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How to Start a Conversation With Someone Who Doesn't Believe Your Borderline Personality Disorder is Real

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Several years ago, I sat through one of the most difficult therapy sessions of my life. My then-husband and I were making one final attempt to “save” our marriage by attending counseling sessions together. At this point, I was still hopefully optimistic that we could find a way to work through the problems in our marriage. In fact, I felt confident that this would be the session something would click and the therapist would help us make a breakthrough.

Yet, as soon as my then-husband mentioned the borderline personality disorder (BPD) diagnosis I’d received a year prior to that, the therapist’s demeanor suddenly shifted. He focused on me completely and asked me questions about my diagnosis. As he did so, he got up and started digging around in a closet, hunting for his DSM-5 to “read the diagnosis” to me.

In this situation, a mental health provider was questioning the validity of my meeting the criteria for BPD. However, many people who live with this condition experience pushback when they disclose their diagnosis. If this happens to you, here’s how you can navigate that conversation.

When Talking to Loved Ones About Borderline

Friends and family members often form perceptions about us that may or may not be the truth. They may take their limited knowledge of BPD from mainstream media and not understand how you fit into that picture. Or, they may discount your experiences entirely and place the blame elsewhere. They may tell you to “quit acting” or say you just need to “suck it up.”

Regardless, here are some things you can do:

1. Validate their feelings, whatever they may be: Use language that shows you hear their position and realize how difficult this is. Say things like, “I understand why you feel that way,” or “I know I’ve done some hurtful things that can’t just be excused with a label.” Pause and listen before speaking so you get a full picture of their stance.

2. Provide resources about your diagnosis: Share links to organizations like the National Institute of Mental Health or the National Alliance on Mental Illness, especially ones that provide guides for loved ones. Gift them books about borderline personality disorder written for family members, such as “Loving Someone With Borderline Personality Disorder” by Shari Y. Manning and Marsha M. Linehan.

3. Explain your symptoms: Share a symptom you experience and give an example where your loved one was present. Share an everyday situation from your point of view and include details like emotions, thoughts, and bodily sensations that the situation brings up for you.

4. Set boundaries if necessary: Sometimes, loved ones aren’t ready or willing to accept what we have to say. If that’s the case, try setting boundaries that help you regulate your emotions and maintain the relationship with this loved one.

When Interacting With Coworkers

For better or worse, coworkers often get a very limited view into our lives. They rarely know about your past, and they probably don’t even know all the things you deal with outside of the workplace. Coworkers can also hold very different beliefs about mental health conditions in general and may not even see therapists or psychiatrists as “real” health care providers.

Although coworkers can sometimes be difficult to deal with, you can try using the following suggestions during your conversation with them:

1. Remain calm: Coworkers can sometimes bring out the worst in us, whether they mean to or not. However, arguing with them or letting their comments dysregulate you won’t prove anything. So, use coping skills to remain calm and carry on a peaceful conversation.

2. Educate them with facts: Unless you work in clinical mental health, chances are your coworkers don’t really know much about BPD. If you listen to them while they share, you may be able to use your own knowledge of your diagnosis to help educate them and break apart some common myths about BPD.

3. Agree to disagree: Unfortunately, your coworker may just be stubborn and unwilling to listen to an opposing view. If that’s the case, simply “agree to disagree” and make the choice to not talk about this particular topic with them going forward. This is a form of boundary setting that can be effective with coworkers.

When Dealing With Health Care Professionals

Borderline personality disorder is still a very misunderstood, relatively under-researched mental health condition. Unfortunately, this means that even health care providers don’t always know the facts about this diagnosis. This misinformation can seriously impact your ability to connect with certain providers and receive the help you need.

Obviously, you don’t want to come across as presumptuous to someone like a medical doctor or psychiatrist.

However, you can try these suggestions if they try to dismiss your diagnosis:

1. Explain yourself: Share your symptoms with your provider. Be honest about how you feel and what you experience in a typical day. Sometimes, this insight can help your doctor better understand.

2. Ask for more information: Sometimes a doctor may be projecting confirmation bias onto you or dismissing your claim because they don’t feel like they’ve seen enough evidence of your diagnosis. If they argue that you don’t meet the criteria, you can ask questions and provide additional details to fill in the gaps for them.

3. Offer the diagnosing physician’s contact information: Although your provider should listen to you when you advocate for yourself, not every clinician will. So, if you’re having an especially hard time getting through to a particular provider, give them the contact information of the clinician who diagnosed you so your provider can vet them out.

4. Find a new provider (if necessary): Not every doctor is the best match for every client, and that’s OK. You have the right to advocate for your care, even if that means asking to see a different provider.

Receiving a borderline personality disorder diagnosis can be a tough pill to swallow. However, it’s even harder to deal with when the people in your life are invalidating and unsupportive. Having these conversations can be hard, but hopefully, these tips give you the starting point you need to land the plane safely.

Getty Images photo via The Good Brigade

Originally published: June 28, 2022
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