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Amanda L. Smith, LCSW

900 Austin Ave
Waco, TX, 76701
941.704.4328
Borderline Personality Disorder, Self-Injury, and Emotional Dysregulation

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Amanda L. Smith, LCSW

  • About Me
  • Consult with Me
  • Help for Families
  • Books and Articles
  • DBT Self-Help
  • Blog

The Power of Natural Consequences: Family Help for Borderline Personality Disorder

May 30, 2023 Amanda Smith

In dialectical behavior therapy (DBT), we often think about the wisdom of allowing natural consequences to occur as a way to help facilitate change. This is the opposite of stepping in and trying to fix something that isn't ours to fix.

Many years ago, I had a smart young adult client who had three speeding tickets in one semester. I think that she had four tickets in the first six months of working with her. Each time she told me about a ticket, I would say something like, "Wow. Speeding tickets are so expensive. Will you complete the defensive driving course to reduce the fee?" I remember that my client would look confused and tell me, "I'm not paying the ticket. I gave it to my parents, and they paid it."

Several years later, something similar happened with a wonderful adult client in her late 20s. She had been in a minor car accident where, thankfully, no one was hurt but she received a citation for reckless driving. When I asked about a defensive driving course to offset the fees associated with the citation and potential increase in car insurance costs, my client said, "I'm not doing that. My husband will just pay it." I, however, saw the car accident as an opportunity for my client to increase her self-respect by taking responsibility for an accident she caused—without any excessive shame, guilt, or embarrassment.

While these examples aren't specific to the diagnosis of borderline personality disorder nor any personality disorder for that matter, they demonstrate an attitude that is not always conducive to emotional health and the goal of taking responsibility for our actions.

When we do for others what they can do for themselves, we send a message that may invalidly communicate:

·    You are helpless.

·    You need my help.

·    You are not responsible.

·    You are not trustworthy.

or

·    I need to take care of you.

This type of invalidation is the opposite message I want for my clients to be receiving from family members, friends, work colleagues, and employers. I'm working hard to send the message, "You are responsible for creating a life worth living. No one can do this work for you!"

A life worth living isn't just about increasing our capacity for joy, meaning, or connection. It also means that we use our DBT skills to help ourselves do the hard job of "adulting" and taking on challenges that will help us to become more independent and self-sufficient.

Many of my terrific clients take these steps on their own, but others may need a gentle nudge toward a temporary uncomfortableness that may only last for a few minutes at a time. The relatively boring (but often stressful) task of paying a speeding ticket or traffic citation may be such a catalyst for many other acts of responsibility and self-care.

When we ask people to take small, reasonable steps to care for themselves and others, we validate them by communicating, "You can do this. I believe in you."

That nudge toward the uncomfortableness of natural consequences is not meant to be:

• punishing or punitive

nor

• a way to throw your loved one into the deep end of the pool so that they almost drown.

Natural consequences, when we allow them to occur, can be expressed by you in a way that is neutral, non-judgmental, and without shame. You are communicating, "These are the facts."

Sometimes we learn best when we are allowed to make mistakes or experience the painful moments where we are faced with a problem only we can solve. If that's been true for you, it may also be true for your family member.

There may be a role in allowing for natural consequences with your family member. How are you empowering your loved one with borderline personality disorder today?


For more information, check out:

My Hopeful Life

Family DBT Course

Setting Limits with People Who Have BPD

← Is "Quiet BPD" Real?63 Reasons for Staying Alive (and Giving DBT a Chance) →

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Amanda L. Smith, LCSW
900 Austin Avenue Suite 304
Waco, Texas 76701
amanda@hopeforbpd.com

Compassionate and confidential treatment options for emotion dysregulation, self-harming behaviors, suicidal thinking, and borderline personality disorder.


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