This article talks about self-harm in borderline personality disorder (BPD). Please know that some parts might be upsetting. If you are struggling with self-harm, please reach out for help. You are not alone.
Borderline personality disorder (BPD) is a mental health condition that is often misunderstood. One of its toughest parts, for those who have it and their loved ones, is self-harm. It is a hard topic to discuss, often kept secret and causing shame.
But to truly understand BPD, we need to talk openly and kindly about self-harm, without judging. This article aims to explain why self-harm happens in BPD, how it feels, and how we can offer support and hope.
Table of Contents:
What is self-harm?
Let’s first be clear about what self-harm means. Self-harm is when someone intentionally hurts their own body. This is usually not an attempt to end their life, though it does carry that risk.
Instead, it is often a way to cope, a way to deal with very strong emotional pain or upset that feels too much to handle. It can involve cutting, burning, hitting, scratching, head-banging or taking too much of something. The specific way of hurting oneself is less important than the deep emotional pain behind it.
Why do people with BPD self-harm?
This is a big question, and there are many reasons. For people with BPD, feelings are often much more intense and overwhelming than for others. Imagine feeling all your emotions at full blast all the time, with little ability to calm them down. This is often what it is like for someone with BPD.
Overwhelming emotions
One main reason for self-harm in BPD is overwhelming emotions. People with BPD often have fast and strong mood swings. They can go from feeling very happy to very sad, angry, or anxious quickly. These feelings can be so overwhelming that they become unbearable. Self-harm can then act as a way to “release” this pressure, a physical way to show the inner chaos. It can bring a short moment of relief, a way to get the intense emotional pain out.
Feeling empty or numb
Another important reason is feeling empty or numb. When feelings are too much, or when there is a strong sense of emptiness, self-harm can be a way to feel something, anything, even if it is pain. It can be a desperate try to feel real and present, to break through the emotional fog that can surround people with BPD. This feeling of “being real” can be very powerful and can lead to a cycle of self-harm.
Self-punishment
Self-harm can also be a way of self-punishment. People with BPD often have deep feelings of worthlessness, shame, and guilt. They might believe they are bad or deserve pain. Self-harm can become a self-inflicted punishment, a way to make up for things they think they did wrong, or to fit a story of being flawed. This self-punishment is often a very upsetting part of BPD and is linked to difficult experiences earlier in life.
A way to communicate
Also, self-harm can be a way to communicate. When words fail, or when someone feels ignored and invisible, self-harm can be a desperate call for help or attention. This is not about trying to trick people. For someone with BPD, it is often a frantic attempt to show how much they are hurting and to get a response, whether that is understanding, care, or help. It is a cry for connection when they feel all other ways are blocked.
Impulsivity
Finally, impulsivity plays a big role. BPD is known for impulsive actions, and self-harm can be an impulsive act, done quickly in the moment without much thought. The intense emotional distress can trigger an immediate, strong urge to self-harm, and it becomes very hard to stop and think about other ways to cope. This impulsivity makes it especially tough for people to stop self-harming without a lot of support and learning new skills.
What it feels like to self-harm
It is easy to judge self-harm from the outside. But to truly understand, we need to try and imagine what it is like for someone doing it. Imagine being stuck in a storm of emotions, with no clear way out. The pain is so strong it feels like it is tearing you apart inside. In that moment, the physical pain of self-harm can offer a strange kind of relief. It is a pain you can feel, a way to focus the overwhelming inner chaos onto something outside.
For some, hurting themselves can bring a sense of control. When life feels wild and out of control, the ability to hurt oneself can be a strange way of feeling in charge, even if it is only over their own body. It is a desperate try to feel powerful in a world that feels unpredictable and scary.
After self-harm, feelings are often complicated. There can be a short period of calm or release, but this is often quickly followed by intense shame, guilt, and regret. The physical injuries are a constant reminder of the emotional pain, and keeping it secret can lead to more loneliness and make the cycle worse.
Many people who self-harm hide their injuries, fearing judgment, misunderstanding, or even more emotional pain if found out. This secrecy can be very tiring and makes them feel even more alone and misunderstood.
Supporting someone who self-harms
If you know someone with BPD who self-harms, it can be very upsetting and scary. It is normal to feel helpless or even angry. However, your support can make a big difference.
Be kind and don’t judge
First and foremost, be kind and do not judge. Remember that self-harm shows deep distress, not a trick to get attention. Do not shame or blame the person. Instead, focus on understanding their pain and offering a safe place for them to talk. Saying things like “I can see you are in a lot of pain” or “I am here for you” can be very helpful.
Encourage professional help
Therapy, especially dialectical behaviour therapy (DBT), is very good at helping people with BPD manage their emotions and learn healthier ways to cope. DBT teaches skills in four main areas: mindfulness, how to handle difficult feelings, how to manage emotions, and how to get along with others. These skills are vital for people struggling with self-harm because they give real ways to deal with overwhelming emotions and stop impulsive actions.
Help spot triggers
Understanding what situations, thoughts, or feelings lead to urges to self-harm is a key step in finding other ways to cope. This could mean keeping a diary or simply talking openly about what causes these urges. Once triggers are known, plans can be made to avoid or manage them.
Suggest other coping methods
This means finding healthier ways to deal with strong emotions. This could include exercise, listening to music, doing creative things, talking to a trusted friend or therapist, using sensory distractions (like holding ice or taking a cold shower), or practicing mindfulness. It is important to find what works for that person, as coping methods are very personal.
Focus on their strengths
People with BPD often have many good qualities, such as creativity, passion, and strength. Noticing and highlighting these positive things can help build their self-worth and give them hope. Remind them of their value and their ability to get through tough times.
Set healthy boundaries
While it is important to be supportive, it is also important to protect your own well-being. You cannot help others if you are drained. This might mean encouraging them to rely on their therapy or support network, or taking a step back when you feel overwhelmed. Your well-being matters too.
Remember, recovery is a journey, not a quick fix. There will be good days and bad days. Sometimes they might self-harm again, and it is important to approach this with understanding and fresh determination, not sadness. Celebrate small successes and recognise the huge courage it takes to face and overcome self-harm.
Final thoughts: Understanding self-harm in people with BPD
Self-harm is a serious symptom of BPD, showing deep emotional pain and a struggle to cope. However, it is also a behaviour that can be managed and eventually stopped with the right support and strategies. Understanding the complex reasons behind self-harm is the first step towards helping effectively. By showing empathy, encouraging professional help, and supporting the learning of healthier coping ways, we can help people with BPD find other ways to deal with their intense emotional world.
It is a long and tough road, but with effort and kindness, healing is possible. There is hope for a life free from self-harm, where people with BPD can learn to manage their emotions, build good relationships, and live a life worth living. Let us keep breaking down the stigma around BPD and self-harm, creating a society where understanding, support, and healing can thrive.
