Being given a diagnosis of Borderline Personality Disorder (BPD), or Emotionally Unstable Personality Disorder (EUPD), can feel heavy, frightening and sometimes shaming. Many people tell me they have felt written off, blamed, or labelled as “too much” by services. You may have had experiences of people, including mental health professionals stepping back when emotions get big or when self harm and risk are part of the picture. 

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I want you to know that I do not see BPD / EUPD as a weakness of character or a broken personality. I see it as a pattern that grows out of real sensitivity, real pain and real experiences in relationships. Your brain trying to keep you safe gives you patterns of relating to yourself and to others. Those patterns can be understood, and they can change.  

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I have worked on NHS emotion regulation pathways and hold a Postgraduate Diploma in Dialectical Behaviour Therapy (DBT). I am experienced in working with intense emotions, self harm and trauma in a structured, compassionate and evidence based way.

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What BPD / EUPD really means

BPD / EUPD is a description of how someone tends to feel, relate and cope over time. Different people will sit in different parts of the picture, but it often includes:

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• Very strong emotions that rise quickly and feel hard to calm

• A deep fear of being abandoned or rejected

• Relationships that feel intense, close and then suddenly distant or conflictual

• Changes in how you see yourself, your values or your goals

• Self harm, suicidal thoughts or other risky behaviours

• Feeling empty, lonely, ashamed or “wrong”

• Dissociation, feeling unreal or detached when stressed

 

For many people, there is often a history of trauma, neglect, invalidation or unstable attachment. The diagnosis does not say that you are the problem. It says that your system has had to adapt to very difficult conditions.

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It is not a flaw in your personality

The old language of “personality disorder” suggests something fixed, faulty and inside you. Personally I hate the name of this diagnosis as by default the terms personality disorder imply that your personality is disordered - it isn't.  What I wish was acknowledged here is that this is a problem with attachments, where there have been experiences of feeling unsafe in relationships that should have been protective.  Modern psychological models look very differently at BPD / EUPD.

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We tend to think in terms of a transactional model:

• There is often an innate sensitivity. You may feel things more intensely, notice more, think deeply and react quickly. None of that is bad.

• There are experiences and environments. For example, growing up around criticism, chaos, emotional neglect, abuse, bullying or sudden changes.

• When a sensitive person grows up in environments where their feelings are not understood, validated or supported, they have to find ways to cope.

 

Over time, the interaction between sensitivity and invalidating or unsafe environments can lead to patterns like self harm, rapid mood shifts or intense fear of loss. These are survival strategies. They may now cause pain, but at some point they helped you get through.

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So instead of “your personality is disordered”, I see it as “your nervous system and attachment system have been working overtime in response to very real experiences”.

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Why so many people feel rejected by services

Sadly, people with a BPD / EUPD diagnosis often encounter stigma. You might have heard words like “manipulative”, “attention seeking” or “difficult”. You may have been bounced between services, or told you are “too risky” or “not ill enough” depending on where you turn.

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There are a few reasons for this:

• High levels of emotional distress and risk can feel overwhelming for professionals who do not feel equipped.

• Services are often set up around short term, single problem treatments, which do not fit well with complex, relational difficulties.

• Old myths about BPD / EUPD still linger, including the idea that people cannot change.

 

My position is very clear. You are not too difficult, too dramatic or too much. You are someone whose system has been shaped by relationships and experiences. With the right support, change is absolutely possible.

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How I work with BPD / EUPD

My approach is warm, structured and collaborative. I draw on DBT, EMDR, CBT, ACT, Compassion Focused Therapy and trauma informed, attachment aware work. We decide together what is most relevant for you.

 

DBT is one of the most researched therapies for BPD / EUPD. It was designed specifically for people who experience intense emotions and self harm.

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DBT brings together acceptance and change:

• Acceptance means really understanding and validating your experience as it is now.

• Change means learning and practising new ways of responding so that you suffer less and live more in line with what matters to you.

 

In our work, DBT skills might include:

• Emotion regulation skills so that feelings become more predictable and manageable

• Distress tolerance skills for crisis moments when you want to act on urges or give up

• Interpersonal effectiveness skills for asking for what you need, saying no and managing conflict

• Mindfulness skills to help you notice thoughts, feelings and urges without immediately acting on them

 

We might use DBT style tools like behaviour chain analyses, where we look carefully at what leads up to an episode of self harm or conflict and identify new options at different points in the chain.

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​Working with trauma, shame and self criticism

Many people with BPD / EUPD carry a heavy load of shame and trauma. You may believe that you are fundamentally bad, unlovable or dangerous to others. You may also have trauma memories that feel raw or easily triggered.

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Depending on your needs and safety, we may:

• Use EMDR to process key traumatic memories, beliefs and body sensations

• Use Compassion Focused Therapy to work directly with shame, self hatred and the inner critic

• Draw on ACT to help you hold painful feelings more gently while moving towards your values

 

This part of therapy is always carefully paced. We do not dive into trauma content without first building strong skills for grounding and stabilisation.

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Managing risk together

Self harm and suicidal thoughts are common in BPD / EUPD. I am used to talking about risk in a direct and compassionate way.

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It is important to be clear that:

• I am not a crisis or emergency service. I cannot hold very high levels of risk on my own.

• If we work together and risk is present, we will involve other professionals or services when needed. This may include your GP, psychiatrist, community mental health teams or crisis services.

• We will create a personalised safety plan, including early warning signs, coping strategies and who to contact when you are struggling.

 

We will talk openly about:

• What self harm and suicidal thoughts mean for you

• What has helped or not helped in the past

• What you need from people around you when you are overwhelmed

 

Wherever possible, decisions about sharing information are made with you and explained clearly. The aim is not to take control away, but to make sure that you are not managing risk completely alone.

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Moving towards a life that feels worth living

Underneath the diagnosis, most people I meet with BPD / EUPD want the same core things as anyone else:

• To feel more steady inside

• To have relationships that feel safe and mutual

• To trust themselves and their decisions more

• To feel less ashamed and more like they belong

 

As therapy progresses, we spend more time on:

• Clarifying your values and what matters to you

• Setting realistic, meaningful goals in work, study, relationships or creativity

• Practising boundaries and communication in real life situations

• Noticing and celebrating small changes in how you respond and how you talk to yourself

 

Change is often uneven and there will be bumps, which is completely normal. My role is to stay alongside you, hold a hopeful, non shaming view of what is happening, and keep us grounded in the bigger picture of your life.

 

Working together

If you have a BPD / EUPD diagnosis, or if you recognise yourself in what you have read even without a formal label, you are welcome to get in touch. You may feel hopeful, sceptical, tired of services or all of these at once.

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In our initial conversations we can think together about:

• Your current difficulties and strengths

• Any risks that are present and how these are currently managed

• What you would like therapy to help you with

• Whether my way of working feels like a good fit for you

 

The aim is not to decide whether you “deserve” help. You already do. It is to see whether we can work together in a way that feels safe, structured and genuinely useful for you.