Helping a Loved One With Borderline PD Build Self-Efficacy

By Dr. William Anixter with Courtney Kelly

Researchers believe Borderline Personality Disorder (BPD) is caused by both genetic and environmental factors; twin studies have indicated the condition is heritable, and 70% of people diagnosed with BPD have experienced severe trauma, often in childhood. By impeding the development of a stable, adaptive self-concept, these risk factors can trigger symptoms such as extreme emotional volatility, an inability to cope with distress, intense fear of abandonment, and impulsivity, all of which make it hard to form secure relationships, hold down stable work, and achieve independence.

Without the emotional capacity to confront their contributions to the chaotic nature of their lives, individuals with BPD may view themselves as perennial victims. This perspective becomes a self-fulfilling prophecy that keeps them from taking initiative to address maladaptive behavior patterns. As a result, instability may seem inevitable and personal fulfillment may feel out of reach. The good news is neither of these things are true; if you have a loved one with BPD, there are proven ways to help them build the self-efficacy they need to reclaim agency in their lives.

Show Up Reliably, Validate Consistently

Many of the unhealthy behaviors exhibited by individuals with BPD are rooted in an intense fear of abandonment or the sense that no one understands them. The best way to re-route these deep-seated insecurities is to show up for your loved one reliably and validate their feelings consistently. Let them know what you’re planning to do before you do it. Then, to the best of your abilities, stay true to your word. "Avoid changing plans last minute unless absolutely necessary, and when it is necessary, take time to clearly communicate what’s changing and why so your loved one doesn’t feel slighted," advises Carrie Hanson, clinical director at CooperRiis Healing Community.

When your loved one does feel slighted, create a nonjudgmental space for them to express that by voicing your awareness of a shift in their affect: “I notice that you seem to be upset, can you tell me why you feel that way?” Doing so not only signals your concern for them, but it also encourages them to advocate for themselves. After they respond, avoid asserting they shouldn't feel the way they do. Even when your loved one is behaving inconsiderately or blowing things out of proportion, pointing that out without acknowledging their perspective won’t help them “come to their senses.” All it will do is confirm your loved one’s belief that people just don’t get them.

Instead, validate their experiences while remaining candid about yours: “I understand you feel offended I didn’t answer your calls last night. But I was not intentionally avoiding you. I turn my phone off at 7pm every day to ensure I can properly wind down. While I won’t change this habit, I will always return any missed calls from you as soon as I can.” Clearly stating and reinforcing your own boundaries when interacting with a loved one who has BPD is a critical part of showing up for them. "It models healthy relational practices," Hanson explained, "And protects you from burnout. Only when you also care for yourself can you offer the consistency your loved one will need throughout their recovery journey."

It’s important to recognize that your loved one’s difficulty with regulating their emotions isn’t intentional; it’s a feature of their disorder caused by neurological differences. Though your efforts to show support and express understanding may not always seem to have an effect on their volatility, persist. Paired with a targeted treatment plan, your steady presence will, over time, assuage their fear of rejection and isolation.

Encourage Participation in Identity-Aligned Activities

All pursuits, whether interpersonal, professional, or recreational, involve both setback and disappointment. While accepting this and following through on commitments anyway is key to reaping the benefits of long-term endeavors, it’s very difficult for folks with BPD to do. Because they have unstable senses of self, many with this condition view setback and disappointment as signs it’s time to quit.

Psychologists have observed that when people view a pursuit as aligned with their identity, they also view difficulty as a signal that they need to work harder. Conversely, when people don’t view a pursuit as identity-aligned, they interpret associated difficulties as signals they should stop. In healthy individuals, this psychological mechanism is adaptive – it helps people conserve their time and energy for the things that really matter to them.

But for individuals with BPD whose identities are constantly shifting, what feels personally meaningful may change from day to day and hour to hour. So when they experience friction, their default reaction is to assume whatever’s causing it is not worth their time and energy. You can help your loved one change this behavior by reminding them why an endeavor is an important expression of who they are, even and especially when no challenges are present.

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Say your loved one has recently been hired for a job they’ve shown a lot of interest in. Before the excitement and novelty of the honeymoon phase has worn off, give them positive feedback for starting their position and make a point of reinforcing its compatibility with their identity: “It takes a lot of bravery to get up there in front of people as a new coach the way you are. I think it’s wonderful you’re sharing your love of movement with others in this role; plus, you’re a natural leader!”

Then, when difficulty arises – a needy client complains, your loved one misses a shift or gets embroiled in a conflict with another coach – empower them to work through challenges by validating their experiences and calling relevant aspects of their identity to mind: “That sounds really hard, and I know having a conversation about it is scary. But I also know you’re a brave person; you’ve done plenty of scary things in the past, and you can do this now. You'll be grateful you did, because then you can keep doing what you're so gifted at."

Support the Pursuit of Delayed Gratification

The more experience your loved one accrues facing challenges head on, the better they’ll get at prioritizing delayed gratification over that which is instant and fleeting. Many individuals with BPD struggle with impulsivity, a trait resulting from neurophysiological irregularities associated with their condition. Fortunately, human brains are plastic, and every time your loved one resists the urge to seek pleasure and avoid pain, they restructure parts of their nervous system. You can support them in doing this by integrating delayed gratification opportunities into their daily routines.

If your loved one is in school, you might instate some kind of weekend reward for logging two hours of distraction-free studying every weekday. Or, if your loved one often neglects their share of household chores, you might establish incentivizing contingencies: “If you and I both finish our after-dinner tasks before eight, we’ll watch an episode of your favorite show.”

Systems such as these are effective tools for building up your loved one’s self-efficacy, but only if you adhere to stipulations consistently. While it may be challenging to withhold what your loved one wants when they don’t uphold their “end of the bargain,” don't placate them with unearned rewards.

Create Space for Failure and Problem Solving

"Everyone should have the dignity to fail, including those with BPD," Hanson commented. "There are some things people can only learn through failure, and resilience is one of them." This is why allowing your loved one to choose "wrong" is important. When they’re not in danger of doing irreparable harm to themselves or others, giving them the space to make mistakes both reinforces the agency they have in their lives and enables them to build self-efficacy.

Say your loved one wants to skip out on a commitment they made to a friend. Instead of forcing them to keep their promises, walk them through the potential impacts of that decision: “You told Maria you’d help her set up for her birthday party tonight, and if you decide not to do that, she might not be able to get everything ready before people arrive. By prioritizing something else over her, you could hurt her feelings and damage the trust she’s placed in you.”

Then, if your loved one decides not to help anyway, support them in confronting consequences, but don’t fix things for them: “Maria is upset at you because of the choice you made, but that doesn’t mean you’re a bad person. We all make mistakes, so how do you think you can make up for this one?” When they can recognize the role they’ve played in a negative outcome and successfully troubleshoot it, your loved one will have concrete evidence of their ability to solve problems. This will help them rewrite their harmful narratives that they are either a victim or a bad person while empowering them to replace maladaptive behaviors with healthy ones so they can lead a personally fulfilling life.