Talking to Someone Who Has Borderline Personality Disorder

Being the loved one of someone who lives with borderline personality disorder comes with challenges of your own. You don't understand the world that the borderline lives in. Outbursts, conflicts, and obstacles come from seemingly nowhere. It feels like walking on eggshells around the borderline.

To communicate with someone who has borderline personality disorder, it's important to understand how the borderline mind works. Borderlines are prone to split thinking, seeing the world as either all-good or all-bad. With you, it means that at any given time, you are either all-support or never-supportive. There's rarely any in between.

Caveat: This is not meant to be professional advice. If you or a loved one is struggling with borderline personality disorder, please contact your primary care provider. This post is anecdotal and describes what works for me and others who live with BPD.

What not to do

The core of what someone with BPD needs is validation. It's terrifying to live in a world where they feel something so intensely, that they cannot contain all of the emotions hitting them at once. Don't challenge these emotions. Don't brush them aside. And never, ever dismiss them or assume that they're crazy.

Instead, one of the ways to help someone with BPD is to communicate with them using the SET-UP method.

The Set-up method

From I Hate You -- Don't Leave Me:

“SET”—Support, Empathy, Truth—is a three-part system of communication. During confrontations of destructive behavior, important decision-making sessions, or other crises, interactions with the borderline should invoke all three elements. UP stands for Understanding and Perseverance—the goals that all parties try to achieve.

The SET-UP method was initially created to help a borderline who is splitting or undergoing crisis. However, this method can and should be used in day to day communication with the person with BPD, to create a consistent and structured way to getting through.

Having BPD can mean that you live in a different world from everyone else. This world is inconsistent, terrifying, and warps itself every several hours. The SET-UP method can serve as a way to translate your thoughts and words in a way that the borderline can understand.

S - Support

From I Hate You -- Don't Leave Me:

The S stage of this system, Support, invokes a personal, “I”
statement of concern. “I am sincerely worried about how you are
feeling” is an example of a Support statement. The emphasis is on
the speaker’s own feelings and is essentially a personal pledge to
try to be of help. 

The support stage means that you are letting the person with BPD know that you are there. That you care. That you're going to try to help them. 

This isn't the time to threaten to call the cops or force them to go to the hospital. It's a time to tell them that you're going to try your best to be a support system.

Some ways to be supportive:

  • "I'm worried about you and how you're feeling..."
  • "I'm not going anywhere because I'm concerned for you..."
  • "I want to help you because I care/love you..."

E - Empathy

From I Hate You -- Don't Leave Me:

It is important not to confuse empathy with sympathy, which may elicit rage over perceived condescension. Also, Empathy should be expressed in a neutral way with minimal personal reference to the speaker’s own feelings. The emphasis here is on the borderline’s painful experience, not the speaker’s.

The key to empathy is to state what the borderline is going through, rather than trying to sympathize or say that you understand. Don't bring your personal anecdotes or talk about how you've been in a similar situation. Don't make this about you.

This is the time to acknowledge any stresses and hardships that the borderline is going through. Bringing up what triggered an episode can also be helpful.

Some ways to empathize:

Do this: This has been a long day for you and you're doing so much. No wonder you're stressed.

NOT THIS: I've had a long day too so I understand how you feel.

Do this: You've been trying your best at balancing everything and you can't seem to catch a break.

NOT THIS: Sometimes things just don't work out and you have to deal with it.

Do this: Seeing that text message really hurt you and you have every right to be upset with what happened.

NOT THIS: Don't you think you're making assumptions over nothing?

Being empathetic is not the same as giving pity. True empathy is when you acknowledge that you may not be able to feel what they are feeling, but you are mindful of their pain.

T - Truth

From I Hate You -- Don't Leave Me:

The T statement, representing Truth or reality, emphasizes that
the borderline is ultimately accountable for his life and that others’
attempts to help cannot preempt this primary responsibility. Truth statements acknowledge that a problem exists and address the practical, objective issue of what can be done to solve it. 

While Support and Empathy are surely important, the Truth component brings it together. This part acknowledges that the borderline plays a part in how they are currently feeling and how they can move forward with this.

Now, this isn't where you place blame. Never accuse or state that the person with BPD has "messed up" or "did this to themselves." 

Making a truth statement should be neutral. This is not the place to put your own opinions or assign emotions to the truth.

For example, you can say, "How do you think you can move forward from here?"

This question puts the ball back in their court. It asks them to assume responsibility for what happens, moving forward, but it doesn't place blame or have accusations. 

Another important way to bring the truth forward is to state what is happening, but not in a challenging manner.

Other truth statements are:

  • "You're having a breakdown and you want me to leave you alone, but I have to stay because I care about what happens to you."
  • "Right now things are looking down so what should we do about it?"
  • "We can go see a doctor soon, together, to get some more help."

UP - Understanding and Perseverance

From I Hate You -- Don't Leave Me:

Just because the sun has risen in the East for thousands of years does not mean it will happen today. He must see it for himself each and every day.

One of the more painful parts of living with BPD is that nothing is constant. Everything must be tested and retested, including relationships with other people. There is a constant waiting for betrayal and expectation of inconsistency.

That's why understanding and perseverance is so important. The SET-UP method is not something that can be used once as a cure-all for communication. It's a method that is to be used over and over, until it becomes a standard in being heard.

Using it all together

From I Hate You -- Don't Leave Me:

If “The Truth will set you free,” then Support and Empathy must accompany it to ensure it will be heard.

Support, empathy, and truth need to be used together to ensure that the message gets through. Let them know that you are there, that their feelings are valid, and present a truth in the situation, to shake the black and white thoughts.

Communicating with someone who lives with BPD can serve as a challenge, but the SET-UP method can prove to be an effective way of talking it out.

Give it a try,

-F