Hi Adam, thanks for your feedback — I get it I really do. As someone who’s recovered from BPD, if a therapist told me “love is all I need to get better” a decade ago I would have punched them (I’m sure some of the people I know would have as well). However, years later, I have have a more nuanced position on this, which I was hoping this article would convey.

What I am trying to say BPD is caused by “mentalisation” deficits, which in turn are the result of early unstable relationships. If in adulthood, a person is able to create a support network made up of stable relationships, which embody the concepts of trust and compassion, mentalisation can be recovered — but it’s not guaranteed.

The problem is people with BPD are very sick; they often can’t maintain healthy relationships, and may actively seek to destroy them as they appear threatening. If they are told by someone “I love you” they will reply “I don’t believe you, you hate me.” They will take their own subjective experience to be equal to or greater than the external reality. They will also only believe love exists if it’s matched by a demonstrable outcome, i.e. “I need to be rescued, and that’s the only way I know you care about me.” Finally, they may be able to talk about love when calm, but it’s abstracted from it’s true significance. The idea and reality of love aren’t in sync. Insight is fleeting, and subsequently lost, causing a repeated pattern of self-destructive behaviours which eventually cause the relationship to fail. Naturally, any chance of relearning mentalisation is lost. The person with BPD lives in a kind of nightmare, where they are locked in to their own subjective experience, which is one of overwhelming pain, and distorted perceptions, which means while love (as the idea of trust and compassion) is the best medicine, it’s not the easiest to deliver.

My argument is with a wide support network, combined with a little bit of insight recovery is possible. However, that insight might be best developed first inside of therapy. (eg. MBT) and then transferred to real life. Of course, skills-training, better coping methods, are also important too.

Best regards

Kevin

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Freelance journalist writing on mental health and disability. Words have the power to shine a light on realities otherwise missed.

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