7 ways to champion girls in your youth ministry
Grace reflects on why girls aren’t coming to youth group as much as they used to and offers practical advice for what we could about it.
Clinical Associate Professor of Psychiatry, Neil Jeyasingam, spoke at the MHPCI Spotlight session on Borderline Personality Disorder. This article gathers information from his presentation and other sources.
This article includes content that some readers may find sensitive. Please take care.
Imagine that you’re four years old and you’re walking onto a train station with your mum. You’re holding hands. The platform is very crowded; there’s people everywhere. The train arrives. There’s a huge rush of people and your mum loses contact with your hand. Then the train begins to pull away and you see your mum in the carriage moving out of sight while you’re left on the platform. Imagine how that feels. And then imagine that most living with borderline personality disorder are feeling like that most of every day.1
Imagine from age 12 having a voice in your head saying critical and horrible things to you, such as, ‘You’re worthless’; ‘You should kill yourself’. You have the insight to know that this is not a real voice, but you can’t stop it.2
These scenarios open a window into the experience of those living with one of the most stigmatised and misunderstood mental health conditions, borderline personality disorder, or BPD.
Combine that with a pervasive fear of being abandoned, and it’s clear that BPD can be extremely distressing. It’s a very hard path to walk.
Perhaps a word that captures much of the BPD experience is ‘instability’—living with distorted perceptions of themselves and others that leads to unstable and impulsive moods, behaviours, self-image, and ways of relating to others.
Combine that with a pervasive fear of being abandoned, and it’s clear that BPD can be extremely distressing. It’s a very hard path to walk.
The term BPD arose in the 1930’s to describe a pattern of mental health symptoms that didn’t neatly fit within the main diagnostic categories of that time. The symptoms were considered to lie on the ‘borderline’ between neurosis and psychosis.
A personality disorder is when normal personality traits become extreme and inflexible, resulting in enduring patterns of behaviour that interfere with everyday life and relationships. But because the symptoms of BPD are not simply personality traits (as is the case in other personality disorders), many mental health professionals believe the condition is misnamed. Some think it is more accurately described as a mood disorder, due to the intense and fluctuating emotional states that tend to characterise BPD.
During his presentation, Neil indicated that the condition often emerges around the age of 12 with negative self-talk, troubling & unstable moods, and other symptoms.
A key guide to psychiatric conditions, the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) of the American Psychiatric Association, provides these diagnostic criteria:
A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
Due to the stigma associated with BPD, many clinicians are reluctant to make the diagnosis. This hesitation, while perhaps well-intentioned, can leave individuals feeling unsure about what is happening to them. In his own practice, Neil has found that many find relief in having a name given to their experience, especially as a diagnosis provides a pathway to treatment.
The precise causes of BPD are not fully understood though a common belief is that it is associated with trauma. Neil, however, pointed to studies showing that although those with BPD are three times more likely to report a history of trauma, 30% of adults with BPD have no such history. We cannot consider BPD cannot to simply be an outcome of trauma.
Recent research is showing that genetic factors play a crucial role in the development of this disorder, with studies showing they have a stronger association with BPD than any other contributing factor.4 Neil suggested that these genetic predispositions may then make an individual more vulnerable to adverse responses to trauma.
It’s best to avoid simplistic explanations of causation and it’s likely that both biological and environmental factors are at play.
The good news is ‘Yes!’ Unlike most mental health conditions, the symptoms of BPD tend to reduce over time. Seeking treatment, however, is invaluable in alleviating the distress associated with the condition and assisting with day-to-day functioning. Early intervention with young people has been shown to be of real benefit.5
Effective treatment may involve lifestyle changes and medication. Neil indicated that regular physical activity—ideally on a near-daily basis—can help manage symptoms. Given the heightened risk of suicide in individuals with BPD, it is also crucial to take proactive steps to reduce crisis factors and limit access to means of self-harm.
The most effective treatments are a range of psychotherapies. These include mentalisation-based treatment (MBT), schema therapy (ST), and especially, dialectical behaviour therapy (DBT). DBT teaches skills in self-awareness and in managing emotions and relationships, as well as tactics to cope with the distressing situations that are an inevitable part of life.
We’ve noted that living with BPD can be very distressing. And this distress impacts family, friends and others in their circle. Unstable moods and impulsive actions can be tricky to navigate and lead to conflict and fractures in relationships. Providing support, therefore, is not straightforward.
We want to treat everyone, irrespective of their behaviour, with dignity and value as God’s image bearers. An attitude of respect can send a powerful message to those with BPD whose inner world may be filled with voices and thoughts telling them they are worthless.
Treating people with respect, however, does not mean we do whatever they want or condone inappropriate behaviour. In seeking to be kind and supportive, Christians can find themselves drawn into all sorts of drama and manipulative behaviours that do not help them or the person with BPD they are trying to assist. Often these behaviours are not deliberate choices but are driven by unconscious factors beyond their awareness.
It’s essential to put boundaries and limits in place—around things like how much of your time you can make available, how often you will respond to texts and phone calls, and behaviours you will and will not tolerate. It’s okay to say, ‘If you yell at me, I will end the conversation’. Don’t budge on these boundaries. If you give in, you are sending the message that if the person with BPD keeps pushing, they can get what they want, and that reinforces unhelpful patterns of relating.
Get others involved as well. A group of people who are firm and consistent in their approach can help shape more healthy ways of relating.
One of the best ways to offer support is to encourage them to seek and continue in treatment. Treatments such as dialectical behaviour therapy bring great benefit. But persevering in treatment can be very hard, so your continued encouragement can make a real difference.
Finally, remember that you can’t make anyone do anything. They are responsible for their behaviour and their treatment, not you. As Neil said in his presentation, psychiatrists, psychologists, GP’s, family members, friends, etc, can be guides, but it’s the person with BPD who remains responsible for his or her treatment.
We will end this article by sharing a prayer you might like to pray for those you know who are living with BPD. Bringing those we care about before our Lord is a powerful act of love. You can download the prayer here.
You may also be interested in our Borderline Personality Disorder (BPD) Fact Sheet which you can download here.
Grace reflects on why girls aren’t coming to youth group as much as they used to and offers practical advice for what we could about it.
Clinical Associate Professor of Psychiatry, Neil Jeyasingam, spoke at the MHPCI Spotlight session on Borderline Personality Disorder. This article gathers information from his presentation and
What interest does a secular broadcasting channel have in a church survey? Do church surveys really matter to Australia’s young people? Well, it has to do with this question, ‘Do you agree or disagree? The Christian religion is good for Australian society.’
This Valentine’s Day, or should we say, Galentine’s Day, Grace shares some honest reflections that have been a source of encouragement and comfort.
