'Strike whilst the iron is cool'

Planning, whilst everyone is calm, is key

Clinic 7

When people are either experiencing severe emotional distress or supporting a person experiencing severe distress it's often nearly impossible for us to think logically. If we have developed a plan when everyone is calm this can act as a prompt and help us, and others, to connect with their rational thinking part of our brains.

So, when things are calm, it can be very helpful to develop a collaborative safety plan to assist during times of escalating distress. Ideally the plan outlines what the family (and others) will do when the person with BPD is in a heightened emotional state, harms themselves or has suicidal thoughts and/or those around them feel scared or threatened. For an example, please visit the Beyond Now app.

  • Ideally the plan should also include what the person has agreed to do, what has worked before and actions that are unhelpful.
  • The plan is best done together with all concerned members (including the person and others such as family, friends and mental health or helping professionals).
  • A family plan, where necessary, should also include a plan for the support and protection of children and possibly pets. It is important that children and other vulnerable people are assisted in making a plan of their own, for times when they are afraid or the person living with BPD requires professional care.
  • It is important for children and other vulnerable adults to be able to identify people or services they can reach out to and feel safe to talk to about how they are feeling and what is happening at home.
  • During a crisis it can be hard for everyone involved to remember that self-harm, statements of suicide and suicidal behaviours are frequently used as coping strategies to help the person manage their intense emotional distress.
  • If basic principles have been accepted and learnt the outcome for all is more positive.

We know that the time and effort that people spend learning about BPD, accepting the experience of the person living with BPD and establishing plans and limits (with the person when they are not in a crisis) shows results.