Borderline Personality Disorder: What No One Ever Teaches You

    Everything useful that I have learned about Borderline Personality Disorder (BPD), I learned on the job. It surprised me just how little information I learned about mental health disorders and personality disorders in my master’s level classes. Abnormal Psychology was one class, one semester. How does a little introduction help you prepare for your internship and beyond?

    For me, it didn’t.

    Something I recommend to anyone going into the mental health field for a bachelor’s or master’s degree is to get a job in mental health as soon as you are able. This will help with the issue of not having enough experience later.

    When I started my masters degree, I had a year of mental health experience under my belt. The year of mental health experience taught me more than the classes did.

    Back to BPD. I had a young woman (let’s call her YW) at my first job who had multiple mental health issues, with the most notable of which being BPD. Having no experience outside of the (maybe) paragraph I had read during my bachelor’s degree, I looked to more senior staff to see how to handle it.

    I didn’t need to know much about BPD to know that what senior staff was teaching me was not correct. Senior staff was very heavy-handed and impatient with YW and it seemed to cause a lot of issues with YW’s behavior. Their response to “How do I help them?” was “You don’t.” I found this highly disturbing. No one is a lost cause. 

    A senior staff from another site came to give a training on BPD, and I learned more in an hour about BPD than I ever had up to that point. I consider that information to be invaluable and reference it to this day. When I tried to utilize this new information, I saw a drastic positive change in YW’s behaviors. YW had a wealth of insight about herself, so I asked her questions in order to learn more.

    It is not uncommon to hear people brush off clients with BPD. People with BPD can be difficult to work with and can be frustrating at times, but the more positives you put into the professional relationship, the easier it will be to work together.

    I personally enjoy working with people who have BPD. They are intelligent, sensitive, interesting human beings who deserve to be understood like everyone else.

    So, what did I learn that changed everything?

    People with borderline personality disorder are very often traumatized as children, usually under the age of 5 years old. The traumatic experience causes a severe disconnect between the person and other people. They no longer feel safe. They want to keep the world at arm’s length, because it’s safer that way; however, they are longing for that emotional connection that everyone craves.

    People with BPD experience emotions more intensely than most people. This can cause them to see the actions of others in a different light. For example, if you have to cancel dinner plans because you forgot you had a prior engagement, this could cause the person with BPD stress. The person with BPD may feel that they are not important and that you do not care about them. They may feel that you actually just don’t want to spend time with them and that you are lying to get out of dinner plans.

    In response to that hurt, they lash out in anger. They may say very hurtful things to push you away. Sometimes, they may even threaten to harm or kill themselves. Some professionals find these threats to be empty and based on manipulation alone. I find that the person really does mean this in that moment and they are trying to explain to you how much they are hurting. Often, they do not actually want to harm themselves, they just don’t have the words to explain the feeling.

    That’s where the Feelings Wheel comes in for me. I’m having a hard time linking this blog post on mobile, so here’s the raw link for now.(https://theplantpoweredtherapist.blogspot.com/2025/03/feelings-wheel-borderline-and-si.html?m=1)

    I find that listening to the person and prompting them to identify how they feel helps tremendously. People with BPD tend to struggle with emotional regulation and taking the time to identify the feeling helps them to find ways to express the feeling in an appropriate way. If you can’t name the feeling, how can you be sure that you know how to cope with it?

    I strive for neutrality. If you behave in a positive way, I will give you positive attention. If you behave in a negative way, I will disengage and give you the most neutral response I can muster. I understand that people with BPD are searching for support (less kindly called “attention seeking”), so I want to encourage you to act in a more positive way. I have found that this works in most situations, whether or not a person has BPD.

    YW told me that she never felt like she couldn’t speak to me. She said that she felt comfortable because she always knew how I would react. She told me that, at first, she would test those boundaries to see if I would change my response. I never did, so our professional relationship became more stable. Over time, I could de-escalate her so quickly that other people were asking what I was doing differently.

     This leads me to another point: people with BPD will test your boundaries. It happens a lot in the beginning of the professional relationship because they are trying to “feel you out.” It decreases over time, since they learn how you respond. It feels like the more calm and stable you can be, the more calm and stable they can be. They need that stability in order to emulate it themselves.

    I have a soft spot for people with BPD. They are incredibly misunderstood, which can lead to them being treated inappropriately, even by professionals. Being genuine, caring about their thoughts, feelings, and emotions, and building a good rapport can help you learn better ways to help them.

    If you personally have or think you have BPD, know that you are not alone. Know that you can work on these reactions and that you can heal.

If you're interested in learning to use the feelings wheel to help people with suicidal ideation, check out my post here. The feelings wheel has helped me help people with borderline personality disorder.