Have you ever heard someone say, “It feels like I am walking on eggshells? Small things become big. There is always a conflict. And I feel like something will erupt at any time.”

They might be describing an intimate relationship with someone who is diagnosed with borderline personality disorder (BPD). Living with someone with BPD is not easy because they are so emotionally reactive.

Here is one person’s account. “One minute I am her best friend and the next, she won’t talk to me. Everything is a crisis or a conflict. And I am wondering if I should even answer the constant text messages blowing up my phone.”

This experience of on-going crisis, characterized by all or nothing thinking, is a marker of the person with borderline personality disorder. It can be exhausting in a relationship.

Fear of abandonment

People with BPD have interpersonal difficulty because they carry a constant fear of being rejected, separated or abandoned. In fact, fear of abandonment is a root of the disorder. Consequently, they can be impulsive, suicidal, engage in risky sexual behavior, substance use and have mood swings. In some cases, intense anger and aggression can land them in trouble with the law. And what makes all this difficult is a noticed lack of empathy because they are so self-focused. Their emotional pain is great.

Remain calm during conflict

When conflict erupts (which happens a lot), the best thing is to remain calm. Then, wait until the “crisis” is over to discuss anything of meaning. If conflict escalates, take a deep breath and do not become emotional reactive yourself. That will only escalate things. Try listening. If that doesn’t help and things still escalate, tell the person you are taking a time-out to get perspective.

Do not get defensive despite what is said and do not invalidate their feelings. And do not try to convince the person they are wrong. Rather simply state your position in a calm and friendly way. Make sure your tone of voice is firm, but matter of fact. Communicate that there is a solution if you both can talk it through. When possible, distract, deflect and delay in order to calm down the emotional reactivity. Most of all, do not take the conflict personally. Most likely, they are responding to some inner emotional pain.

Pay attention to self-harm

If the person starts threatening self-harm, even if it is attention-seeking, take it seriously. This means you need a plan to deal with this behavior. Have the person call his or her therapist, go to the emergency room with you or call a hotline. Let the person know you care and are listening to their emotional pain. Reflect and summarize what they say so they know they are heard and not being abandoned. This will help de-escalate the situation.

Treatment 

There is no medication treatment for borderline personality disorder (BPD). This is because problems stem from interpersonal interactions. Typically, the person is always testing you to see if you will abandon them like others have in their past. Thus, relationships issues need to be addressed.

An effective and evidenced-based therapy for BPD is Dialectical Behavior Therapy (DBT). DBT helps the person with interpersonal effectiveness, mindfulness, emotional regulation and distress tolerance. Developing these skills helps the person respond better in relationships. They learn better ways to cope with feelings of intense emotional emptiness.

Keep in mind that you can’t change the person’s intense reactions, all or nothing thinking, or feelings of rejection. They have to work on those areas in therapy. But you can control your response to the person. The less emotionally reactive you are, the better. Your ability to stay calm will take the air out of the conflict balloon and make life easier.

Spiritually, you can remind them that God never leaves, abandons or forsakes them. Our relationship with God is secure. He can fill that emptiness and calm the chaos in one’s life.

Walking on eggshells: Borderline Personality Disorder

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