When we understand BPD, we can support people with BPD.
BPD is easy to understand in terms of the five domains of dysregulation: emotional; behavioural; relational; cognitive; and identity.
At BPD Community we focus on relational regulation as a way to learn about the other aspects of dysregulation. We have developed a program of psychoeducation to build relational skills that can be used for all people with lived experience of BPD. These are the skills described here: validation, boundary setting, mindfulness and acceptance. Each of these concepts has techniques that can be applied in everyday life, they are the four pillars of our psychoeducation programs. In understanding BPD, we understand that recovery is possible and we can learn the concepts and apply the techniques that help us improve our relationships with people with lived experience of BPD (people with BPD and their families and friends).
We can see how BPD works:
At the base of the skull, deep inside is a small area called the amydala. This is the primitive brain we have inherited from our dinosaur days, the days when we were constantly on alert for threats to our lives from the dinosaur lions and tigers. To cope with these threats we learnt the fight, flight and freeze response. One of the strongest and oldest emotions is fear. Behind our foreheads is our pre frontal cortex where we do our thinking, problem solving and workings out. It's a very large part of the brain.
When the neural pathways between the amygdala and prefrontal cortex aren't working well enough, we will struggle to be emotionally regulated.
People with BPD have been described as hypersensitive, 'like emotional burns victims', they are for example, susceptible to strong feelings. The neural pathways that connect between the amydala and the prefrontal cortex are not as strong as with people who do not have BPD. This will mean that they will feel strongly and react quickly to that feeling, especially, for example, fear.
The brain is 'plastic' we can change how it works:
The challenge is to build those neural pathways between the amydala and the prefrontal cortex to manage for example, that primitive response of flight, fight or freeze. Afterall, there are no dinosaur lions and tigers waiting to pounce any more. We all want to have control of our minds, we can learn techniques to help us do this, to rebuild and strengthen neural pathways.
Porr, Valerie: Overcoming Borderline Personality Disorder.
A general introduction to BPD by the mother of a daughter with BPD, the book includes chapters on Validation and Boundaries and also the therapy Mentalisation. Sympathetic to the family members affected by BPD as well as the person with BPD, Valerie is behind the Tara Organisation based in New York.
Aguirre, Blaise A., Md: Borderline Personality Disorder in Adolescents:
A Complete Guide to Understanding and Coping When Your Adolescent Has BPD. Fair Winds USA; 1st edition 2007.This book deals with adolescents with BPD specifically. It includes information on treatments, comparison with other diagnoses, how to know when inpatient treatment is necessary and information on the tools of validation and boundary setting.
Gunderson, John G Md. & Berkowitz, Cynthia Md.: Family Guidelines– Multiple Family Group Program. New England Personality Disorder Association, 2006.
BPD Resource Centre, New York Presbyterian Hospital: Back From the Edge – Borderline Personality Disorder This excellent video explains BPD from the perspectives of 3 adults who recovered from BPD. It also explains the neurobiological basis for the disorder.
Understanding BPD can present a challenge. It can manifest itself in so many ways. BPD Community offers a simple explanation to guide our understandingFollow the link
Facing the Facts: A USA based website for support and guidance for families and partners of people with BPD. This site has discussion forums, workshops, articles and other resources to inform and support. Follow the link
Spectrum: Spectrum is a Victorian Mental Health Service for personality disorders. See their 2015 Guide to Accessing Services for BPD in Victoria. Follow the link