People with Borderline Personality Disorder (BPD) have lives
fraught with emotional upheaval and frequent crises. Often their work life is inconsistent.
They change jobs frequently due to being fired or because of personal
dissatisfaction. Relationships usually are strained. They frequently put others
into no-win situations. Friends and family become burnt-out with the constant
demands, radical emotional swings, self-centeredness, and impulsivity. Risky
and self-destruction behaviors are the norm.
Friends and family members usually recognize their loved ones
need professional help, before individuals with BPD see the need. Like people
who have Narcissistic Personality Disorder, people with BPD rarely admit their
need for help. Instead, they tend to blame their problems on to external
circumstances or other people.
Randi Kreger in her book, The Essential Family Guide to Borderline Personality Disorder, identifies
six stages family members or friends of BPD go through in the process of trying
to motivate their loved one to get the necessary help. (Please note that the
labels of the stages are mine.)
Stage 1—Denial: Individuals
with BPD don’t see their need for help, but rather blame their family members
or friends for the problems. They see others’ efforts to help them as controlling
and abusive.
Stage 2—Threats: When
a crisis arises, friends and family will use threats to push their loved ones with
BPD to get help. They may say, “I will leave you” or “I will stop supporting
you,” hoping such threats will motivate their loved ones to seek treatment.
Stage 3—Reluctant or
Anxious Compliance: The threats often frighten sufferers of BPD enough that
they apprehensively seek treatment. Unfortunately professional help usually isn’t
useful since those with BPD are not motivated to change, but are only trying to
secure the threatened relationship.
Stage 4—Relapse: Once
the threatened relationship seems to return to normal, those with BPD lose
interest in therapy and find some reason to drop out.
Stage 5—Reluctant
Acceptance: Eventually family members and friends realize that coerced
treatment is rarely effective and reluctantly accept that only their loved ones
with BPD can decide to get help. This often takes several failed attempts to
push those with BPD into treatment.
Stage 6—Disillusionment:
Family members and friends of those with BPD come to realize that any effort to change their loved ones is
only adding more conflict to their already troubled relationship. This
revelation causes friends and family to become discouraged, depressed, angry,
and disillusioned.
As outlined in Kreger’s six stages, it can be difficult to
motivate those with BPD to seek treatment.
These individuals get into significant trouble before they are ready to
accept help. This may mean several suicide attempts, psychiatric hospitalizations,
legal trouble, personal bankruptcy, being fired from another job, or
experiencing another relationship break-up (such as a divorce) before they
recognize their need for professional treatment. Real change is only possible
when those who are in trouble recognize their own need for help. No one can threaten, cajole, or coerce another
into changing.
The next article will address the current treatments
available to help those with BPD.
For more information on this topic, please also see:
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