# The Borderline Personality Disorder Workbook by Daniel J. Fox - Blinkist What’s in it for me? Take control of your BPD. Borderline Personality Disorder – or BPD for short – is characterized by symptoms like emotional outbursts, self-harming behavior, and difficulties forming stable relationships.  For people affected, it can feel like BPD controls their entire life. But with the right tools, it can become a very manageable disorder.  This Blink will help you understand the roots of your BPD, so you can arm yourself with proven tactics against destructive patterns. It will teach you to recognize your emotional triggers, combat your dysfunctional beliefs, and rebuild your relationships.  Just a note before we begin: This guide does not pretend to replace therapy. It is recommended that people suffering from BPD seek professional help. This guide is meant to serve as a starting point or as support material in your healing process. What is BPD? Before you begin to address this disorder, you need to understand it. This is especially important for BPD, which is often mischaracterized and misunderstood. Borderline personality disorder, or BPD, is one of ten personality disorders recognized by the DSM-5, the diagnostic manual for psychological professionals. It affects around six percent of Americans – so you’re not alone! The DSM-5 defines BPD as an inability to regulate behavior, thinking, and responses to situations. This instability often manifests as problems with relationships, self-image, and emotional outbursts. Following are the nine official symptoms of BPD. You must meet at least five to receive an official BPD diagnosis. Which ones apply to you? Fear of abandonment – you frantically try to avoid people leaving you.  Emotional reactivity – you often act impulsively based on intense emotions. Unstable relationships – you have intense swings in how you view others.  Unstable self-image – your sense of self is frequently shifting. Self-harm & Suicidal behavior – you engage in or threaten self-harming or suicidal gestures. Feelings of emptiness – you often feel alone and empty. Intense anger – you have emotional outbursts you can’t control. Stress-related paranoia – when you're stressed, you feel like the world is out to get you. BPD symptoms show up differently and with different intensity for everyone. Let’s consider an example. Betty is a 22-year-old woman who has trouble making and keeping friends. She often feels alone and misunderstood. One day, she falls head over heels in love with Steven. But when he takes too long to respond to a long text, she abruptly breaks up with him. She starts calling him “the devil.” After breaking up with Steven, Betty starts cutting her arms. When her coworkers notice her scars, Betty finds the courage to seek treatment. She receives a BPD diagnosis, which helps her begin healing. As you can see, Betty displays the symptoms of unstable relationships, self-harm, emotional reactivity, fear of abandonment, and feelings of emptiness. What’s your story? To manage BPD, it is essential to identify your symptoms and develop strategies tailored to them. Many people like Betty see improvement through treatment.  And with this guide, you are already on the right path! Where does BPD come from? Where does BPD come from? Research shows it likely stems from a combination of genetic, environmental, and neurological factors.   For instance, studies show that 37 percent to 60 percent of BPD cases may have a hereditary component. However, a difficult childhood is very common among people diagnosed with BPD. Many grew up in family environments characterized by abuse, abandonment, and inconsistent affection.   As children, chaos and crisis were the default states. They only received love and care when they were visibly suffering. This teaches the damaging lesson that you need to suffer in order to receive affection.  For the same reason, people with BPD also often display unhealthy attachment styles. They often present with preoccupied attachment, characterized by an overly intense desire for connection. Or they may demonstrate fearful attachment, characterized by wanting connection but feeling unworthy of love. Often, they demonstrate both.  Brain imaging shows that people with BPD have altered functioning in regions related to emotion regulation, impulse control, and aggression.  To gain further insight into your BPD, reflect on your family history. Are there relatives who also exhibit BPD behaviors? Did you experience childhood trauma or inconsistent affection from caregivers? How would you characterize your attachment style? Although these reflections can be painful, greater self-understanding will empower you to make necessary changes. BPD has deep roots, but you are not defined by your past.  And although recovery is a process with many stages, including the occasional relapse, it’s absolutely possible. Think about where you currently are in the cycle of change. Are you still contemplating whether to start changing? Or are you already committed? Recognize your triggers People with BPD often exhibit beliefs, behaviors, and patterns that offer short-term relief but generate long-term harm.  Let’s consider another example. Growing up with an emotionally distant mother, Tony internalized that he’s not important enough to be loved. As an adult, he becomes very clingy with his girlfriends. He calls his girlfriend Mary multiple times a day and tells her continuously how much he loves her. At first, Mary feels forced to reciprocate every gesture. Tony feels recognized and loved. But after a while, Mary starts feeling suffocated and overwhelmed. Eventually, she breaks up with Tony. He feels more worthless and abandoned than ever.  It’s important to identify such destructive patterns in order to change them. But where do they come from? Unhelpful patterns stem from unhealthy behaviors. They offer short-term relief, so they become automatic responses to certain situations. In the long-term, though, these behaviors feed your dysfunctional beliefs – and with it, your BPD. For example, Tony believes he's unlovable, so he compulsively smothers his girlfriend with affection. This behavior temporarily quells his fear, but it has become such an entrenched pattern that he ultimately drives her away, confirming his negative belief. What do you believe about yourself, others, the world? What behaviors stem from these beliefs? Can you name a pattern where short-term gain leads to long-term pain? You will find that many of your patterns have so-called “triggers.” Triggers are situations that compel us to respond in default, unhealthy ways. They can be emotional or physical states, certain people, environments, thoughts, and so on.  For instance, one of your triggers may be being criticized. This trigger confirms your belief of being not good at anything, causing you to fall into your negative pattern of lashing out.  List your triggers and typical reactions to them. At this point, you might not feel like you have much control over your trigger responses. But with practice, you can manage triggers and choose new reactions. In the next part, we’ll learn some strategies to do just that. Take control of your emotional buttons People with BPD often have deep-seated emotional triggers rooted in childhood experiences. These can get pressed like buttons, prompting impulsive reactions that make situations worse. Learning to control your emotional buttons is essential.  In the last part, you learned how to recognize your triggers as well as the unhealthy beliefs, behaviors, and patterns connected to them. Now we’ll learn some strategies you can use to manage your buttons. Keep in mind that it’s best to practice these strategies before a triggering situation arises. To do this, simply visualize one of your triggers, and practice a new, healthy response.  The first one of these is to Break Time. Remove yourself from the triggering situations. This will create space between the trigger and your default response. You can excuse yourself to go to the bathroom, tell your partner you will call back later, or go for a walk around the block. Once you’ve calmed down, you may choose to re-engage with the triggering situation. Breaking time also combines very well with the other strategies, such as mindfulness.  Mindfulness is another useful skill you can practice to create space between trigger and response. Mindfulness is about focusing on sensations in the present moment and simply observing your thoughts and feelings. For instance, when triggered, grab an object and focus on its texture. Let your thoughts and feelings float by like balloons flying into the sky. Do this until you're calm enough to envision an alternate reaction.  Venting is another option to work through your intense emotions. On your phone or as a notebook, keep a venting diary where you can write out all your thoughts and emotions when you’re triggered. Don’t stop until you’ve gotten it all out! A fourth strategy is to practice positive Self-Statements. Recite positive assertions that remind you that your response stems from the past, not present. Make positive assertions like “I’m safe” and “This is just my past talking,” and visualize your emotional buttons cooling down.  Finally, there’s Strategic Distraction – divert your mind by calling a friend, reading, or exercising. Then re-engage the trigger when calm and centered.  If you regularly practice these strategies, you can begin to respond in a healthy way when your emotional buttons get pressed. Challenge your dysfunctional beliefs Many people with BPD harbor deeply ingrained dysfunctional beliefs that fuel their disorder. Identifying and disputing these beliefs can be challenging, but truly transformational.  Dysfunctional beliefs distort perception in unhealthy ways. Let’s look at another example. Betty, who works as a nurse, believes she must be perfect for others to like her. At her new job, one of the nurses kindly offered her help after Betty made a mistake. But Betty's dysfunctional belief twisted the nurse’s kind offer into criticism, prompting her to lash out angrily.  Common dysfunctional beliefs include “I'm worthless,” “I'll never find happiness,” or “Others should always accommodate me.” Pinpoint your dysfunctional beliefs. What thoughts, feelings, and memories accompany them? The good news is that such negative beliefs are often countered by plenty of evidence. For instance, Betty believes she must be perfect for others to like her. But it’s also true that she often gets in small fights with her friends, and they still like and accept her.  Begin actively challenging your dysfunctional beliefs. For each one, list factual reasons why it is untrue.  Next, cultivate healthy counter-beliefs to replace dysfunctional ones. Examples include “I'm doing my best,” “I have the power to achieve my goals,” or “Mistakes are human.” Match each dysfunctional belief with a healthy rebuttal. Repeat your empowering new beliefs frequently to cement them. Post sticky notes around your house, jot the new beliefs down in your notes app, and recite them morning and night. When an old belief surfaces, immediately counter it with a new one. Cultivate healthy relationships Relationships affect well-being profoundly, but for people with BPD, they can be challenging. Assessing the positive and negative factors in your relationships can help you rebuild them in a healthy way. Consider the people close to you – your family and partner, your friends and colleagues, even occasional contacts. For each relationship, write down the positive elements, such as mutual trust, compassion, and calm interactions. Now write down negative aspects, such as intense arguments, feelings of distrust, and not admitting to mistakes.  You’ll quickly find that no relationship is all good or bad. Relationships that balance good and bad elements are quite common, and not necessarily unhealthy. But overly negative relationships breed loneliness, confusion, and low self-worth.  Strengthening relationships involves exchanging negative habits for positive ones. Begin by noticing your own unhealthy relationship reactions. Perhaps you have a tendency to yell at your partner or make unfair black-and-white statements. Now identify the habits you wish to build instead. Perhaps you want to practice speaking calmly and offering a nuanced perspective. One empowering habit to practice is validation, which means acknowledging the other person’s thoughts and feelings. An example of this would be, “I understand you feel hurt that I canceled our plans. I should have given you more notice.” Validation is a positive relationship habit that diffuses conflict and deepens mutual understanding.  Use visualization to practice these empowering habits. Imagine a challenging interaction with your partner and see yourself responding with positive habits – even if the other person doesn't react how you’d like them to.  Through frequent visualization, you’ll learn to react to real relationship challenges in constructive ways instead of default negativity. Keep in mind, though, that you’re likely not the only one engaging in negative relationship patterns. Ideally, the other person is willing to work with you on building positive habits. If not, it’s on you to be the bigger person – or, if necessary, move on from the relationship. Life beyond BPD You now have a group of tools to help you start taking control of your BPD. They will help you challenge your dysfunctional beliefs, behaviors, and patterns so that you can transform how you relate to yourself and the world.  Take stock of your progress along the way. How are your new patterns improving your well-being and relationships?  Be patient with yourself, though. The road to recovery is long and winding. Setbacks will occur, especially during stressful times. View them as opportunities to employ your new skills and maintain your self-acceptance.  In addition, you may find that certain people or situations substantially impede your progress.  For instance, Betty realized that her new boyfriend Robert was undermining her efforts to heal. When her view was distorted by BPD, she thought his abusive behavior was the price she had to pay for being loved. But when she started working on a healthier view of herself and the world, she realized she was worthy of a much healthier relationship. So she ended things with Robert. Consider reducing contact with people who keep you stuck in old patterns. Instead, surround yourself with supportive influences.   In addition, learn to be your own biggest supporter. Create empowering self-talk to cement your new self-narrative. Write down and repeat motivational phrases that remind you of the path you're on, such as “I am determined” or “I will be at peace.” This Blink finishes, but your journey continues. BPD once felt intractable. Now you know how to dismantle ingrained patterns and build the life you deserve – one step at a time. Final summary BPD is the most common personality disorder, affecting around six percent of Americans. Genetic factors contribute to BPD, but roots in childhood trauma are most common.  Key symptoms involve emotional instability, a fractured sense of self, and turbulent relationships. Often, unhealthy beliefs, behaviors, and patterns have “triggers” that cause intense emotions. Mindfulness, self-talk, and relationship skills can help you to take control of these triggers and begin developing new, adaptive responses. Recovery from BPD takes time and courage, but transformation is possible.