Book Review: The Buddha & The Borderline

The Buddha & The Borderline

By Kiera van Gelder

Reviewed by Margarita Tartakovsky, M.S.

The Buddha & The Borderline, by writer, artist and advocate Kiera Van Gelder, exposes a regularly hushed-up topic: borderline personality disorder (BPD). BPD is shrouded in stigma. There’s little information about the disorder and, while effective treatments exist — namely dialectical behavior therapy — it can be tough to find a mental health professional who’s educated and experienced in administering them.

If you’re someone with BPD or a loved one of someone with BPD, you probably already know this. The devastation this disorder causes is immense but the misunderstanding and lack of treatment may be just as heavy. With The Buddha & The Borderline, I believe that you’ll find relief, reputable information and hope. It’s far from an easy read. But it’s real, authentic and truly valuable.

In this memoir, Van Gelder documents her diagnosis, treatment and recovery from BPD. She begins the book when she’s 30 years old, when she’s already attempted several times to take her own life, gone through a handful of hospitalizations, been diagnosed with depression, anxiety and post-traumatic stress disorder and recovered from alcohol and drug addiction. She is in the arms of yet another boyfriend, attaching herself to him in such a way that she loses herself completely. (She writes later in the book: “If Taylor were gone, it would be like pulling the plug in a basin that holds all the shapeless, turbulent liquid of my life. I would drain away.”) This is a pattern: With every boyfriend, her identity, her musical tastes, how she dresses, what she believes tend to change. Yet she doesn’t know why. After each relationship ends, she starts searching for another savior. 

Van Gelder desperately wants to find out what is wrong because as she writes, “…despite being clean and sober for almost a decade, I’m still a mess.” For almost two decades, she’s been in therapy. She has tried various types of treatments, medications and 12-step programs, but yet nothing seems to be working. 

When she’s finally diagnosed at a local hospital, Van Gelder witnesses firsthand the stigma, shame, myths, insurance woes and unavailability of treatment. Yet even as she’s struggling with out-of-control symptoms and suicidal urges and grappling with such a stigmatized diagnosis, Van Gelder continues fighting. Her initial motivator? Rage. She writes:

Ultimately rage, not hope, hurls me into recovery when I finally understand that it’s not simply my illness, but incompetence and avoidance from the mental health system that has created my ‘incurable and hopeless’ condition.

This book is a must-read for several reasons. One of the main reasons is that Van Gelder demystifies BPD, clearly defining the symptoms both from a scientific level and a personal one. She writes about deeply intimate slices from her life so readers receive an inside look into what it’s like to have BPD. This is very uncommon, as BPD is largely marred in mystery in our society. The public gets very little solid information about what this disorder really looks like. 

Van Gelder also addresses her loved one’s denials of her diagnosis — also common. In the beginning, her mom repeatedly questions her being “mentally ill.” In a therapy session with her mother, Van Gelder says:

But why can’t you take my mental illness seriously? I feel like I’ve been set up, over and over. Like I’m a cripple without a wheelchair, and everyone keeps signing me up for marathons, then shaming me for not winning the race.

She also faces similar frustrations as she tries to share information about BPD with her grandparents:

Indeed, I discover that the less I say, the happier everyone seems to be with me. I sometimes wonder if I wouldn’t have been better off as a paraplegic or afflicted by some tragic form of cancer.

Secondly, she demystifies dialectical behavior therapy (DBT) — a treatment developed by Marsha Linehan, Ph.D., which has scores of research studies to back up its effectiveness — and informs the reader in great detail about this treatment. So while this is a memoir, it also serves as a valuable teaching tool. Loved ones and individuals with BPD will benefit from learning about their options and the nitty-gritty of DBT, which like BPD itself, many people have no clue about. Therapists and graduate students also will learn a lot.

Relying on research studies and books on DBT, Van Gelder quotes Dr. Linehan (and other experts) and describes the theories, goals and techniques of the treatment in layman’s terms throughout the book. As she gives readers the theory behind each step, she illustrates this in relation to herself and her therapy.

For instance, DBT focuses on the concept of dialectics, which on a practical level is, according to Van Gelder, “…what happens when opposites combine to create something new…On a deeper level, dialectics is a viewpoint that recognizes reality and human behavior as fundamentally relational.”

Throughout the book, Van Gelder tries to reconcile the opposing parts of herself. Can she really resist something and long for it at the same time? Can she be healthy in some ways but still lack a secure sense of self? 

Interestingly, the book, too, mirrors this dialectical nature. It’s painful, frustrating and potentially triggering while being uplifting, soothing and hopeful.

In the last part of the book, Van Gelder discovers Buddhism and explores how it applies to BPD and her life (dialectical behavior therapy is actually based on Buddhist philosophies). Just as she does throughout the book, in the end, she provides several profound insights. 

In addition to the perceptive content, Van Gelder’s writing is beautiful and heartbreaking. Van Gelder is a gifted and eloquent writer, and readers will instantly get pulled into her story. 

As mentioned briefly above, parts of the book may be triggering to some readers. Van Gelder writes poignantly and often in-depth about painful experiences, including her cutting, suicidal urges and sexual abuse. So while this level of detail may be necessary for readers to gain a better grasp of BPD’s desperation, confusion and grief, it can have a negative effect on someone who’s vulnerable. 

As much as this book is about seeking the correct diagnosis and the struggles of recovery, The Buddha & The Borderline is also about Van Gelder’s journey to find herself and lead a life worth living — the ultimate goal of DBT. Even though this is a memoir, it’ll no doubt echo the stories of other sufferers and help readers better understand BPD and its treatment. 

The Buddha and the Borderline: My Recovery from Borderline Personality Disorder Through Dialectical Behavioral Therapy, Buddhism and Online Dating
By Kiera van Gelder
New Harbinger Publications: August 2010
Paperback, 246 pages
$17.95

I Am No Longer My Illness, I am Elizabeth Charlotte Bogod.

Thank you so much to Elizabeth who sent her story to our email address, BPDaware@hotmail.co.uk

You can share your story with us - anonymously if you wish - and help give insight into our illness. 

Don’t Call Me Borderline!

This was my initial reaction when I first learned that I have commonly misunderstood mental illness called Borderline Personality Disorder (BPD). Unlike, Depression, Schizophrenia or Bipolar Disorder few people have heard of my illness and it is only just beginning to come into the light as far as advocacy and awareness are concerned. 

I am among the many millions of people with this disorder (2-3% of the population). Like Schizophrenia, BPD is a devastating mental illness and is usually diagnosed in adolescence or early adulthood. In my case, it struck very young, probably around puberty, but I was not diagnosed until twenty six years of age. For more than ten years of my life I struggled to get well. It has only been in the last four years that I have found true health and wellbeing. I am doing wonderful now! 

There were many times when I honestly thought I would never get better – I gave up hope. I became suicidal. I seriously attempted suicide nine times. These attempts were serious yet impulsive acts and extremely hard on my family who never knew if they would come home to find me dead or alive. This was before mental health professionals learned that BPD is actually a highly treatable mental illness!

During my illness, I suffered from typical BPD symptoms. I had great difficulty regulating my emotions (especially in relationships with others). I was very impulsive and self-destructive. I engaged in self-injury where I cut or burned my skin to get a sense of relief from emotional pain. I had uncontrollable bouts of rage either aimed at myself or others. I lost a lot of friends during this period and my family did not know how to help me although they tried their best to be emotionally supportive. I also experienced severe depression and feelings of being completely empty. I felt like a burn victim – my skin so raw I lacked the “emotional skin” to cope with, what others would consider the normal everyday trials and tribulations of life. At times, I did not know who the person looking back at me in the mirror really was – I thought I was a bad, evil and despicable person although I had never committed a crime and by many accounts was a caring, thoughtful and highly-sensitive individual. At other times, I dissociated from reality. I felt numb or unable to feel. For prolonged periods of time, everything around me looked and felt fake. On one day, I remember multi-coloured fall leaves blowing by that looked like plastic – nature was ugly and lacked any meaning or beauty. I felt as if I was living in a doll house where nothing around me was real. At other times, I heard voices in my head telling me “You are worthless, you are worthless...” over and over again.

I went to Toronto in search of treatment that I could not find in BC at the time. Unfortunately, although I got on the waiting list for Dialectical Behavioural Therapy, I never got into the program despite waiting nine months. In the end, I ended up homeless and lost in the shelter system unable to find treatment. Finally, my living situation became so unbearable it was impossible for me to continue waiting. I decided to come home where my parents were living with stable housing. 

As for my recovery, I was finally hospitalized in Victoria with severe depression. After two month of hell my psychiatrist landed on the right medications for me – a combination of mood stabilizers and antipsychotic medication. At last, through medication and self-taught Dialectical Behavioural Techniques ( DBT) I found peace within my mind. These techniques help me manage my emotions. They help me tolerate difficult emotions so I don’t act on them and cause myself further emotional distress. Now that my mood swings were regulated I felt ready to go to college. I am now a certified Community Mental Health Worker. As a Peer Support Worker (PSW) at a local mental health agency, I work both one-to-one and in groups with people who have mental illnesses. With the help of a young woman with BPD and our mothers, I have started a local support group for people with BPD and family members http://bpdsupportgroup.wordpress.com  I also co-facilitate a psychoeducational workshop for those with overwhelming emotions (cross-diagnosis) called the New Light Recovery Workshop where participants learn Dialectical Behavioural Techniques (DBT).

But, I am no longer my illness. I am a daughter, a sister, a team-member, a facilitator, an artist, a public speaker, a volunteer, a passionate person, a caring person, a nature lover (I see beauty again!), an animal lover,  an advocate, a spiritual person,  an avid novel reader, a bell collector, a person who knows me well... I am Elizabeth Charlotte Bogod.

As an advocate, I urge everyone who reads this article to join the advocacy movement to bring BPD out of the darkness where stigma festers and grows. The term BPD says little about the true nature of this illness. It does not reflect the core symptoms – emotional dysregulation and impulsivity and in my experience, has led to increased stigma, misunderstandings and the all horrible self-stigma that slowly erodes the soul. To be told I had a “personality disorder” (especially when I was most vulnerable and hurting) was to be told there was something intrinsically wrong with the essence of my being – my whole identity and personality flawed. There is currently a move to change the name and designation of BPD in the next publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Possible new names include Emotional Regulation Disorder, Emotional Processing Disorder and Emotional Deficit Impulsivity Disorder. You can help!!! Please sign the following petition to bring BPD into the light! http://www.thepetitionsite.com/1/Advocacy-for-Borderline-Personality-Disorder

"I Did Not Write This, But I Could Have" Author Anon.

We have come upon another of those heartwarming pieces of writing that give our friends and relatives insight and help us to feel less alone in how we think and act. The author of this piece is anonymous but the sentiment is extremely familiar. If you would like to share your experience of BPD, whether diagnosed or carer, send it to bpdaware@hotmail.co.uk.

You wanted to know the worst about me, the things I told no one and hid below the surface. How do I explain it? How do I explain who I am when I am not even sure of it myself? How do I put into words the worst parts of me that I have run from for so long? I will tell you my secrets, I will tell you everything. Maybe it will help me. Maybe you will hate me for it or maybe you will understand. I don't know, but I am sick of running. So here it is, I will give you what you want.

I hate you. That is not true, but sometimes I think it is. I will not answer the phone when you call, even though I want to talk to you. I will not call you, even though it is all I want to do. I will not reach out to you, even though every part of me wants to. I will be mad at you, I will want to hurt you, I will drive you away because I am afraid to let you closer. I need your constant attention, your reassurances, but I will greet them with cold indifference. I will be jealous of the attention you give others, and I will get mad at you for ignoring me. I will feel close to you and care for you one day, only to be mad and want you out of my life the next.

I am an emotional amnesiac, maybe I always have been. I take each event, each day, each conversation as a seperate event, always looking for signs that you might hurt me. When I feel neglected, I will get mad and forget that the day before you told me how much you cared. I am an inconsistent mess. There is a part of me who is happy and confident and another part that is insecure and needy. These days, I never know which one it will be. Every time I think I am in control, that I know you care and I feel comfortable with our relationship, the fear and doubt will come back. Maybe with time it will go away completely, but doubt it. All it will take is another close relationship, another new friend, another day and it will be back.

You ask what you can do and I do not know what to say. The needy part of me wants your constant attention, it needs your words and thoughts, your presence. But I know that is not the answer, I must accept the limitations on our relationship. The scared part of me wants you out of my life because it would be easier. The hateful part of me wants to hurt you because it thinks you have hurt me. All I can ask you to do is to understand, to not give up. I will ignore you at times, I may be rude to you, I may try to hurt you. I may hide from you and wait for you to reach out to me, so I know you will care. It is not fair to do these things, but I will. I cannot ask you to put up with this, it is not fair and no matter how I act, I care too much to put you through this. But you asked, and this is all I have to tell you.

I do not like this. I do not like that I am needy and clinging. I do not like that I hurt people. I do not like that I am rude and sarcastic to those around me. I do not like this part of myself. For years, I have ignored this and pretended it was me, but I have realized that is wrong. This is not me, it is a false identity created to protect me from the world. This was not an easy realization, and perhaps I haven't fully accepted it yet. But I have found my path, I have realized I can change and I can accept this side of me and keep it from becoming who I am. It will not be easy and it will not be quick, but I have faith that I can do it. Perhaps one day I will see me as the person you see behind my defenses, and perhaps one day I will let others see that person as well.
This is for you, but you are many people. You are the people close to me now. You are the people I want to be close to even though I have kept you away. You are the friends I have pushed away in the past, the friends I never forgave and never let back in my life, the friends I never had the chance to tell this to. You are the people I will meet in the future, the people I will care about until once again I push them out of my life. You are the part of me that is still trying to understand who I am. You are all of these people and many more.

A Capitalist Take On Mental Health

This is an article by a member of the Socialist Party of England and Wales. They are talking about how they believe capitalism influences mental health problems and treatment, and the answer to the problems they believe capitalism poses. This is not necessarily our view, it is just one of many views of BPD worth discussing in order to learn more and understand more.

At Socialism 2010 I went to the session on Mental Health and Capitalism and I asked if I could feed back from it. This is a summation of the talk and discussions we had.

The speaker, Steve Bell, a mental health nurse and a Unison Service Group Executive, explained that he felt that mental illness is actually a sane reaction to the craziness of capitalism. Mental health problems are a natural reaction to stresses in our lives.

Everyone has stresses in their lives, but not everyone goes on to suffer mental health problems because of this. However, one in four people do experience some sort of mental illness during their lives. The sorts of stresses people have include neurological trauma pre-birth, during birth and in the vital months after birth, childhood abuse of any kind, bullying, existential and identity concerns during puberty and for women, often, pregnancy. 

There are also the stresses that are more explicitly linked to capitalism. Housing concerns, work stress, being downtrodden by management, long hours, banal jobs, underpayment, difficulty finding a job, lack of job security, lack of free time, lack of money to enjoy social activities, lack of sufficient childcare and education for one’s children... and all the other problems we often discuss. These stresses are increasing, especially in the current climate, and so too is the prevalence of mental health problems.

What a person with mental health problems essentially suffers is the reliving of these stresses over and over again every second of the day. Their body is shot by the stress and their mind is battered. The links between the mental and physical aspects of mental illness are shown in the cognitive behavioural model. In it, there is a triangle of factors that affect or are affected by mental ill health. They are behaviour, thoughts and feelings. For example, behaving in a negative way reinforces the person’s idea that they are a bad person, and this in turn makes them feel depressed. Feeling depressed they end up behaving negatively again. This makes them feel worse and thus reinforces their idea that they are hopeless. The cycle goes on, but can be broken.

The treatment of such illnesses is often a subject of heated debate by those on the left, with the ‘Big Pharma’ and all medication often being seen as entirely negative, and the anti-psychiatry movement resenting even the diagnosis of such problems as a way of labelling someone incurably ill. None of this, however, is a balanced reaction to the real problems. Medication IS effective in helping those with mental health problems. It tackles the ‘feelings’ bit of the cognitive-behavioural model – thus calming and stabilising the patient enough to be open and responsive to therapy. Talking therapy can then challenge the thought and behaviour patterns, and all together the medication and therapy can help to dramatically reduce the impact of the mental health problem on the person’s life, or, even, to cure it.

However, there is a problem with medication and the ‘Big Pharma’. And there is a point to be taken from the anti-psychiatry movement who resent labels that seem to give people a hopeless diagnosis of a seemingly perennial disease. There are two factors to this. The first is the link between pharmaceutical companies and the mental health practitioners. The companies want the practitioner to prescribe more and more drugs. 

Mental health problems are encouraged by the market to be treated with ‘medication, medication, medication!’ If one drug doesn’t quite work, they’ll throw another one in to balance the side effect, and then another for the side effects of that if necessary too. Most mental health patients are over-medicated. At the other end of the problem is the lack of therapy being offered by the NHS. Without therapy a diagnosis may seem like a life-sentence. Without therapy mental health problems can be seen as a weakness that someone has been labelled with forever. The anti-psychiatry movement no doubt gain momentum from the fact that the status quo is not to offer therapy. Therapy is expensive to the NHS and can take years to be effective to the state of a patient being considered ‘cured’ of their mental illness. In fact, when you ask a GP for counselling or therapy, they will no doubt refer you to a charity who is doing the government’s work for them, or to a private therapy company that the government is funding to do the job of the NHS for less. 

Of course, without the stresses of a capitalist society, there would be a lot less mentally ill people needing such services. Without imperialist wars there would not be another generation of ‘shell-shocked’ soldiers with PTSD. There would be suitable homes for all. Jobs for all. A good wage. A good and free education. Crime would no doubt have fallen. Drug abuse would be lower. However we cannot hold up socialism as a plaster to the wound – it would be an insult to those currently suffering. We cannot say ‘join the party, bring in the revolution, then you’ll be ok!’ Instead our demands and efforts need to be transitional.

We need to protest, lobby, petition, inform and even strike for the good of the mentally ill. Cuts to the NHS and to disability benefits can hit the mentally ill the hardest. Cuts to services such as talking therapies will see more over-medicated but under-therapised patients who see no future ahead. The mentally ill will fall foul of ‘fit to work’ initiatives due to nonspecialist practitioners seeing no visible symptoms of their problem and thus declaring they must seek work or their benefits be ceased. We need to fight the closure of acute mental health wards. We need to resist the privatisation of mental health services. We need to stand by the NHS workers when they strike. We need to fight against cuts to DLA and ESA. That way we can truly stand by the mentally ill and fight capitalism together as one.

Is there a link between politics and mental health? Is capitalism really the enemy or is socialism a far greater threat to health and the health service?  

Mind and Soul

Is belief in God a big part of your journey with BPD? Have you found that your religious beliefs have comforted you through the tough times? Or has your faith community let you down, not knowing how to treat someone who is mentally ill? Perhaps you have been told that your disorder is a result of sin, or demons? Maybe you see your symptoms in a spiritual light, and the the fluctuations of energies that you experience as a manifestation of a higher power?  Here, Paul tells his story of childhood sexual abuse, Borderline Personality Disorder and christianity. If you want to know more about a christian mental health perspective, visit Mind and Soul, a website exploring christianity and mental health. I was sexually abused as a child. It went on for approximately six years. It had a very big effect on me. I found it very confusing. My parents provided a stable home environment and cared about me. Like many people, communication between my self and my parents was not very good. My parents did not know I was being sexually abused. I told them about it when I was an adult. They both believed me when I told them which I found very helpful. I did not feel able to tell anyone about it at the time. The person abusing me told me that if I told anyone I "would go to Hell", which was quite a deterrent to a ten year old. As I grew up I had this "big secret", about an adult having sex with me, which I felt I could not tell anyone about. I started to have very strong feelings and troublesome thoughts about the whole situation. I felt very guilty about what was going on. I felt very ashamed of my self. I felt very angry. I felt deeply resentful towards my abuser. I also had confusing and contradictory feelings, for example sometimes I liked the attention and some bits of the sex. This would confuse me further. The person abusing me seemed to really enjoy the power they could have over me. They would repeatedly tell me how wrong this activity was and stop it, for a few days, and then they would start it all up again. This repeated acceptance and rejection over and over again really 'did my head in'. This went on for years. I also had increasingly high levels of anxiety and a constant fear of being found out. I started to hate my self and struggle with suicidal, violent and self-destructive thoughts and impulses. During this time I appeared fairly normal to the outside world. My grades fluctuated a lot. When I got to thirteen I discovered alcohol and some drugs and gambling. I found if I did these excessively and impulsively then the really bad mixture of thoughts and feelings in my head would go away for a short while, only they always came back and my repetitive excesses caused me and those around me increasing problems. I ended up spending four months in a rehab for alcohol dependency when I was nineteen. I joined A. A., did their 12 step program and stayed sober for five years. I tried two years of psychotherapy. I went to university and got a first class honours degree and started teaching at university. However I still felt very hurt and troubled inside and struggled with suicidal thoughts. Nothing seemed to solve my inner turmoil. I returned to drink and drugs, and became addicted to amphetamines. Sometimes I stopped drink and drugs for weeks or months but found my problems stayed the same. I had difficulty forming relationships as they caused me great anxiety and I found it difficult to manage my feelings such as resentments, fear, low mood, violent thoughts, loneliness, envy, shame and guilt. I spent the next four years in and out of the psychiatric hospital in Bradford. I lived a very self destructive lifestyle. I was given lots of medication and diagnosed with bi-polar disorder, then psychotic depression and finally with "Borderline Personality Disorder". No one explained what this meant. Sometimes I took overdoses or cut my self. I felt utter despair. Then I overheard someone called Barry telling someone that Jesus had died to set them free from all their wrongs and had risen from the dead so they could be 'born again' into a 'new life'. I suddenly thought, "it's true" and I knew I needed to be 'born again'. I then joined a church. The best thing was that I was accepted into a home group and the people really seemed to care about my well being and believed I could get better. I felt I belonged somewhere instead of being an outsider. I worked through the 12-1/2 Steps to Spiritual Health, outlined in a book the vicar (Howard Astin) had written. This was just basic Christian practice: I admitted that I did not have the power on my own to sort out the serious set of problem habits I had. I asked Jesus to be the Boss ("Lord") of my life from now on. Barry prayed for me to be filled with the Holy Spirit, this gave me the power to live out this new way of life. I then admitted every thing I had ever done wrong in my life, wrote it down and shared it in confidence with two other Christians who I had come to trust (Barry and John). I admitted all the problem habits I had formed in reaction to being abused (self hatred, addictions etc.), I then turned away from my previous way of life and believed God had forgiven me. I also shared all the hurtful and damaging things that had been done to me with these two men and forgave anyone who had hurt me, including the person who had sexually abused me. This was a great relief. I then was prayed for to be healed of the hurts of the past. I do not think I could have been healed without admitting my wrongs, turning away from them and forgiving the wrongs of others towards me. I then have spent the next seven years living out my salvation and growing and maturing in line with God's word (the Bible). I got and continue to get a lot of support from my church. I started dating for the first time in ten years and have since married my wife who is a great blessing and loving support to me. I also have two step children. I came off benefits and am now in full time employment working with clients who have a "Personality Disorder" diagnosis like I had. I enjoy life and feel fulfilled. God has been very good to me and I want to share some of his love with others. Jesus promised that he had come to give us new life to the full, and he has. Along the way have been many struggles as I have had to submit to God's will and not my own. I love 'the new way of the Spirit' and am glad the power of the evil one was broken by the power of Jesus' resurrection from the dead. I was 'dead' in my spirit but rose again with Jesus! Praise be to God, who has the power to transform people's lives.

BPD Survey

American charity, Love Is The Cure, are running a survey at the moment and need as many people with BPD as possible to take it in order to get the best results. There is a link to their website in our side bar and the results will be made known in due time.

www.kwiksurveys.com/?s=HHOMNO_9e65258


Thank you ever so much for helping us to help them.

BPD Relationships - I Hate You, Don't Leave Me

Unstable and intense interpersonal relationships are taken by some to define the life of the borderline. Those with BPD swing from extremes of ideation to devaluation, or, in simpler terms, are renowned for pushing away those they are desperate to draw close to. But are relationships always doomed to fiery burnouts for those with the disorder?


Many psychiatrists see that a stable, loving relationship can be the catalyst to a 'cure' for someone with BPD. A partner who can't be pushed away, won't let words said in fear of loss make them actually lose them, and won't believe that things will never get better can be the stability and unchanging rock that a borderline needs. Extremity can be tempered by a calm presence and irrationality needs a rational, listening ear to be comforted, confronted and changed.


For many, such a stable relationship has never materialised. They learn instead that if they push hard enough, one time they will push too far. They see that they can at least control the pain by being the one to bring it, rather than waiting for the other person to do the seemingly imminent breaking up of the relationship. They see that their fears of losing those they love become realities time and time again. They become closed off to the idea of love when love could be the cure.


This highlights yet another reason why greater awareness and understanding of BPD is needed. When the person that a borderline is in a relationship with truly understands why they are behaving as they are, it is much easier for them to rationalise it, not be pushed away by it, and even challenge it and comfort the concerns causing the person to behave in such a way in the first place. But whilst there is still ignorance about the disorder and while people still believe that once a borderline is always a borderline, the sufferer will be reinforced in their sense that they are and can be their own worst enemy.