Understanding Romantic BPD Relationships

Couple arguing in bed
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Borderline personal disorder (BPD) relationships are often chaotic, intense, and conflict-laden, and this can be especially true for romantic BPD relationships. 

If you are considering starting a relationship with someone with BPD, or are in one now, you need to educate yourself about the disorder and what to expect. Likewise, if you have been diagnosed with BPD, it can be helpful to think about how your symptoms have affected your romantic relationships.

The Affect of Symptoms

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the resource mental health professionals refer to when making a diagnosis, symptoms of BPD include "intense, unstable, and conflicted personal relationships." 

In essence, people with BPD are often terrified that others will leave them. However, they can also shift suddenly to feeling smothered and fearful of intimacy, which leads them to withdraw from relationships. The result is a constant back-and-forth between demands for love or attention and sudden withdrawal or isolation.

Another BPD symptom that particularly impacts relationships is called abandonment sensitivity. This can lead those with BPD to be constantly watching for signs that someone may leave them and to interpret even a minor event as a sign that abandonment is imminent. The emotions may result in frantic efforts to avoid abandonment, such as pleading, public scenes, and even physically preventing the other person from leaving.

Another common complaint of loved ones in borderline relationships is lying. While lying and deception are not part of the formal diagnostic criteria of BPD, many loved ones say lying is one of their biggest concerns; this can be because BPD causes people to see things very differently than others.  

Impulsive sexuality is another classic symptom of BPD, and many people with BPD struggle with issues of sexuality. Also, a large percentage of people with BPD experienced childhood sexual abuse, which can make sex very complicated.

Finally, other symptoms of BPD, including impulsivityself-harm, and dissociative symptoms, which can have an indirect impact on borderline relationships.

For example, if a loved one with BPD is engaging in impulsive behaviors like going on spending sprees, it can cause major stress within the family. In addition, suicidal gestures can be scary for romantic partners and can introduce lots of stress into the relationship. 

What Research Says

You may be surprised to learn that scientific research has confirmed that people with BPD tend to have very stormy romantic relationships characterized by a great deal of tumult and dysfunction. For example, one study demonstrated that women with BPD symptoms reported greater chronic relationship stress and more frequent conflicts. Also, the more severe a person’s BPD symptoms are, the less satisfaction their partner reports.

In addition, research has also shown that BPD symptoms are associated with a greater number of romantic relationships over time, and a higher incidence of unplanned pregnancies in women.

People with BPD also tend to have more former partners and tend to terminate more relationships in their social networks than people without personality disorders. This suggests that romantic relationships with people with BPD are more likely to end in a breakup.

Finally, in terms of sex, research has shown that women with BPD have more negative attitudes about sex, are more likely to feel pressured into having sex with their partner, and are more ambivalent about sex than women without BPD. Unfortunately, no research has been done on sexuality in men with BPD.

Starting a Romantic Relationship

Given all the difficulties that exist in BPD relationships, why would anyone start a relationship with someone with the disorder?

First, it's important to remember that despite these intense and disruptive symptoms, people with BPD are frequently good, kind, and caring individuals. Often they have many positive qualities that can make them great romantic partners some of the time.

Furthermore, many people who have been in a romantic relationship with someone with BPD talk about how fun, exciting, and passionate a BPD partner can be. Many people are drawn to a BPD partner precisely because people with BPD have intense emotions and a strong desire for intimacy.

Can You Make a Romantic BPD Relationship Last?

Most BPD relationships go through a honeymoon period. People with BPD will often report that at the beginning of a new romantic relationship they put their new partner “on a pedestal” and sometimes feel they have found their perfect match, a soul mate who will rescue them from their emotional pain. This kind of thinking is called “idealization.”

This honeymoon period can be very exciting for the new partner too. After all, it's really nice to have someone feel so strongly about you and to feel as if you are needed.

Problems start to arise, however, when reality sets in. When a person with BPD realizes that her new partner is not faultless, that image of the perfect (idealized) soul mate can come crashing down. Because people with BPD struggle with dichotomous thinking, or seeing things only in black and white, they can have trouble recognizing the fact that most people make mistakes even when they mean well. As a result, they may quickly go from idealization to devaluation (or thinking that their partner is a horrible person).

The key to maintaining a relationship with someone with BPD is to find ways to cope with these cycles and to encourage your BPD partner to get professional help to reduce these cycles. Sometimes partners in a BPD relationships are helped by couples therapy.

Managing a Romantic Relationship

In addition to couples therapy, for the person with BPD, there are therapies that have been shown to be effective in terms of helping with relationships:

Dialectal behavior therapy (DBT) 

DBT is a form of cognitive behavioral therapy that relates a person's thinking to their behavior.  There are four main skills taught in DBT, and one of them is managing interpersonal skills.

Mentalization therapy (MBT) 

MBT is a therapy that entails examining your present emotions and then seeing how they are linked to your behaviors or actions. 

Medications 

There are currently no medications approved to treat BPD, but they are sometimes prescribed by doctors to help improve interpersonal relationships. Research suggests that certain medications can help a person manage their anger, impulsivity, and depression. On that note, though, it's important to weigh carefully the side effects of a medication with its potential benefit.

Breaking Up A Romantic Relationship 

Many issues may arise when a BPD relationship is ending. Because people with BPD have an intense fear of abandonment, a breakup can leave them feeling absolutely desperate and devastated. Even if a relationship is unhealthy, a person with BPD can often have trouble letting the relationship go. This is particularly true of long-term partnerships or marriages.

This is why it's a good idea to have a support network for you and partner, especially if a break-up may occur, and this network often includes a mental health professional and/or therapist.

A Word From Verywell

On a positive and final note, please remember that the prognosis for BPD is good. This means that while most people with BPD do experience residual symptoms even after time and treatment, in the long term there is hope that your relationship with your loved one can work. 

Sources:

American Psychiatric Association. "Borderline Personality Disorder". Diagnostic and Statistical Manual of Mental Illnesses, 2013.

Bouchard S, Godbout N, Sabourin S. Sexual Attitudes and Activities in Women with Borderline Personality Disorder Involved in Romantic Relationships. J Sex Marital Ther. 2009;35(2):106-21.

Clifton A, Pilkonis PA, McCarty C. Social Networks in Borderline Personality Disorder. J Pers Disord. 2007 Aug;21(4):434-41.

Edel, M., Raaff, V., Dimaggio, G., Buchheim, A., and M. Brune. Exploring the Effectiveness of Combined Mentalization-Based Group Therapy and Dialectical Behaviour Therapy for Inpatients with Borderline Personality DisorderBritish Journal of Clinical Psychology.  2017 Mar;56(1):1-15.

Hill J et al. Attachment, borderline personality, and romantic relationship dysfunction. J Pers Disord. 2011 Dec;25(6):789-85.

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