According to the interpersonal psychotherapist Lorna Smith Benjamin (born 1934 and renowned for her innovative therapy for working with clients suffering from borderline personality disorder (BPD) and other personality disorders who have proved treatment-resistant in relation to more traditional types of therapy), families in which children develop borderline personality disorder (BPD) later in life commonly display four characteristics of particular significance. These are as follows:
- Demonstrations of love and concern only derived from parents when the child is emotionally upset or sick
- Family life is chaotic and subtle signals are given to the child that it is s/he who is at the root of the family’s problems (i.e the child is treated as a scapegoat or as the ‘identified patient).
- The child is subjected to an environment/environments which fluctuates between periods of traumatic levels of parental abandonment and periods of traumatic levels of parental over-involvement fluctuate.
- Any efforts the borderline personality disorder (BPD) sufferer makes to be autonomous and in control of his/her own life, separate from his/her family are treated as signs of disloyalty.
Number 4 (above) is particularly interesting as it suggests that, on some level, the family has a need for the individual suffering from BPD to REMAIN ILL rather than recover and maintain his/her place as the family’s identified patient.
HOW THESE FOUR FAMILY CHARACTERISTICS MAY HELP TO EXPLAIN SOME OF THE MAIN SYMPTOMS AND BEHAVIOURS ASSOCIATED WITH BORDERLINE PERSONALITY DISORDER (BPD):
These four characteristics make sense in terms of helping to explain some of the symptoms and behaviours demonstrated by the BPD sufferer.
First, if, as a child, we were only shown concern when emotionally upset or distraught (or, as psychologists say, ’emotionally dysregulated) such behaviour was reinforced and, therefore, on an unconscious level, we may be motivated frequently to become distressed as adults. (Emotional dysregulation is such a central feature of BPD that many mental health professionals believe that BPD should be renamed emotional intensity disorder).
Second, if our family has projected its own psychological problems on to us and treated us as the source of everyone else’s problems (i.e. the scapegoat) we are much more likely to grow up with deeply damaged self-esteem and with a profound sense of guilt, shame and culpability.
Third, if we experience repeated fluctuations between periods of parental over-involvement and periods of abandonment we are likely to develop an intense fear of others deserting us (physically and/or emotionally) yet, at the same time, fear of being engulfed by relationships leading us to repeatedly swing between desperately trying to get closer to others and pushing them away.
Finally, with reference to point 4 (above), some families may have an unconscious need for the BPD sufferer (or future BPD sufferer) to remain in his/her ‘sick’ role so as better to divert attention away from the rest of the family’s, psychological difficulties (in connection with this, you may wish to read my previously published article, Family Secrets And The Damage They Do) and, as such (again on an unconscious level) resent any significant signs of recovery and disapprove of any actions s/he takes associated with becoming self-reliant and independent.
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David Hosier BSc Hons; MSc; PGDE(FAHE).