Borderline personality disorder and the church

A PLEA TO THE CHURCH

Where do you go when you have an illness that medical professionals and counselors don’t want to deal with – treated like an untouchable in a modern world? Have you ever thought what that would feel like? It’s happening all the time to people with BPD.

In their book Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder, John G. Gunderson MD and Perry D. Hoffman PhD, explain:

 

“Seldom does an illness, medical or psychiatric, carry such intense stigma and deep shame that its name is whispered, or a euphemism coined, and its sufferers despised and even feared. Perhaps leprosy or syphilis or AIDS fits this category.

 

“Borderline personality disorder (BPD) is such an illness. In fact, it has been called “the leprosy of mental illnesses” and the disorder with “surplus stigma.” It may actually be the most misunderstood psychiatric disorder of our age.”

People with BPD are truly – in every way – today’s outcasts. And I think of the many stories in the Bible of those Jesus befriended, cared for, healed. Where is Jesus today? Where is the acceptance we need? The love we so very much need? The care?

In the way Jesus was there for the outcasts in his day, Jesus calls us to be his presence for those the world has rejected. He calls us to be there for people suffering from mental illnesses – and especially that most stigmatized of all, BPD. I believe compassion can do much to help such people heal. The potential for healing is great.

BPD entered most lives as a result of a difficult childhood, through pain that is always under the surface. I think to myself: Surely, it’s such hearts that Jesus came to heal. What can we as his followers do to help them?

In an article on the evils of stigma attached to BPD I wrote:

“I’m glad that I believe in a God who pays no attention to man-made labels. The God I know sees those of us with BPD as people who might have had rough lives, making us overly sensitive. He sees the hurt child that is deep within so many of us. In other words, he sees our true character. He is less concerned about the personality we display on the outside, because he knows this is not always a good reflection of the character we have within. He will always see us the way we truly are.”

I pray that churches will offer sanctuary for those the world has rejected. A place where they can be encouraged and assured of God’s understanding and love.

 

RESPONDING TO A PERSON WITH BPD

One of the causes of stigma is that people don’t know how to respond to those who have mental illness. They fear how the person with mental illness might respond to them. As a result their social life is severely affected, particularly when inappropriate behaviour starts coming into play.

If the church is to be a safe spiritual home for people with BPD, it’s essential to become informed about the disorder. Having a grasp of what makes them the way they are will go a long way to helping them do well and respond to ministry. Understanding will help us give them the kind of love and care Jesus has modelled for us.

Probably the most prominent part of BPD is emotional dysregulation. Through life challenges and trauma, often occurring in childhood, people with BPD have developed a very strong sensitivity. This often results in uncontrollable anger that can include feelings of hurt, disappointment, sadness and hatred. If not understood, a person displaying such anger or other emotions might be considered bad or evil and be treated that way.

But such emotions are not usually an indication of the person’s character. Most probably he’s a different person on the inside. Uncontrollable emotion is usually triggered by something said or done causing pain that’s rooted deep in his past. The behavior is not intentional. It can’t be helped.

Don’t judge a person with BPD by the emotions he shows. No matter how scary he may sound, it’s not likely an indication of who he truly is at all. On the inside he could very well be gentle, kind and loving.

Although my condition is improving, I did go through a difficult period with frequent uncontrollable anger. In many cases I wasn’t even aware of it. People started fearing me and stopped talking to me. I lost friends.

But I had always thought of myself—and been thought of—as a giving person. I led a godly life with compassion for those who, like me, suffered from mental illness. In big and small ways I gave support. Even while I went through periods of intense anger and pain, I continued writing devotionals, sending them out to a long list of individuals every week. The writings comforted and encouraged my readers, reminding them of God’s love. As I wrote, I myself was blessed as well. I was reminded that God still loves me.

So here I was, scaring people with my angry outbursts and at the same time showing love and compassion to those who were suffering. The anger I showed was not the real me. It was only behaviour people saw on the outside. Unfortunately, that’s what I was judged by.

The anger was an emotional response by a very sensitive person – a response to things said and done that triggered pain left from a traumatic childhood.

 

FEAR OF BPD

The fear people have of those living with BPD must be one of the most tragic things for those who suffer. Fear is what causes the stigma that brings with it exclusion from groups and activities and avoidance by others. It becomes difficult to have friends, to have a job, to have a normal life.

Stigma engenders a significant loss of self-esteem, destroying vitality we might otherwise bring to our lives. In fact, stigma often causes greater pain than the illness itself. There’s nothing worse than being thought of as a person set apart – a person not like others. Not given respect. Some are even made to feel less than human. It’s enough to make you wonder if you should even live. No wonder there’s a high suicide rate amongst those living with BPD.

Where is the acceptance that people with BPD need? Don’t we all deserve acceptance? Don’t we all deserve love?

Remember the story about the prostitute? Jesus showed her love she had not thought possible. He showed her the compassion she so badly needed. Her tears tumbled down like the tears of a child. In the greatest expression of gratitude, one that she didn’t plan and couldn’t have helped, tears spilled over Jesus’ feet as he was reclining. After the life she had been leading—a stigmatized empty life—you can understand why the deep emotion.

We who are also stigmatized need to have such love shown to us. We too need Jesus. We need godly individuals who can be his representatives – people who will take the time to learn about our illness. We want friends who are not afraid to spend time with us, learning that there’s no need to fear us.

 

BPD – I’M NOT A BAD PERSON

When asked, most will say a person should be judged by what’s in their heart, not by their outward appearance. But it’s amazing how that goes out the window when they see behaviour they find alarming. Behaviour they don’t understand.

In my own case, I was hurt by things said to me or done to me. Without the ability to stop myself I got angry, even experiencing emotional dysregulation at times. Because of that behaviour, the people around me started thinking of me as a bad person. I started to be treated as a bad person—with disrespect and anger. More hurting followed. More “misbehaviour.” It became a vicious cycle.

I wasn’t a bad person at all. I had done a lot of good in my life before all this started occurring. Why was this happening? Inside, I felt like the good person I had always been. But I was helpless to change people’s view of me—to remind others of who I truly am. Eventually, all the good that people had known about me was forgotten. I lost my reputation.

What I needed was compassion. What I needed was to be treated like the good person I had inside me.

Those who care have it in them to show such compassion, despite the oft-scary emotional dysregulation, despite anger that sounds threatening. We need to remember that this behaviour is an expression of deep pain and requires a sympathetic response.

The previous piece describes how we can give such a response. The important thing is to give the person space to recover, staying close. Encourage them to talk. Listening to a person express their pain is to acknowledge it, even to share in it. This is a good way to show compassion. It’s healing.

If this kind of caring response were to become common in our churches, we might be surprised at how much healing would be done.

Don’t forget to follow Jesus. He does not judge us on our outward appearance or behaviour. He sees who we are on the inside. He sees what’s in our heart. That’s where our real self is to be found.

 

BPD – THE COMPASSIONATE RESPONSE TO ANGER

Suppose someone said something or did something especially hurtful to the person with BPD. Such a sensitive person might not be able to help but react, often with the over-the-top anger (or emotional dysregulation) we’ve been talking about. That’s the feature of BPD that’s most alarming in the eyes of the people around us.

And yet, it was only a reaction to a hurtful situation. It doesn’t necessarily mean we are any “crazier,” or that we’re dangerous, or that we’re bad or evil. If we were good people before this, we’ll be good people after, despite this reaction.

Trouble is, it only takes two or three of these angry outbursts for us to be branded—to have a lot of negative talk about us circulating. And no matter how good a person we might be, no matter how much we’ve done for others, these tend to be forgotten. The “bad person” we come to be known as overshadows the good. We become ostracized—outcasts. Victims of stigma.

Such is the tragedy of BPD. But does it have to be?

What can you do when someone gets angry—perhaps even sounding like they might attack you?

Unless there’s a true danger of attack (not  likely), a caring response would be to stay with the person, treating them as you would any other hurting person. Be kind. Keep respect. As the anger starts to subside:

• Give them some space, maybe bringing them to a quiet place.
• Ask if they’d like you to stay with them.
• Offer a glass of water.

When they have settled down, ask if they would like to talk:

• What caused the anger?
• Was it something that was said?
• Did they misinterpret something?
• Spend some time praying with them, bringing it to God.
• A hug would be good.

That’s how we can accept a person with BPD. This is how we can bring Christ’s love to them and make our church a safe place for them.

 

BPD – LOVING THE UNLOVABLE

As mentioned earlier, borderline personality (BPD) has greater stigma attached to it than any other mental illness. Those with the disorder are feared and avoided to such an extent that it’s been referred to as “the leprosy of mental illnesses”.

We know too that in his day, Jesus did not avoid or fear the leper and the demoniac. He reached out to them with the compassion that was so much part of who he was. How can we follow Jesus by bringing such empathy to those the world turns away?

I believe the compassion God calls us to have—the compassion Jesus has modelled for us throughout the Bible—is the most powerful healer for those who are hurting. The heart of God is at its centre. Through our obedience to God’s leading, we can carry the love of God to those who suffer.

Jesus does not look at the sores on the leper’s body. He does not fear the demoniac’s behaviour. He sees the heart that lives inside them. He recognizes the love such individuals hunger for. And Jesus has love to give—love he gives to all of us, but especially to those who suffer most.

People with BPD are stigmatized and ostracized. They are lonely. They need friends who will care about them. Can we give them the kind of love that Jesus, as our example, is teaching us to give? How can we bring healing to them?

Those who live with BPD need to be able to talk once in a while to people who won’t be judgmental. When we listen to them tell us about their pain, we are helping them carry that pain. That’s compassion. That’s love.

With such love, we can bring God’s healing power to those who need it—even to those the world has deemed unlovable. The more regularly such compassion is shown, the more effective the healing will be. People with BPD can and do recover.

 

TREATMENT OF BPD

BPD IS TREATABLE

Borderline personality disorder is treatable and recovery is possible. Though mental health specialists rarely use the word “cured,” many people recover or at least have the symptoms of their disorder controlled so that they can live a fulfilled life.

One very common myth is that borderline personality disorder can’t be treated. Fortunately, this myth just isn’t true. In the past, experts did believe that BPD did not respond to treatment. However, in the past few decades, a number of new treatments for BPD have been developed.

DBT

The most successful and effective psychotherapeutic approach to date has been Marsha Linehan’s dialectical behavior therapy (DBT). Research conducted on this treatment have shown it to be more effective than most other psychotherapeutic and medical approaches to helping a person to better cope with this disorder.

DBT focuses on helping the client build skills in acceptance and tolerance of intense negative emotions as a means to take better control of their lives, their emotions, and themselves. Therapy modules include exercises for improving self-knowledge, emotion regulation, distress tolerance, and cognitive restructuring.

Evidence shows that many people who are diagnosed with borderline personality disorder can lose the diagnosis within a few years because they no longer meet the criteria. This sometimes happens even without treatment. Misdiagnosis of borderline personality disorder appears to be very common.

FAITH

I believe God can do much to help us recover (though not necessarily cure) from mental health problems, including BPD. Staying close to God can help us cope with our day-to-day lives. Time spent with him, in prayer and in reading his Word, will help fortify us and give us the strength we need to stay well. It’s amazing how big a role our faith can play in keeping us well.

The church family and the support of godly people form an important part of the wellness plan for people living with mental health struggles.

God “is able to do immeasurably more than all we ask or imagine.”  (Ephesians 3:20)

 

BPD AND THE NEED FOR COMPASSION

“Compassion.” We all know the word and we know that—among other things—it’s a description of what Jesus showed the outcasts—those the world had rejected.

The Bible tells about his unconditional love, the love he has for each of us, no matter who we are, no matter how good or bad we are. We would like to be his followers. We want to show that kind of love to the people around us. Can we do that? Or will we unwittingly make exceptions?

Some people may be so different that we find it hard to get close to them, hard to say hello to them, hard to ask how their day is going. We may fear them, not knowing what to expect in response. But remember what the Bible said:

There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love. (1 John 4:18)

Everyone feared the demoniac and the leper. But through his unconditional love, Jesus had compassion for them.

He was as one with them. Though divine, he was a human being in the same way those who were rejected were human beings. He knew how to put himself in their shoes, appreciating what their lives must be like. He was able to feel their pain and join them in it.

Isn’t that “feeling with” exactly what compassion is all about? This is why Jesus came to earth to be with us as a fellow human being. This is why he knows us so well.

Christ’s compassion healed many hurting individuals. Through us, and the love God gives us to share, his compassion continues to heal those who may be starving for such love.

How can we show God’s love to people who may be having a hard time when we’re not at ease with them?

Just asking how they’re feeling, is enough to help them feel cared for. It’s enough to help them feel some of their pain lift. It takes away the loneliness of carrying it.

This is like the compassion we see expressed in the life of Jesus. He asked the blind Bartimaeus, ““What do you want me to do for you?” (Mark 10:51) Wasn’t that, in essence, asking him about how he was and what he needed? Most likely, the healing started the moment Jesus showed an interest in this lonely individual.

Imagine if you had BPD and you had just gone through a bout of uncontrollable anger or emotional dysregulation. You’re struggling with the pain, and someone asks you if you’d like them to stay with you awhile. “Tell me what’s going on for you,” they ask. They show no fear, only concern and compassion. They care enough not to leave you alone with your distress.

It’s through that kind of compassion that healing begins. That’s how Christ’s healing can work through his people.