Relationship problems in people with borderline personality disorder

What is it about?

People with borderline personality disorder (BPD) frequently have difficulty with close relationships, but we do not know the specific behaviors that might lead to these difficulties. We recruited romantic couples in which at least one person had 1) borderline personality disorder, 2) a personality disorder other than BPD, or 3) were in treatment, but did not have a personality disorder. We observed their behavior as they argued about a conflict. We found people with BPD and their partners engaged in behaviors that damage their relationships. One way to keep a relationship healthier is to be positive about five times as much as you are negative in an interaction. This is called the emotional bank account. The partners of people with BPD were lower in this ratio and it predicted worsening relationship satisfaction over 12 months. Another way to keep your relationship healthier is to avoid engaging in four behaviors that have been found to be particularly destructive to relationships - the four horsemen: defensiveness, criticism, stonewalling and contempt. People with higher BPD symptoms criticized more, and their partners defended and stonewalled more - suggesting a problematic attack-withdrawal dynamic.

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Why is it important?

People with BPD often have severe relationship problems, but there are few specific recommendations for what people with the disorder may try to do differently to increase relationship health. The current study suggests people with BPD and their partners may benefit from couples therapy focused on decreasing negative behaviors, attending to one another's emotional state and increasing positive behaviors in the midst of conflict.

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