The lack of focus of the mental states of oneself and others in people with Borderline Personality Disorder

It is common for people to say that it is difficult to understand the behavior and thinking of people with Borderline Personality Disorder (BPD).  One of my clients with BPD threw temper towards her husband for not replying her text messages related to her request for accompanying her to a medical appointment.  In the dialogue between her and her husband, she said, “You intentionally avoided replying my text messages.  I know you did not want to accompanying me to my medical appointment because you think I am troublesome”.  Her husband felt wronged and replied, “I was in a meeting and I could not reply to your text messages.  I thought I would accompanying you to the medical appointment anyway”.  The client insisted, “You gave me an excuse.  I know you did not care about me”.

This dialogue is common between a person with BPD and his or her spouse.  In fact, when people with BPD felt threatened by their fear of abandonment, their emotional arousal caused them to be unable to focus on the mental states of oneself and the other party.  Due to her fear of abandonment, this client tended to interpret her husband nonresponsive acts to his intentional avoidance.  As she had poor self-image all along, she thought that her husband did not want to accompany her to her medical appointment.  She actually believed in what she was thinking without considering any alternative explanation of her husband nonresponsiveness in the text messages.  That is, when she was in high emotional arousal, she thought her thinkings reflected the reality. 

Furthermore, in the above dialogue, after my client’s husband explained that he was in a meeting, my client still insisted that her husband did not care about her.  In fact, for people with BPD, it is also common for them to sudden shut off from her emotional connection with others and cannot readjust their interpretion of the others’ intention or behaviors.  In this case, their misinterpretation of the situations become unshakable even after the other party explained to them.  My client with BPD above cannot shift her thinking to a more positive one after her husband reassured her that he would accompany her to the medical appointment.  She insisted to believe that her husband did not care about her.

For all of us, we may also fall into trap of neglecting the mental state of ourselves and others when we are stressed or emotional.  However, when we calmed ourselves down, we may be able to tune into our own inner feelings towards the other party and accept alternative explanation of others’ behaviors.  We are able to take a more tentative stand in our interpretation of others’ behaviors.  For people with BPD, their own interpretation of others’ behaviors and the situations is fixed and they strongly believed that this reflected the reality.  How could we deal with these lack of focus of mental state of oneself and others for peole with BPD?

It is important for us to understand their difficulty and not to argue with them when they were emotionally aroused.  We could avoid agreeing in what they thought as the reality, and we could also give them the facts and let them to know what the reality is.  Before they could accept our explanation, it is important to calm them down first.  After they become less emotionally aroused, we can talk to them in a soft way to ask them to be more tentative in their thinking about what the reality is.  Of course, it is not easy at all to deal with such a situation with a person with BPD.  It really takes a lot of time to train them to be more focus on reflecting on their own and others’ mental state.

With compassion, we understand that people with BPD have underlying beliefs about others and themselves developed from their previous experiences.  With patience, we can cultivate harmonious relationship with them too.

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