How I Support Clients With BPD: Favorite Books and Effective Strategies

Written By Courtney Thurston
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People with borderline personality disorder (BPD) often face stigma—from peers, family, and sometimes even healthcare professionals. Coping with BPD symptoms can feel overwhelming. It can be confusing trying to manage emotions, relationships, and daily life.

From my experience, these approaches can help, but everyone’s lived experience with BPD is different. These books, strategies, and approaches may be helpful for anyone with BPD or anyone who struggles with emotional, attachment, or regulation challenges.

Understanding BPD and Why Support Matters

Borderline personality disorder (BPD) is often associated with trauma, particularly childhood trauma. However, there is no definitive evidence that childhood trauma is the only factor in developing BPD. As mentioned earlier, many people with BPD experience stigma due to myths or misconceptions about the diagnosis.

Myth vs Reality

Below are some common myths about BPD and my perspective on why these behaviors may appear a certain way. I’ll also explain the realities behind these myths and why they’re inaccurate.

Myth: People with BPD are manipulative.
Reality: Behaviors that are often seen as “manipulative” in people with BPD are usually driven by intense emotions and a fear of abandonment, not by actual manipulation. Many of these actions are ways their nervous system is trying to keep them safe. Everyone is responsible for their own actions and how they treat others. I’m not excusing harmful behavior, but having BPD does not mean someone’s behavior is motivated by manipulation.

Myth: BPD is just “drama” or attention-seeking.
Reality: Emotional intensity is often a core symptom of BPD. It usually happens when someone is pushed outside their window of tolerance. Emotions are how our brain and body communicate. For someone with BPD, this communication is often louder and more intense. Their responses usually match that intensity.

Myth: People with BPD can’t have healthy relationships.
Reality: With support and the right skills, people with BPD can form stable, meaningful relationships. Someone with BPD often benefits from co-regulation, secure attachment, and reassurance from others. They need unconditional support. This is something everyone needs on a basic human level.

Support Makes a Difference

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Therapy can help people with BPD build skills like distress tolerance, emotion regulation, and awareness of dysregulation. Dialectical Behavior Therapy (DBT) is especially effective for this. Other approaches, like Internal Family Systems (IFS) or nervous system–based therapies, can help people feel safe and secure. Therapy also provides psychoeducation and a secure space with clear boundaries.

Support outside therapy is just as important. These relationships let someone practice skills, challenge distorted thoughts, and navigate emotions in real life. People with BPD benefit from support that is compassionate but maintains healthy boundaries. Everyone messes up from time to time, and having supportive relationships helps manage that safely.

My Favorite Strategies That Help Clients

I love using psychoeducation when working with people who have BPD. Many of my clients are incredibly intelligent and appreciate understanding mental health concepts and how the brain works. Below are a few strategies I often use in sessions.

Emotion Regulation and Distress Tolerance Skills

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I often teach emotion regulation and distress tolerance techniques. TherapistAid has great worksheets for practicing these. There are many moments in session where we need to use these strategies in real time, especially when frustration turns into dysregulation. This gives clients a chance to practice co-regulating with me as the thearpist, and build confidence using their skills.

Many larger cities also have DBT programs, which offer a more intensive education in these techniques.

The Window of Tolerance & Tracking “Stacking” Stressors

The Window of Tolerance is a helpful concept for understanding how different stressors—like overstimulation, relationship conflict, or daily frustrations—can “stack up” and push someone outside their ability to regulate.

When that window narrows, people may shut down (depressive symptoms) or react intensely (anger or impulsivity). Building awareness of when you’re getting close to the edges of your window helps you pause, take space, and use coping skills sooner.

Boundary-Setting

Identifying boundaries with family, friends, and even yourself can be an important part of treatment. When someone is emotionally dysregulated, clear boundaries create structure, safety, and predictability. This helps support emotional regulation and healthier relationships.

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Books I Recommend

I have a few workbooks I often recommend for learning distress tolerance and emotion regulation skills. These resources are supportive, practical, and great for anyone wanting to build coping tools.

If you’re looking for a book that explores the lived experience of BPD, I also recommend Buddha and the Borderline by Kiera Van Gelder. It offers honest insight into one person’s treatment journey, emotional world, and recovery process.

Progress, Not Perfection

Making progress toward your mental health goals can feel frustrating. For someone with BPD, it can feel especially overwhelming—like things will never get better. But small steps are often more sustainable than trying to achieve perfection overnight. Remember, small steps add up. With support, skills, and a little patience, change and growth are within reach.

Resources

Courtney Thurston
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