Targeted Support Systems for the Borderline Personality Disorder (BPD) ‘Family’

BPD is demanding and confounding for everyone concerned: the people who have it, those who love the people who have it, their children and those who research and treat it; help and support are needed for all. However, challenges aside, there are effective corrective and support mechanisms and behaviors that help.

The particular focus today will be on how to help a BPD mom or dad improve their parenting skills and how to mitigate any damage done by them in moments of dysregulation. Here is a typical example that I see a lot. A child has a homework assignment that is due tomorrow. The BPD parent wants him or her to do well and becomes mildly anxious without being aware of it. Soon this anxiety begins to express itself as agitation or anger. The child proposes his or her idea for the project and the BPD parent feels it won’t result in a good grade, so the anxiety/agitation is further heightened. The BPD parent responds to their child by saying, “That’s a stupid idea, you are such a disappointment, you are not the child I dreamed of having”. The child is devastated and runs off to his or her room. The BPD parent is devastated as well on several levels: 1) They are still afraid their child will not succeed in school. 2) They know they haven’t been helpful and, in fact, have been hurtful. 3) They have no idea what to do to fix the problem and everyone suffers.

This topic is unfortunately not something that has been well researched. BPD itself takes up most of the ‘oxygen’ in the therapeutic, research ‘room’. However, there are several things we have learned from something psychotherapists call, practice wisdom. Practice wisdom defined, are the non-research based observations made ‘in real time’ and over time, with BPD patients and their families while they are being treated.

Given the seemingly constant nature of the emotional ups and downs that the BPD parent experiences they are frequently immersed in one or more of the following: denial, blame and/or shame. These three states of mind are defenses which are ways of distancing the self from distasteful, painful and/or scary things, people and behavior.

As long as the BPD parent is putting their psychological energy into maintaining a defensive mindset they don’t have the emotional resources available for self-monitoring or behavioral change. So the key is to do everything possible to help move the BPD parent away from defensiveness. This, of course, can be quite challenging as it is hurtful and scary to have BPD.

One of the most frequent questions I get asked is, “How do I get my BPD partner into therapy?” First let me begin by saying that I think it is extremely important that there be a skilled therapist to provide support for a ‘BPD family’. This doesn’t mean, however, that the parent with BPD needs to be singled out as the person who is the ‘holder’ of the problem. The ‘problem’ can be identified as a parenting concern that both the BPD and non BPD parent share.

The non BPD spouse can approach this issue with a discussion something along the lines of, “Having kids is harder than I ever thought it would be. Sometimes I get impatient and angry and sometimes you do too. We also have difficulty agreeing on limits and boundaries for the kids. I want to support you in the wonderful job you’ve been doing and I want to improve my skills as well. Let’s go talk to someone together.” If the visit to the therapist is structured in this way it is often much easier for all concerned to avail themselves of help.

I urge the use of a psychotherapist here because it is an unrealistic and I think destructive burden for the non BPD parent to bear if they are trying to be both spouse and ‘lay therapist’. This is the same advice I would give, by the way, to any family who is experiencing parenting difficulties. Parents need to be parents and not try to be untrained psychological specialists. In both cases taking on too many roles, especially roles one is not trained for, has the potential to cause great damage to the parenting and marital relationship. I often say that working with the BPD parent without a therapist is like walking a tightrope without using a net. It’s dangerous and not a good idea.

The two most powerful people in the ’defense’ intervention process are the BPD parent’s therapist and his or her spouse. Now, how much constructive effect the non-BPD spouse can have, is, of course, entirely dependent on the nature of their relationship. However, the most effective scenario for change is one in which the spouse, therapist and the BPD parent work together.

The most important thing, psychologically speaking, is that the BPD parent learns to frame their way of looking at, and reacting to, the world not as ‘bad’ but as a form of extreme sensitivity and hyperfocus. He or she can come to understand that they tend to react to stimuli quickly, emotionally and intensely. Sometimes so much so that it causes great hurt and alienation for themselves and those they love most. I often liken it to a gunslinger in the Old West who at the first sign of trouble draws their weapon, aims for the heart and shoots to kill. The pain experienced by all parties after a moment of destructive conflict often feels like a deep and sometimes fatal wound. The knowledge that the ‘Gunslinger’ approach can be harmful or potentially deadly, at least emotionally speaking, to both the BPD parent and those with whom they have conflict can help motivate him or her to learn and use countermeasures when things become contentious.

To facilitate development of new, constructive behavioral responses the parent with BPD needs help in understanding that it is vital that they learn to care for themselves emotionally by using ‘self-soothing’ techniques. BPD parents often see themselves as victims who are at the mercy of others who either ‘save’ or ‘attack’ them. But with the skill of self-soothing the BPD parent can experience a sense of independence and self-control that is both empowering and reassuring.

The first step in this process is for the psychotherapist to teach the BPD parent how to recognize ‘danger signs’. In other words, how to be aware of, and read the signals, that the body gives when stress begins. Things like ‘knots’ or ‘butterflies’ in the stomach, tightening muscles, feeling hot, sweating, dry mouth and so forth. Of course the more self awareness the better, but the ability to achieve this will vary greatly with the severity of the BPD. Learning to attend to these physical changes as cues that it is time to take a break, or a ‘time out’, allows him or her to emotionally regroup and self-nurture. It is very important that the BPD parent be taught how to be kind to him or herself. In most cases the BPD parent must literally receive instruction in how to create various scenarios for self-nurturing and self-soothing; things like listening to music or a relaxation CD, watching a favorite movie or taking a bath.

In therapy the BPD parent can also learn to accept help when tempers escalate. Using a subtle signal, like a squeeze on the shoulder or a gentle touch on the back, developed prior to conflict and when everyone is calm, the non BPD partner can quietly let the BPD parent know that it’s time for them to disengage from the disagreement at hand, rest and self nurture while he or she (the non BPD parent) deals with the child and the problem. For example, if the BPD parent and non BPD child are having a heated argument that is escalating fast and moving further and further away from resolution, the non BPD partner would walk up to the BPD parent and use the signal, possibly, rubbing their back. The non BPD parent would then say to the child, “We’re going to stop talking now, you need to go to your room and we’ll discuss this when things are calmer”. He or she can then walk the BPD parent into another room of the house and praise them for disengaging while expressing empathy for having to handle a difficult situation. Then the non BPD parent would suggest that their spouse choose something from the list of relaxing activities that they’ve worked out with the therapist and that he or she would go deal with their child.

The non BPD parent would then go check in with their child and reassure them and praise them for disengaging as well. If the child is calm enough they can have a discussion about solving the problem at hand. If not, the non BPD parent can check in later and resolve things then.

It is also very important that the BPD parent learns to apologize and make amends for their behavior when it escalates and gets out of control. The BPD parent will need help and support in how and when to do this and still feel safe. A skillful psychotherapist can frame an apology in terms of the BPD parent ‘not leaving’ their child feeling hurt and confused. These are feelings that the BPD parent understands well as they are identical to their own. The BPD parent will also need help and support in coming to understand that saying they’re sorry does not mean that their own feelings were wrong or invalid, only that they expressed them in a hurtful way. And, that to accept responsibility for their behavior and handle conflict constructively is a powerful way to create and sustain intimacy and trust with those they love most.

Now, let’s now look at the other side of this parenting relationship, the non BPD child of a BPD parent. The majority of BPD parents do not want to hurt their children emotionally or physically and often experience deep regret and remorse after doing so. However, the children of BPD parents are in danger of sustaining emotional wounds at the hands of their BPD parent that can last a lifetime. There are resources available that can be identified and tapped to make sure that this doesn’t happen or at least that the effects are lessened.

If the BPD parent is doing his or her recovery work diligently then they will take ‘time out’ and move away from contentions engagements. They will use their self imposed ‘time away’ to self sooth and then reengage when they are calmer. However, sometimes this doesn’t happen and it is important that the children of BPD parents have what I call ‘Emergency Backup Support Systems’ or EBSS. These systems are comprised of individuals in the child’s life who will help regulate their feelings and reassure them of their desirability and value in the world. People who might assume this role are the non BPD parent, therapists, school personnel, clergy, friends’ parents, scoutmasters, coaches, dance instructors, etc. The EBSS can bolster a child’s flagging ego and give him or her a chance to safely vent their frustration, anger and/or sadness. This can be as simple as a trip to a friend’s house where the child can ‘let off steam’ or it can occur in a more structured way with a visit to the child’s therapist.

While it is important that the child of a BPD parent have their feelings validated and accepted by others it is also vital that he or she be given to understand that they are not responsible for causing their parent’s anguish or rage, nor can they fix it. They must also learn to respect their BPD parent’s need for ‘time out’ and their own ‘times out’ in which they can utilize techniques for soothing themselves. In particular this is a time in which the non BPD child can make good use of the EBSS .

For example, the non BPD parent, or some other member of the EBSS, can explain that it’s normal to feel bad when their parent is upset, but they did not make their parent feel bad. It is important to tell the child that they cannot cause other people to feel things, good or bad, and they cannot fix their parent’s tendency to get angry quickly. It must be explained to them that when their parent says, “time out”, or walks away from an argument that they must not try to engage in conversation or go after him or her. When their parent is angry it is good for them (the non BPD child) to take a ‘time out’ too and do something that’s fun, like talk to someone in their EBSS like a friend, their scoutmaster, or the non BPD parent, etc.

Dealing with conflict can be both challenging and rewarding for the BPD family in varying degrees. But no matter what the stressors or obstacles, remember love is a powerful force that when harnessed and supported by a non BPD parent, the child’s EBSS and a skilled psychotherapist, it and they can constructively change lives and relationships in amazing and wonderful ways.

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One Response to Targeted Support Systems for the Borderline Personality Disorder (BPD) ‘Family’

  1. helpful so far, thank you. but you don’t mention single parents with bpd

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