Enabling Borderline Personality Disorder

Individuals who suffer from a borderline personality disorder (BPD) are in great pain. Those who live with them or love them naturally want to be supportive and ease their pain. Without understanding some unique aspects of this disease, your efforts to be supportive may actually be making their illness worse. In this post, you will learn to tell the difference between supporting your friend or relative in a healthy way and enabling them in a way that makes them sicker.

Helping or enabling? Sometimes hard to tell.

Source: Peggy and Marco Lachmann-Anke/Pixabay

The key is to reward healthy behaviors and not reward unhealthy behaviors. This seems simple enough, but unfortunately, in many families suffering from BPD, healthy behaviors are ignored, and unhealthy behaviors are rewarded.

Consider the following exchange between Betty and her son Jeremy, who suffers from symptoms of BPD.

Jeremy: Mom, can I have the car keys, please?

Betty: Did you finish cleaning up from last night?

Jeremy: I will finish when I get back.

Betty: We had an understanding that you need to do all of your chores before you borrow the car.

Jeremy: Just let me have the keys, and I will clean it when I get back.

Betty: That is not our understanding.

Jeremy: It’s not an understanding; it is your rules.

Betty: It is my car.

Jeremy: Mom, I have to go now. Give me the keys!

Betty: Why don’t you just finish cleaning and then go?

Jeremy: You are the worst parent. I hate you.

Betty: Why do you have to make such an issue about cleaning up after yourself?

Jeremy: Forget it. I might as well just kill myself.

Betty: All right, here are the keys. Just make sure that you clean up by tomorrow.

In the above example, Jeremy has not fulfilled his obligation to clean up after himself. Betty tried to hold him responsible, but he escalated the situation by threatening to hurt himself. Betty gave in. She told herself that her son has issues taking responsibility, but she will be supportive by giving him some slack.

The problem is that Betty is rewarding Jeremy for not taking responsibility for himself, escalating the conversation, and threatening self-harm. Choosing to reward behaviors increases their frequency in the future. By giving in to Jeremy this way, she is making him sicker by reinforcing his unhealthy behaviors. This error is also made by therapists who do not specialize in treating personality disorders.

Healthy Behaviors Should Be Supported

Any behavior that is targeted at independence, autonomy, self-care, self-improvement, or the improvement of others should be supported and rewarded. Assistance with education, medical treatment, child care when (when used for healthy purposes and not used as a codependent crutch), etc., should be supported.

Healthy social behaviors should, whenever possible, be rewarded and not ignored. This includes being courteous, responsive, responsible, and respectful towards others. Rewards for such behavior can include direct validation, such as by making statements like “how nice of you” or “what a pleasure to be around you” when appropriate. Other types of rewards can include increased responsibility and privileges, such as the lifting of curfew or increasing allowance.

Rewarding Unhealthy Behaviors Is Enabling, Not Supportive

When you respond to hurtful behavior by giving in, you are making the illness worse. You are feeding the illness by enabling unhealthy behaviors. In the above dialogue, Betty is enabling Jeremy to avoid taking responsibility for not fulfilling his obligation to clean up after himself. She is also enabling his being threatening and hurtful towards her by rewarding him for doing so. These are all unhealthy behaviors that Betty is enabling.

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Why Does Betty Enable Unhealthy Behavior?

There are several reasons why Betty might be enabling Jeremy’s unhealthy behaviors. Here are a few of them:

• Betty might not understand the connection between her giving in and Jeremy getting sicker.
• Betty might give in to Jeremy in order to end the escalating conversation.
• Betty might think that giving in to Jeremy is the best way to avoid him harming himself.
• This might be part of a pattern where Jeremy needs certain responses from Betty to be well. In the above example, he needs Betty to allow him to avoid taking responsibility to stop him from self-harm.

What Can Betty Do When Jeremy Threatens Self-Harm That Is Not Enabling?

First, Betty needs to realize that if Jeremy is going to hurt himself, then giving him the car is not a healthy solution. She needs to confront him. For example, she might say, “Are you serious about hurting yourself?” If he says yes, then she needs to make arrangements for him to get urgent psychiatric care. If self-harm is imminent, then an emergency room or a call to 911 may be necessary. In less severe situations, outpatient or telehealth may be sufficient.

If Jeremy acknowledges that he is not serious about hurting himself and that he just said it to manipulate her, then she must not give in to his demand. She can, however, be supportive in encouraging him to quickly do the cleaning because showing up late wherever he was going is better than not at all. She also can coach him as to how to get it done most efficiently so as to quicken his departure.

In my next post, we will look at how people with symptoms of BPD enable themselves and make their BPD worse. Different approaches will be offered to pursue healing and growth for those affected by this troubling disorder.