experienced by those who suffer the disorder and those who love them, BPD has a good prognosis. Most sufferers will get better as they get older, and many who seek adequate treatment (and remain involved) will even recover.

When we love a person with BPD, and we see and know his or her strengths, it’s easy to become not just hopeful of recovery but expectant of continued positive change. Having hope is important for us and for them, though it’s important to realize that expectations may not always be positive for our BPD loved ones or for us. BPD sufferers may feel our high expectations for them as a kind of pressure, or worry that since we believe they are doing much better we will choose to no longer be as involved, potentially triggering abandonment fears. This is only natural; we should be able to let go—a step we need to take for ourselves and one they need us to take for them. But when and if they experience a behavioral relapse in response, we should not be surprised.

Managing Our Expectations

When relapse follows major improvement, it can feel baffling and painful for everyone. Yet progress of any kind is rarely a straight shot upward; it almost always involves leaps forward followed by dips or lags. Two steps forward, one step back. A BPD sufferer may be riding high, registering for classes, tackling a new job, blissfully engaging a new romance. And yet when loved ones encourage his or her new independence, or step back because they believe in the progress their family member is making, the BPD sufferer may suddenly feel isolated. In a case such as this, the family member has rarely done anything wrong.

On the way to recovery, BPD sufferers must go through the natural process of autonomy-building, and although they may react many times, it is important that they and their loved ones learn to separate a momentary back step from the overall trajectory. Stay patient, manage your expectations and continue to have hope.

Posted on September 12th, 2015

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