Understanding and helping individuals with BPD

For the month of May, BPD awareness and education is front and centre. Instead of sharing more education that is already out there, I choose to share my personal experience working with these individuals. 

Borderline Personality Disorder (BPD) has traditionally been a feared diagnosis. In therapy sessions, client’s have asked me tentatively, “Do I have BPD? Am I screwed? Is this the end?”. Many individuals with BPD share moments of feeling ‘crazy’, ‘disconnected’ and terribly ‘unsure of themselves’. Clients tend to report difficulties with connecting and respecting boundaries and often, feel out of control and alone in their struggles. 

As a clinician it is no walk in the park. Clinicians describe individuals with BPD to be complex, difficult clientele and many a time, struggle with self-doubt whilst engaging in the work. Each session at times feels like a battle with clinician and client getting ready for “war”. “What are we doing this for!” is probably a question that frequently runs through clinicians’ minds. 

If you can identify with being an individual struggling with BPD or a clinician struggling to manage your clients, I want you to know that you are not alone. I see you and your struggles, and these are all valid and meaningful experiences. 

It may be hard to see this at times but individuals with BPD are not inherently bad or mean and out to get the world (even if their behaviour might lead one to think that way). I like to think that individuals who have a diagnosis of BPD are usually kind at heart but really lost in their ways. Look deeper beyond the “prickly shell” and you will see a little child part of themselves, lost, hurt, and crying out for help. Many of these clients have not ever had a chance to experience what is “good” for them and have unfortunately experienced constant stress or abusive situations resulting in the development of such a personality disorder. BPD is like a fierce protector with no guidance – killing everything and everyone that comes close without the ability to distinguish who is the real enemy.

Tiring? Definitely. End of the world? Most definitely not.

The idea of duality is quite important when working with individuals with BPD. One feels emotions intensely and this can mean intense sadness or despair AND intense joy and excitement. One can experience unstable relationships AND have meaningful experiences through the relationship. There is an understanding that one is doing the best they can AND we know they can do things differently (or better). In my work with these clients, I have found that the practice of validation and sitting with can be a very powerful experience. Learning how to sit with and look beyond the unhelpful expressions of pain to connect the client with their struggling inner child is crucial. Providing space to for this inner child to breathe, to be heard and to feel a sense of safety is what helps strengthen the bond between our clients’ current selves and their vulnerable inner child. This leads to opportunities to heal with an increased willingness to experience the spectrum of emotions that comes with being human. 

I have found working with these clients a challenging, stressful and yet meaningful experience. I feel humbled to have learnt a great deal from those whom I have had the privilege of crossing paths with and this process is something I will always value in my work as a clinician. All our experiences are unique and I hope that you will find your space as you embark on this journey as well.

Written by:

Dr Cherie Chan

Clinical Psychologist

Doctorate in Clinical Psychology

MSPS, Registered Psychologist

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