A Borderline Dilemma: Relationship difficulties in those with Borderline Personality Disorder

Written by Calyssa Middleton

Quick Overview of Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a personality disorder with patterns of behavior and cognition that are maladaptive. These patterns are known to have an impact on the ability to form healthy interpersonal relationships. All of the symptoms of BPD listed by the Diagnostic and Statistics Manual of Mental Disorders (5th ed.; DSM-5) can be found at this link.

How does BPD affect relationships?

​In one study, participants wrote in a diary every day for 14 days and discussed experiences in their romantic relationships. These entries were intended to test the hypothesis that individuals with BPD perceive relationship experiences more negatively than individuals without BPD. The results indicated that BPD features - even when controlling for relationship satisfaction, total number of relationship experiences, and depressive symptoms - were correlated with a more negative view of all interactions within the relationship (Bhatia, Davila, Eubanks-Carter, & Burckell, 2013). Even when the individual’s partner did positive things in the relationship, individuals with BPD viewed these actions negatively. For example, their partner saying “I love you” was often perceived as negative, rather than positive, by individuals with BPD because they distrust their partner’s love.  

​Another study focusing on relationship dysfunction in those with BPD found that attachment was specifically related to romantic dysfunction (Hill, 2011). Insecure attachment styles, such as ambivalent attachment, were the largest predictors of relationship dysfunction for those with BPD. Ambivalent refers to having mixed feelings and contradictory ideas; those with this attachment style tend to crave intimacy and close relationships but push others away due to a lack of trust. Individuals with insecure attachment styles are already known to experience more difficulty in their relationships; thus, those with an insecure attachment style and BPD symptoms have the most difficulty maintaining healthy relationships.   

How can one cope with BPD and its effect on relationships?

​There are a few known treatments for BPD, with dialectical behavioral therapy (DBT) being one of the most common. This therapy focuses on helping the individual learn to manage emotions. This management leads to benefits in many areas, including less anger and improved social functioning (Barnicot, Gonzalez, McCabe, & Priebe, 2016). Another important factor that DBT addresses is the tendency to self-harm. One study on the treatment processes of BPD indicated that more frequent use of DBT skills is associated with less frequent self-harm and a lower likelihood of dropping out of treatment (Barnicot, Gonzalez, McCabe, & Priebe, 2016). In this study, a significant amount of participants completed the entire treatment process and greatly reduced their suicidal behavior. 

'​Research has shown that it is more beneficial for those with BPD to receive treatment individually before being treated with their partner (Barnicot, Gonzalez, McCabe, & Priebe, 2016). However, couples' therapy can be beneficial. The processes of couples therapy vary depending on the therapist, but this type of therapy has consistently been shown to be important in aiding couples' ability to learn techniques that can prevent the escalation of arguments or negative emotions (Oliver, Perry, & Cade, 2008). Oliver and colleagues (2008) found that proper use of these techniques has a high success rate in those with BPD. These findings support the idea that therapy can help those with BPD function more normally within their relationships with others and lead these relationships to be more stable and rewarding. 

​Ultimately, it is important to understand that individuals who have BPD and similar disorders are not in control of their negative thoughts. However, with the correct treatment, it is possible for them to gain more control of their thoughts and behaviors and improve their relationships. 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Barnicot, K., Gonzalez, R., McCabe, R., & Priebe, S. (2016). Skills use and common treatment processes in dialectical behaviour therapy for borderline personality disorder. Journal of Behavior Therapy and Experimental Psychiatry, 52, 147-156. doi:10.1016/j.jbtep.2016.04.006

Bhatia, V., Davila, J., Eubanks-Carter, C., & Burckell, L. A. (2013). Appraisals of daily romantic relationship experiences in individuals with borderline personality disorder features. Journal of Family Psychology, 27(3), 518-524. doi:10.1037/a0032870

Hill, J., Stepp, S. D., Wan, M. W., Hope, H., Morse, J. Q., Steele, M., & ... Pilkonis, P. A. (2011). Attachment, borderline personality, and romantic relationship dysfunction. Journal Of Personality Disorders, 25(6), 789-805. doi:10.1521/pedi.2011.25.6.789
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Oliver, M., Perry, S., & Cade, R. (2008). Couples therapy with borderline personality disordered individuals. The Family Journal, 16(1), 67-72. doi:10.1177/1066480707309122