Helping Someone With BPD

1. Assess: ask what has happened.
2. Listen actively; don’t contradict, judge, or say your loved one is overreacting.
3. Validate: find something in what happened that makes sense and is understandable, that you can relate to; say what that is.
4. Ask if you can help, not to solve the problem but to get through the moment.
5. If your loved one says no, give him or her space and remember the emotions of emotionally vulnerable people last longer. 

 Areas of Dysregulation

• Emotional dysregulation — extreme emotional responses, especially with shame, sadness and anger.
• Behavioral dysregulation — impulsive behaviors like suicide, self-harm, alcohol/drugs, binging/purging, gambling, shoplifting, etc.
• Interpersonal dysregulation — relationships that are chaotic, fearfulness of losing relationships coupled with extreme behaviors to keep the relationship
• Self-dysregulation — not knowing who a person is, what their role is, being unclear on values, goals, sexuality
• Cognitive dysregulation — problems with attentional control, dissociation, sometimes even brief episodes of paranoia

Validation

Validation is a way of acknowledging some small piece of what the person says as understandable, sensible, “valid.” An important piece of validation that people miss is that we don’t validate the invalid. For example, if your loved one is 5’7,” weighs 80 pounds and says “I’m fat,” you wouldn’t validate that by saying, “Yes, you are fat.” That would be validating the invalid.

You can validate some part of what she is saying by saying “I know you feel fat (or bloated, or full)”, whatever is appropriate to the context of what she is saying. Try to find some small kernel of validity. Remember that tone and manner can be invalidating when words are validating. “I know you FEEL fat” can be invalidating because it communicates that the feeling is wrong.