Have you helped an employee with Borderline Personality Disorder?

It’s hard to find positive case studies about the workplace and individuals with borderline personality disorder (BPD). This illness is often misunderstood and maligned. Yet there are plenty of good news stories out there—they just don’t get published. So this piece is an overview of the symptoms, and offers a couple of tips to help you to do the right thing by your organisation, your employee and the team.

What are the symptoms?

The symptoms can be heightened under stress, and include four main areas:

  • emotional instability – strong emotions, poor concentration
  • disturbed patterns of thinking or perception – sometimes called “cognitive distortions”
  • impulsive/reckless behaviour
  • intense but unstable relationships with others.

Having said this, it’s important to bear in mind that, as with other mental illnesses, BPD can present itself in different ways. You should also try to see any personality disorder on a spectrum:  for example, we all use cognitive distortions to some degree—think “jumping to conclusions” or “all-or-nothing-thinking;”  and many of us can act impulsively from time to time.

Unsurprisingly, people feel the BPD label is stigmatising because personality represents who we are. It’s about our pattern of thinking, feeling and behaving: and when an individual is labelled as having a “disorder” of personality it implies that there is “something wrong with them.”

Yet, rather than asking ourselves “what is wrong with them?” we should be saying “what happened to them?” because the majority of individuals with a diagnosis of BPD have experienced early childhood trauma. We’re not sure why the two are linked, but it does mean that thoughts, feelings and behaviours create enduring difficulty in day to day life.

A double dose of stigma

We all know of the stigma surrounding mental illness in the workplace. It is hard for an employee to be open about depression or anxiety for fear of being judged. How much harder it is, then, for an employee to disclose a diagnosis of BPD. Yet this illness is often the result of childhood abuse—which in itself gives rise to feelings of shame.

First of all an employee will fear being judged because of their childhood abuse, and second they may fear being judged for the consequence.

How you can help

Don’t be afraid of getting it wrong: showing that you care and being non-judgmental can go a long way. If your employee is experiencing difficulties and you bury your head in the sand you’ll be storing up problems for the future.

Therapy

First off, you should find out if the individual has ever received appropriate therapy. This is essential if you’re witnessing conflict or poor interpersonal relationships: it’s no good saying  “they should know better”—after all, you wouldn’t tell someone with depression to “pull their socks up”.  An individual with BPD needs help to manage their symptoms.  If you have an EAP, be aware that brief therapeutic interventions may not be appropriate—indeed the NICE guidelines indicate that brief interventions (less than 3 months) should be avoided.[i]

The illness does not excuse bad behaviour

Your employee is not the sum of their diagnosis. With understanding, individuals diagnosed with BPD can flourish in the workplace. We’re not saying that BPD can excuse poor performance, but it can help you to understand.  You can try things like being flexible with hours if the work allows, or asking an employee what situations or scenarios can provoke symptoms.

Process and clarity. Always!

We can’t overstate the importance of transparency and sticking to process, and seeking advice from your HR department. You must also remember that a personality disorder is a mental health condition as defined by the Equalities Act (2010).

Be consistent and clear

When emotions run high, it’s important to have boundaries. This follows from the above: you must be consistent and really clear about what you expect from your employee—follow up with reviews and keep written records of agreements.

Awareness

People with a personality disorder often experience other mental health problems, for example, depression, bipolar disorder, eating disorders and substance misuse (including both alcohol and drugs). You should also be aware that individuals who were abused as children also risk being victimised in adulthood—for example, experiencing domestic violence.

Further information

The Thrive portal provides employers with inclusive solutions for mental well being in the workplace—and do contact us or email team@goddardconsultants.com for advice!

Final word

Individuals with a diagnosis of BPD have tremendous resilience and courage. Imagine you’ve experienced and survived trauma in your childhood. You have spent years living with shame and rejection. You may have tried many ways to cope with your distress—drugs, alcohol, binge eating, suicide. And in spite of what life has thrown at you, you want to work. Not only that, you can work and be an asset to your organisation.


Notes
[i]Borderline personality disorder: recognition and management | Guidance and guidelines | NICENice.org.uk. (2009). Borderline personality disorder: recognition and management | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg78/chapter/1-Guidance#assessment-and-management-by-community-mental-health-services [Accessed 21 Aug. 2018].

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