Safety Plan for Borderline Personality Disorder

Safety Plan for Borderline Personality Disorder BPD Living With BPD Print Safety Plan for Borderline Personality Disorder By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Updated on December 05, 2019 SummitView/E/Getty Images More in BPD Living With BPD Diagnosis Treatment Related Conditions A safety plan is a critical part of treatment for borderline personality disorder (BPD). People with BPD are among the most at risk of attempting suicide  or engaging in other high-risk activities. Without a safety plan, you may be in danger of harming yourself or someone else. A safety plan can reduce your risk and make it less likely that you will make a decision in the heat of the moment that will have serious consequences. This article covers the steps in preparing a clear and comprehensive safety plan. This is not something that can be done when you are already in the midst of a mental health emergency but should be done ahead of time so you are ready. If you or a loved one are currently at immediate risk of harming yourself or someone else, call 911 or go to an emergency room right away. Talk to Your Therapist About a Safety Plan If you have BPD and have been going to therapy, talk to your therapist about developing a safety plan or emergency plan. Depending on your unique situation, she may recommend including specific things or skipping other areas so that it is tailored to you and your needs. If you do not have someone to work with on a safety plan, find a therapist. If the stigma of seeing a therapist is keeping you from this important step, keep in mind that its likely every person could benefit from seeing a therapist at times. Just as we see physicians (medical doctors) routinely to take care of our physical health, seeing a therapist can be an excellent investment in maintaining and maximizing your emotional health. Find a Therapist With the 9 Best Online Therapy Programs Evaluate Your Behaviors Once you have enlisted your therapist, you can have her help you to evaluate your risk and potential dangers, including: Thoughts of suicide, even if infrequent and fleetingUrges to harm yourselfThoughts of harming othersIssues with violence These will be the targets of your safety plan, so it is important that you think carefully about what behaviors you may need to plan for. Along with evaluating your risk, you should evaluate whether there are factors that may be increasing your risk of completing suicide or harming others, such as owning a weapon or access to potentially dangerous medications. Depending on your situation, your healthcare provider may help you minimize your risk of harming yourself or others by handing your weapons over to police or prescribing medications in only small quantities. Identify Triggers   Once you have a list of the behaviors or symptoms that put you at risk of harm, identify the events, situations, people, thoughts or feelings that trigger those behaviors or symptoms (BPD triggers). For example, many people with BPD have abandonment sensitivity, which makes experiences of real or perceived abandonment very painful. For those individuals who suffer from this symptom, abandonment experiences may trigger suicidal thoughts or thoughts of harming others. Think about the events or thoughts that tend to trigger urges to engage in harmful behaviors for you and create a list of triggers. Make a Safety Plan for Coping Resources Now, identify how you can respond to your triggers in ways that will keep you safe. These will be coping resources that you will use before your symptoms become so intense that you are having a mental health crisis. Make a list of  healthy coping skills for BPD that you are familiar with and that work for you, as well as  sources of social support and people or places that can help you if you need it. These can include: Coping techniques like mindfulness meditationYour therapists emergency numberList of emergency mental health clinics and emergency roomsThe National Suicide Hotline (1-800-273-8255) Document Your Safety Plan Now it is time to put it all together. You have a list of your risk behaviors, your triggers, ways you can cope before symptoms become too intense and ways you will respond in the case of an emergency. Put these all together to give yourself a step-by-step plan of action. For each risk behavior, write out the triggers for that behavior, the coping responses you could engage in if you experience a trigger and what you will do if the coping responses do not work and you begin to experience an emergency situation. Continue until you have a safety plan for all of the risk behaviors you identified. Make a Safety Plan Commitment The last step is to make a commitment to your safety plan. This means committing to yourself that you will follow this plan when the need arises and then committing out loud to someone else that you will follow this plan. This is also called “contracting for safety.” In fact, sometimes your therapist will have you actually sign a statement saying you will follow the plan.