Working with Substance Abuse and Borderline Personality Disorder
Marsha called me frantic about her daughter, Sally. Just 21, Sally had bombed out of college and was in her mother’s words “a fire breathing dragon.” Pot, alcohol and cocaine became her bedside partners; boys came and went and when she entered into her parents living room, she ordered all with fierce command.
Likewise, Ted called about his son, Mitch. Somehow with surfboard in hand he managed to graduate. Mitch, like other college students, took the 7-year plan. Strong, robust and overly argumentative, he always was finding fault with everyone in his family. He is nice and attentive one day – sending notes of gratitude to his grandmother; and the next second he would be screaming at his mother, throwing things across the room, scaring her.
Both families were walking on eggshells not knowing whether they will be greeted by a two-headed monster or their sweet, wounded young adult child.
The truth is these families are not alone. One out of every four people in the US will struggle with mental health issues in their lifetime and 1 out of 3 families will have a loved one experience a substance use disorder. With the coronavirus, a troubled economy, racial tension and the opioid crisis, (which is still present) many are in crisis now.
More than ever people need a trustworthy place to turn to for information, guidance and help. That is our mission at All About Interventions.
What Is Borderline Personality Disorder?
According to The National Institute of Health “Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image and behavior. These symptoms often result in impulsive actions and problems in relationships . People with borderline personality disorder may experience intense episodes of anger, depression and anxiety that can last from a few hours to days”. Substance induced behaviors may often be confused with BPD.
Loved ones with borderline personality disorder (BPD) tend to have major difficulties with relationships, especially with those closest to them. Their wild mood swings, angry outbursts, chronic abandonment fears, and impulsive and irrational behaviors can leave those around them feeling helpless, abused, and off balance. Partners and family members of people with BPD often describe the relationship as an emotional roller coaster, like walking on eggshells.
You may feel like you’re at the mercy of your loved one’s BPD symptoms—trapped unless you leave the relationship, or the person takes steps to get treatment. But you have more power than you think.
Some signs in your relationship that your loved one maybe experiencing Borderline Personality Disorder or a Substance Use Disorder or both
Do you feel like you are walking on eggshells, tiptoeing around your loved one? Watching what you say for fear of setting them off and realizing that no matter what you say from pass the salt across the dinner table to a simple
Does your love one shift instantly between emotional extremes-from being a fire breathing dragon to a remorseful child/
Is the word all good or bad-have black or white thinking?
Do you feel like whatever you do or say you will be found at fault/ Your words will be twisted and used in hurtful ways against you.?.
Is everything always your fault-? Are you constantly blamed or faulted for things that do not make sense? Are you misunderstood or not heard when you try to explain things?
Are you manipulated by fear, guilt and outrageous behaviors / Does your loved one swing into violent rages verbal , does he/she throw things, make dramatic declarations that whatever is ailing them is your fault (they dropped out of school, they can’t get a jo etc), do dangerous things (hang out with the wrong crowd, take illicit drugs, Storm out or leave or demand that you leave your own home?
You can change the relationship by managing your own reactions, establishing firm limits, and improving communication between you and your loved one. There’s no magic yet with the right treatment and support, many people with BPD can and do get better and their relationships can become more stable and rewarding.
Whether it’s your partner, parent, child, sibling, friend, or other loved one with BPD, you can improve both the relationship and your own quality of life, even if the person with BPD isn’t ready to acknowledge the problem or seek treatment.
It’s important to remember.
I did not cause these behaviors
I cannot cure or control my loved one’s behavior
I can communicate and set healthy boundaries
I can take care of myself
I can get professional help
I can offer treatment solutions
Here Are Some Communication Tips
- Listen actively, be empathetic- While you do not have to agree with the person you can nod and avoid distractions like cell phones dining, tv etc. You can nod and you can do active listening ice. Repeat what someone has said i.e. -If I hear you correctly…
- Focus more on the emotions that the person has then their actions Validate their emotions
- Staying, calm and collective is probably the hardest thing to do when a loved one is experiencing a mental health crisis such as BPD or a substance use disorder. Avoid getting defensive or argumentative no matter how unfair they are. Defending yourself, raising your voice may only exacerbate an already untenable situation. For example , you might say. If you are not able to stay calm when we talk then I invite you to leave.
- To the extent possible, distract so as to deescalate the situation
- Develop An Emotional Intelligence Toolkit to help guide you and your loved one https://www.helpguide.org/articles/mental-health/emotional-intelligence-toolkit.htm
- Encourage your loved one to explore healthy ways of handling stress and to seek treatment. As I share on my web site and in my new book, Addiction In The Family Helping Families Navigate Challenges, Emotions and Recovery – having a professional help who is well versed in both mental health and substance use disorders as well as interventions to help you navigate your way
The Importance Of Setting Boundaries
Think of setting boundaries as a process not just a single event. Boundaries may be introduced one at a time.
Make sure everyone is on the same page with the boundaries you want to put in place.
Do not make threats or ultimatums you cannot carry out. I always ask families to take a look in the mirror and ask themselves if they can carry out the boundary they are setting. If yes go ahead, they no, then do nod. If you cannot and are unable to enforce whatever the boundary is your loved one will know the boundary is meaningless and the negative behavior will continue.
Remember the adage “Rome was not built in a day”. Take small steps rather than huge ones that will end up only frustrating you and your loved one, Success is as;one step at a time.
Always remember to take care of yourself. For more information or consultation give us a call at 619-507-1699.