How to communicate support to someone who is emotionally disconnected?

Question

I have a friend I'm having a hard time communicating with for the past few months. She's been diagnosed with Borderline Personality Disorder (BPD) for a handful of years (which has been the backbone of a history of emotional instability and suicidal behaviors), and lately this has reared its ugly head all over again. (FYI she is undergoing professional help throughout this time)

Where I feel uncertain/uncomfortable is that while I want to be there for her, we haven't been in contact during past episodes of hers and thus I'm not sure what is the best way to support her. She's essentially emotionally "blank" during these episodes, and they can last for days/weeks/months. So far this has resulted in our conversations starting/ending on her emotional state (usually about how she feels so tired and hopeless).

I've tried responding to this by:

• Telling her I care about her wellbeing and her place on this Earth

• Talking about her experiences with all the other people who care about her (family, close friends, etc)

• Talking about the positives she contributes to the world

• Talking about every day life so she can have a break from talking about her illness

• Offering to listen if she ever needs to talk about something (including "call me anytime" privileges)

• Asking her if there's anything I can do to better support her

However, it feels like these things make 0 impact to her when she's in this state. While I don't believe I can "save" her from these episodes, it makes me wonder if there are better ways I could be responding to support her.

Similar to how using an "I-statement" is a proven method of expressing how you feel, are there any specific interpersonal skills/strategies that work best when speaking to someone who is in emotional distress or emotionally disconnected from the world?

P.S.: We don't live near each other anymore (several states apart), so my words are all I have for supporting her.

P.P.S.: Again, she is already seeking professional help, and I'm not trying to be a replacement for that.

Answer 1

First, I would suggest that you follow the NIMH advice; especially the last two points.

From https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

Tips for Family and Caregivers

To help a friend or relative with the disorder:

• Offer emotional support, understanding, patience, and encouragement—change can be difficult and frightening to people with borderline personality disorder, but it is possible for them to get better over time
• Learn about mental disorders, including borderline personality disorder, so you can understand what the person with the disorder is experiencing
• Encourage your loved one who is in treatment for borderline personality disorder to ask about family therapy
• Seek counseling for yourself from a therapist. It should not be the same therapist that your loved one with borderline personality disorder is seeing

My background; I had a partner with mental illness; I have also worked for a mental illness research doctor (as a layman.)

Here are some opinions I developed mostly from living with someone with a mental illness. I could be 100% wrong for your circumstance, so do check with a professional first.

Help Her Get Multiple Levels of Help and Support

• Make sure she sees an appropriately skilled doctor.

• Ensure she has people around her that are supporting her on a regular basis in person. She shouldn't be left alone or be isolated.

• She should ask her doctor about support groups in her area. For some mental disorders, there are local support groups run by former sufferers that have beat the disease or at least have found coping mechanisms. Sometimes knowing that you are not alone and that other people have beat it can be encouraging.

Be Reliable

• Be consistent and reliable with your contact with her. She needs to know you are not going to disappear on her. Don't be afraid to always call at the same time. It's like being a good parent: the most important part is being there and not about being perfect or always having the right thing to say.

• Send her a postcard or something physical that will remind her of you.

• Send her a birthday card and Christmas card every year.

Help her Develop a Routine as a Coping Mechanism

• Help her form a schedule/routine that she does no matter how she is feeling. E.g. get up at same time, go to bed at same time, eat healthy meal(s), exercise daily, etc.

Don't Go Down the Rabbit Hole

• When her feelings are messed up. Don't focus on them. You need to get her thinking about something else.

• Approach 1: Focus on actions. Ask her to do things. They can be simple things but be insistent. It can be simple things like: "when I get off the phone could you write down and send me that recipe to that meal you cooked me last time I visited, because I really liked it". I know this advice may sound weird, but when my former partner was having a episode of major depression, I wouldn't talk with her about her feelings because it was pointless. Instead, I would sometimes force to her into action. E.g. "you need to weed the garden while I mow the lawn; then when we're done we're going to go do X, come on let's go." Where X was something I knew she normally liked. Sometimes when my partner was really depressed, I'd even have to get mad at her and get her to do her "chores". Oddly, this sometimes helped and she got angry back at me; as I saw it I was happy because anger was better than no emotion.

• Approach 2: You do the talking. Tell her an engaging story about what is going on in your life. Funny or embarrassing stories are the best. E.g. "You won't believe what a huge fool I am, today I ..."

In the end there is no magic words you can say. It's a mental illness that she needs to manage with help.

Answer 2

Introduction note, I'm not sure you could really help when she's in such periods. We're talking about an illness & though I don't know much about bipolar disorders, I've suffered from depression & know pretty much that when someone's going through a circle of suicidal thoughts, there's little to do that would help for sure.

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Have you tried determining which love language is hers? It might help you discover what could work best for comforting her/express that you're here for her.

For example, say you're figuring that her primary love language is presents. Then you can send her a box filled with sweet things she likes and little notes, it coulp help her realizing your support more than words. If it's words, then you could write her a letter and tell her how much she's important to you.

I wish you all the best, as her I've been suffering from psychological problems and I realized it's not a piece of cake for people who care about you as well. Hope she'll be better soon.

Answer 3

It sounds like you are already saying most everything I would recommend as well as a couple of things that I would not have thought of.

At this point what your friend needs most from you is consistency. Just keep doing what you are doing. You see you can't help anyone unless they want your help. The fact is the only person capable of fixing your friend is herself. No amount of professional help or friends like you will help her unless she listens and apply what she hears. She has my sympathy, changing yourself is hard when you're feeling good, it's nearly impossible when you're feeling depressed.

So just keep doing what you are doing. Show her an example of how life can be enjoyable despite the hardship inherent in living. Give her encouragement and that she matters. And hopefully one day she will wake up, metaphorically speaking, and realize that what you have been telling her is true.

Also, you should consider that some changes are unseen. Perhaps your current efforts have already started to have a positive effect on her and you just don't see that effect on the surface yet.

Good luck, to both you and her.