“My daughter has been diagnosed with Borderline Personality Disorder, what now?”

Many families come to Sunrise with fear and hopelessness after hearing that their daughter has been diagnosed with BPD. Often, one of the first questions parents ask is, “How can I help my daughter with borderline personality disorder?” If you are in this situation here are some things you can do.

1. Learn as much as you can about BPD and DBT

Learning about the patterns that characterize borderline personality disorder can help you gain insight into why your daughter acts the way she does. This knowledge can help you have empathy for your daughter. It may also empower you to know how to avoid some patterns. This education helps you align with your daughter. You want her to know that you’re on the same team – that it’s you and her versus the BPD, not you versus her.
Dialectical Behavior Therapy is widely accepted as the primary modality for treating BPD. Learning the DBT skills will not only help your daughter manage her borderline personality disorder, it will also stabilize your whole family system. DBT provides a common language for your family, so you can identify and discuss the emotional rollercoaster.

2. Take Care of Yourself

You may find yourself investing all your thoughts, energy and emotions in the relationship with your borderline daughter. This can be a recipe for frustration, resentment and burnout. To prevent this it is important you take care of yourself. Not only are you keeping yourself healthy, you are also modeling for your daughter how to work to keep herself healthy. Here are some ways you can do that.

a) Don’t Take it Personally.

As a parent, it can be natural to ask, “Why does my daughter have BPD? What caused it and could I have done anything to prevent it?” Borderline personality disorder is incredibly complex and isn’t the result of any one event. Remember that you did the best you could with what you had. Shari Manning, Ph.D and author of Loving Someone With Borderline Personality Disorder put it this way:

“People with BPD are born with an innate, biological sensitivity to emotions, e.g. they have quick to fire, strong, reactive emotions. Children who are emotionally sensitive take special parenting. Sometimes, the parents of the person who develops BPD just aren’t as emotional and cannot teach their child how to regulate intense emotions.”

b) Maintain healthy friendships.

One of the hallmarks of borderline personality disorder is “unstable and intense personal relationships, marked by alternating idealization and devaluation.” In order for you to not burn out and be there to support your daughter, you must invest in healthy relationships that recharge you.

c) Join a support group.

It can be hard for friends and extended family to understand what your family is going through. Know that you are not alone in this process. Others have experienced the same relational turmoil and can help support you through the process.

d) Practice emotional independence.

Another struggle that your daughter with BPD will face is a lack of emotional regulation. She has an unstable sense of self, marked by intense mood swings, chronic feelings of emptiness, and sometimes bouts of intense anger. If you are emotionally dependent or codependent with your borderline daughter, you will burn out emotionally.

Practice identifying and labeling your emotions, self-soothing and using the DBT skills ACCEPTS and IMPROVE to improve your distress tolerance. Use Relaxation techniques, mindfulness, meditation, yoga and deep breathing to manage stress. Over time you will be able to show love for your daughter, without basing your personal emotions on her mood.

e) Maintain your physical health.

One of the best ways to help your daughter with borderline personality disorder is to teach her how to maintain her physical health. It is equally as important for you to maintain your physical health as well. Dialectical Behavior Therapy teaches a good system to do this using the acronym PLEASE-

PhysicaL Illness- If you get sick or injured, promptly go to the doctor
Eating- Eat a healthy and balanced diet.
Avoid mood-altering drugs- Don’t take any non-prescription or illegal drugs.
Sleep- Try to get between 7 and 9 hours of sleep every night.
Exercise- Exercise releases endorphins that will help in stressful moments.

3. Look Past the Borderline Personality Disorder Label

Labels can help you understand your daughter’s borderline behaviors, but too often the label comes with a huge amount of stigma.

Does your daughter need help coping with borderline personality disorder? Call us to learn how our fully-integrated DBT treatment center can help your family. 866-754-4807.

Use the BPD label to provide understanding and develop compassion and empathy. Then move beyond the label and embrace the fact that your daughter is a unique human being that deserves to be treated like a person, not a label. Identify and love your daughter’s personality and separate it from those traits associated with borderline personality disorder.

4. Focus on Validation & Communication

Dealing with Borderline Personality Disorder requires a huge effort to communicate with and validate your daughter. One of the main struggles your daughter faces with BPD is an intense feeling of worthlessness or emptiness. Here are some steps you can take to validate your daughter’s emotions:

a) Focus on emotions, not words.

There are three levels of communication:

1. Primary Communication– Words or behaviors.
2. Secondary Communication– The underlying feelings behind the words.
3. Core Issue– The persistent negative self-view that drives your daughter’s feelings.

Focusing on the core issue can be frustrating because change is so difficult and takes a long time. Focusing on words and behaviors can make your daughter feel like she isn’t being heard. But when you focus on the emotions behind the words, you will start to see your communication resonate with your daughter. For example, when your daughter is struggling, you might say, “it sounds like you are feeling hurt right now. Is that correct?”

b) Validate in a way she feels heard.

When your daughter shares her feelings of worthlessness, you might be tempted to say something like, “No you’re not a bad person.” But don’t try to talk her out of feeling the way she does, that actually invalidates her feelings. Instead, say, “It sounds like you feel bad about how you acted and that makes you think you are a bad person.” Then re-orient their attention to building mastery, problem-solving the emotion, or simply recognizing the emotion and choosing to do the opposite of her urges.

5. Learn to show love while holding boundaries

You may think you have to choose between loving your daughter and holding boundaries with her. But it isn’t an either/or decision. Instead, try loving her by holding boundaries. Together with your daughter:

a) Have everyone agree on what the boundaries will be.

Be consistent and unified. Try using a contract or written agreement that outlines what the boundaries are and what the consequences will be if broken. Then your daughter, both parents and anyone else involved should agree and sign it.

b) Identify the values behind the boundaries.

Doing this will help you connect how the boundary will help your daughter. This helps provide a simple way for you to demonstrate that by holding the boundary, you are supporting and loving your daughter.

c) Change slowly.  

Adopt a process of change and evaluation. Implement one boundary, then after a week or so sit down with your daughter and talk about how it has been going and what the next step should be. If you both feel the time is right, implement another boundary.

d) Drop the empty threats & embrace consequences.  

Consequences are life’s natural teachers. Because consequences can be painful, your natural inclination is to protect your daughter from as many consequences as possible.

Many parents often use empty threats instead. When your daughter was little, that may have looked something like, “If you don’t eat your dinner, you won’t get dessert” even though you knew you would always give it to her. As a teenager, it is even more important that there are clear, logical consequences tied to every boundary. Include both positive and negative consequences. Then let your daughter choose what consequences she wants and honor her decision by not protecting her from those consequences.

f) Have a zero tolerance policy for abusive behavior.

When you establish boundaries, make it clear that you will not tolerate abusive behavior. Then discuss acceptable reactions with your daughter that will protect both of you. For example, you can let your daughter know that if she starts to yell and abuse you emotionally, you will walk away. Tell her beforehand that this does not mean you don’t love her. It only means that abuse is unacceptable and you will re-engage with her when she has calmed down. Then let her know she is welcome to do the same if she feels emotionally unsafe.

e) Consistency = Emotional Safety

6. Get professional help

20 years ago people thought that borderline personality disorder was incurable. Thankfully today we’ve discovered that DBT can help most cases of BPD. That being said, having a daughter with borderline personality disorder can be incredibly hard on the whole family. You should not feel that you have to solve this struggle by yourself. Please seek the help of a DBT trained therapist or treatment center.
Healing from BPD is possible, but you will still have hard days. A borderline personality disorder diagnosis is the beginning of the healing process, and treatment is slow. Celebrate baby steps rather than expecting giant leaps of progress.
Here at Sunrise, through DBT and other therapeutic modalities, we are able to teach our students skills that assist them in living with and managing this disorder.  In conjunction with our Family Systems approach to treatment, these are things parents and family members can do to support your daughter in treating her BPD.
By Nicole Andra, Admissions Director at Sunrise Residential Treatment Center