Imagine you have a cut. The skin around your cut heals. But it heals all wrong. The scarred tissue is extra sensitive. So much so that every time you simply touch the area, it’s like the wound tears open again, and again, and again; and the pain peaks every single time. Now imagine this wound represents your emotional sensitivity and how you deal with the world every day. This is akin to the emotional susceptibility of borderline personality disorder (BPD).

As Shari Y. Manning, Ph.D, writes in her excellent book Loving Someone with Borderline Personality Disorder, “People with BPD have an exquisite vulnerability to emotions.” And this susceptibility is hardwired.

For instance, Manning cites one interesting study where researchers tickled infants on their noses with a feather. Their responses ranged widely: Some infants didn’t react at all, others moved around and still others started crying and it was tough to calm them down. These babies were seen as “sensitive to emotional stimuli.”

Like other disorders, BPD also involves an environmental component. (Not everyone who’s emotionally sensitive goes on to have BPD.) Individuals with BPD aren’t just genetically vulnerable to emotions; they’ve also grown up in an “invalidating environment.” So they might’ve never learned how to regulate their emotions, or their emotions were continuously ignored or dismissed.

What It Means To Be “Emotional”

According to Manning, being emotional isn’t a lack of control; it has more to do with “three separate tendencies that cause emotional arousal in different ways.” These are:

  • “Emotional Sensitivity.” Loved ones aren’t the only ones confused when someone with BPD has an emotional reaction seemingly out of nowhere. People with BPD may be unaware of the trigger, too. But they still have a strong reaction. “Emotional sensitivity wires people to react to cues and to react to their reactions.” Manning explains that: “To understand emotional sensitivity, think of the person with BPD as being ‘raw.’ His emotional nerve endings are exposed, and so he is acutely affected by anything emotional.”
  • “Emotional Reactivity.” A person with BPD not only reacts with extreme emotion (“what would be sadness in most becomes overwhelming despair. What would be anger becomes rage”), but their behavior also is intense and doesn’t fit the situation. They might sleep for days, scream in public or self-harm. Manning points out that emotional reactivity isn’t self-indulgent or manipulative, which is an unfortunate myth attached to BPD. Instead, research has suggested that people with BPD have a higher emotional baseline. If most people’s emotional baseline is 20 on a 0 to 100 scale, then people with BPD are continuously at 80. What can intensify their reactions are the secondary emotions of shame and guilt because they know “their emotions are out of control,” Manning writes. Let’s say your loved one is angry. “On top of the original anger, these secondary emotions feel intolerable, and their fear of all this emotion, ironically, tends to fire off another series of emotions—perhaps anger that is now shifted to you, for ‘not helping’ your loved one or for some unexpressed reason.”
  • “Slow Return to Baseline.” People with BPD also have a hard time calming down and stay upset longer than others without the disorder. And there’s interesting evidence to back this up. “In a person with average emotional intensity, an emotion fires in the brain for around 12 seconds. There is evidence that in people with BPD emotions fire for 20 percent longer.”

An Exercise in Understanding

In Loving Someone with Borderline Personality Disorder, Manning also helps readers better understand what it’s like to be emotionally vulnerable. She suggests thinking about an extended period of time when you were very emotional.

For Manning her emotional explosion happened when the company she’d worked for was going bankrupt. Not only was everyone upset and Manning barely sleeping but then her friend passed away. “At that point I felt like every emotion that I had was at the surface of my skin. I physically felt like I would explode with emotion if one more thing happened.” She notes that she was “an emotional sponge.” She didn’t even want sympathy because she felt like this would put her over the edge.

When thinking about your own highly emotional experience, Manning writes:

…Remember what it felt like emotionally and physically. Remember how it felt like emotions were just building on each other. Remember the experience of no one understanding how bad the situation was and how emotional you were. Now tell yourself that this is the experience of your loved one every moment of every day.

How Loved Ones Can Help

Manning shared her insight on how family and friends can help in a two-part interview on Psych Central (Part 1 and Part 2). And loved ones can do a lot, especially when it comes to helping the person when they’re upset.

In her book, Manning provides readers with step-by-step strategies and detailed examples. Below is a brief list of suggestions from her book:

  1. Assess: ask what has happened.
  2. Listen actively; don’t contradict, judge, or say your loved one is overreacting.
  3. Validate: find something in what happened that makes sense and is understandable, that you can relate to; say what that is.
  4. Ask if you can help, not to solve the problem but to get through the moment.
  5. If your loved one says no, give him or her space and remember the emotions of emotionally vulnerable people last longer.

Also, it’s important to remember that people with BPD do get better and simply need to learn the skills of managing their emotions. While this requires hard work and effort, treatments such as dialectical behavior therapy (DBT) have been shown to be highly effective. You can learn more about DBT here and here.