Helping Others When You Need Help Yourself With Borderline Personality Disorder

“Borderline patients are typically very dependent and prone to helping others at the same time… Clearly, it is very difficult to help others if one is hungry for help oneself.”
– Mary C. Zanarini, In the Fullness of Time

Recently I read this above quotation from the excellent book “In the Fullness of Time” on recovery and remission in borderline personality disorder (BPD) based on an overview of BPD studies both historic and recent. I was actually in hospital at the time, which I know is ironic, but it gave me hope to know the path to recovery and remission. This quotation isn’t particularly hopeful and no doubt not only limited to people with BPD, but it really hit me because even in hospital, I tend to try to help others even at the expense of helping myself. I had prided myself on my compassion and empathy for others, especially my ability to see what is really going on for people under the surface. In one of my first Mighty articles I called this one of my BPD superpowers, but back in hospital for the fourth time I felt the superpower had switched back to being a curse.
Let me explain.

My hospital visit three years ago that I journaled and shared contained a friendship with two fellow patients, one who had survived a suicide attempt, and the other who was dealing with great trauma. I could see that they were both very unwell and I also saw that they could easily get themselves thrown out of the hospital for breaking hospital rules. I slipped automatically into the role of decoy to try to keep them from trouble, and also mediator and even therapist at times in conflicts between them. In the process of assuming these roles, I de-prioritized my own therapeutic needs even though I was also hungry for help, but feeling too unworthy or ashamed to prioritize myself.

For my latest stay in hospital a few months ago, I was determined not to repeat this misstep of an inadvertent self-sabotage. I even promised my psychiatrist that this time I would make my issues the reason I came into hospital to face. And for the most part I was successful. I worked on myself in my room. I participated well in groups. Every day I went on the group walk. I got to know some people in the groups, on my unit and in the dining hall — but from a friendly distance. I even sat in the dining hall the first night and identified the patients who were most likely to trigger my help giving urge and vowed caution. However, I did slip up when I began talking to some of the borderline kids in the dining hall, those in their late teens and early 20s. My heart broke for what the great pain they are already experiencing and will have to struggle with into the future and activated my paternal urge to protect them from the big bad borderline wolves. Once I realized what I was doing I was able to curb it and this meant sitting away from them and learning to be friendly, but to let go wishing them well as best I could.

Once I got out of hospital I found my help giving heart further challenged by learning a friend from hospital had relapsed into drugs and alcohol. It took me a few days to let go of the sadness I felt for the friend I had grown the closest to there. I thought our friendship had stronger boundaries than ones from my previous hospital visit. And then after I had released my friend in my heart my young neighbor knocked on my door and announced that he hadn’t taken his antipsychotic for five days and was seeing hidden messages in written texts. While he eventually stabilized, this experience again left me feeling bruised and invalidated. Clearly, it is very difficult to help if I am hungry for help myself.

These three examples support Mary Zanarini’s proposition that “Borderline patients are very dependent and prone to helping others at the same time.” I have not specified how I was very dependent in these relationships, but I absolutely was dependent on my help being received, making a difference and somehow returned to me in a show of validation of me as a person. I essentially wanted to hear:

“Andrew you have helped me so much, you are worthy of being taken care of too.”

This is an implicit dependency that usually is unstated and it is no wonder I am so bereft when the affirmation I’m craving is not given as I can’t even state what it is I’m aching for.

The question of where this help giving to cover my own help yearning comes from is no doubt tied to my roles in my family and my childhood. Most of all the bullying I experienced in high school made me think I did not deserve having my needs met, so I focused on others instead. There certainly has always been a pull towards helping others from my early experiences of suffering, which made me much more attuned to recognize pain in other people. But also there is a kind of high of intimacy and connectedness from helping someone in a vulnerable state. It is a high that can distract from my own pain at times, especially when the help is well received and reciprocated (and that is usually more often than not, more than I’ve indicated here.)

I wonder if many of you diagnosed with BPD or otherwise also have this strange paradox between being prone to help others while being dependent and hungry for help yourself. I’m really interested to know how you have managed this seeming contradiction so that you can prioritize your own need for help. It seems likely that the desire to help as a distraction away from yourself is universal across many mental illnesses, different relationships and human experience generally, even for those without a mental illness. It seems that this is part of us trying to adapt and survive with the pain we’ve been allotted to carry and regulate.

For all of us battling through this life the old adage is true: we need to help ourselves first before we can effectively help others. And at its heart, we need the self-compassion to believe that we are worthy of such care.