Tuesday, February 19, 2013

Book Review: Transcending the Personalty Disordered Parent: Psychological and Spiritual Tactics.

Self-help books for the adult offspring of highly dysfunctional, personality-disordered parents are in woefully short supply. Children raised in such households often grow up to have high emotional vulnerability,  a poor self image, and a high degree of confusion about what kind of people they are supposed to be or what they should expect from their relationships.  Worse yet, they sometimes become just like their parents in some way, even if they try to do things in an exactly opposite way.

If they do not have access to a therapist for whatever reason, is there anything they can do in order to better understand what has happened to them, and how to think about the problems that have resulted from their bewildering and traumatic upbringing? 

In a new book, academic psychiatrist Randy Sansone and academic psychologist Michael Wiederman attempt in ordinary language to help such individuals recognize the dysfunctional parenting styles they had been subjected to, and to understand a little bit about what makes their parents act the way they do. 

They describe in detail how such parents may do any or all of the following, among other things:  

  • ·     They act like monsters with their family members, but are liked and highly-respected outside of the home - creating an almost Jeckyl and Hyde situation. 

  • ·     They seem to think that their children should be taking care of them - but undermine any effort the children make to actually try and do so.

  • ·     They seem to see children a big burden, yet won’t them go.

  • ·     They pit one of their children against another, creating even more widespread family discord.

  • ·     They accuse their children of the very negative traits that they themselves display in spades.

  • ·     They seem to over-react to seemingly minor transgressions made by family members, and in response become abusive and bullying.

  • ·     They seem to be in a constant state of denial about past misdeeds.  Or are they maybe just lying about it?

  • ·     They oscillate between intruding on the lives of their children when they don't need help, and neglecting them when they do.

The authors go on to suggest ways in which readers who have grown up with parents like these can conceptualize and think about their family experiences. 

Although they do not cite her by name, many of their recommendations seem to stem from the concepts of “mindfulness” and "radical acceptance" that come from the work of Marsha Linehan with personality disordered patients.  These ideas involve the adult children giving up trying to completely make sense of their dysfunctional parents, completely accepting their situation as it is, stopping efforts to make their parents change, and viewing their experiences as an opportunity for growth rather than as an obstacle to it.

As I mentioned, there is a serious need for a book like this, and I applaud the authors for their efforts. I also think many of their suggestions are indeed helpful, especially for those who are not seeing a family-systems oriented psychotherapist for whatever reason.

I do, however, have some quibbles with their explanations for the personality disordered parents, and I frankly strongly disagree with a couple of their recommendations.

The authors do try to be somewhat empathic with the plight of the dysfunctional parents, but their descriptions of them, understandably, veer away from that. The authors could benefit from an understanding of family systems theory. They come ever so close to Murray Bowen’s three generational understanding of the origins of self-destructive behavior, but just miss it.

For example, they discuss how the reader may have been given what Transactional Analysts call a “script” by their parents – in which the recipients of the script act out in ways that seem to be for the benefit of their parents at the expense of their own happiness. The authors do not mention, however, that perhaps the dysfunctional parent is also the unfortunate recipient of such a script from the grandparents.

In the same vein, the authors, like Marsha Linehan herself, mix up the personality disordered parent’s true self with his or her false self or persona. Is the exemplary behavior seen by outsiders the "true" nature of their personalities, or is it within their hidden-from-view dysfunctional family behavior?  This issue is somewhat analogous to my problem with Linehan’s idea of apparent competence – that somehow people can demonstrate through performance an ability they do not in fact have. How is that possible?

One father who they describe was a physician who was loved and idealized by his patients, but treated his children like crap. The authors seem to assume that the father’s “real” personality was the one he exhibited at home, while the one he exhibited at work was a fraud. Could it not be in fact the other way around?

I disagree with the authors recommendation that children of dysfunctional parents give up the idea of ever truly understanding their parents' behavior. I believe that through the use of three generational family histories called genograms that it is indeed possible to understand parental misbehavior (which, BTW, does not entail approving of it).

The authors also seem to be saying that nothing will ever change in their relationship with their parents, and that there is nothing the child can do about it. Those who read this blog know that I believe that, while adults (not children) are indeed powerless to change their parents, they  certainly do have the power to change their relationship with those parents.

The authors provide an example (p.187) purportedly showing the futility of getting personality-disordered parents to even admit that they did anything wrong in the past:  

“A patient was on the telephone with her highly dysfunctional mother. The mother was intoxicated with prescription analgesics, which was typical for her. The patient broached the issue of a babysitter who molested her and her sister for an entire year during their childhoods. At the time, both girls had told their mother about the molestation by the female sitter, but the mother continued to employ the sitter anyway. During the telephone conversation, the mother defensively stated in a slurred voice, “She only molested you girls a few weeks,” as if this nullified the injustice. Understandably, the patient exploded and proceeded to call her mother a number of obscenities.”

The authors concluded that the mother lacked the ability to validate her daughters feelings. The daughter therefore would never be able to get this validation, for which she longed.

I completely disagree. Let’s look at what happened in more detail. First of all, the daughter called the mother when the mother was intoxicated. I understand that it might be difficult to find a time to call when she was sober, but that fact alone guaranteed that the daughter would fail in her efforts to obtain validation. Second, I suspect that the way that the daughter brought up the molestation made it obvious to the mother that the daughter was highly critical of the mother’s lack of responsibility - as obvious as that lack of responsibility was. To the both of them, I might add. 

When anyone is attacked, they tend to respond with defensiveness, flight, or a returned attack. This is especially true in this case since I would wager that the mother really did, covertly, feel terrible about what she had done, and believed that the daughter was right to hate her for it.  Furthermore, I find that such parents feel they deserve hatred, and that their children are really better off without them.  

Mother therefore responded in a very hateful manner, which very helpfully gave the daughter more righteous justification for her hatred, and pushed her away to a place in which the mother viewed the daughter as safe from the mother’s pernicious influence.

If this daughter really wanted validation, she went about asking for it in exactly the wrong way, and the horrific response was entirely predictable.

Not that the right way is something easy to devise or to do, or that the complicated techniques that do in fact work are obvious. And this problem is further complicated by the fact that the right approach is different in every family and must be customized to each family member's sensitivities. Generic assertiveness skills are often useless.

Confronting maladaptive family patterns may in fact be extremely dangerous if done poorly. It almost always requires the coaching of a therapist who does this sort of work. As I have said repeatedly in this blog, finding such a therapist is well worth the effort.


  1. I really appreciate this book review.

    Is this the kind of work you do, Dr. Allen? Coach people to confront maladaptive family patterns?

    Best, Smitty

    1. Yes I do.

    2. Thanks! I'll remember you to others who might need it. I am a member of one of the Stop Walking on Eggshell's groups online and it is rare for anyone to have a viewpoint like you share.

      I have a very troublesome mom, who fits all the criteria for borderline. I like being able to see her as a complex and troubled person, not one who is out to fool the world, and keep their kid in hell. (Though the crazy-making of seeing a mom "turn off" her normalcy can make it seem she has faked it in public and is her "real" self--unedited-- with you.)

      Many time, kids of borderline will say that their bp parent "knows better" because they can behave appropriately in public.

      I got a sense of a larger truth than that, from your post. I appreciate that.

      Best, Smitty

  2. Dr. Allen, what do you think of the technique of writing letters to one's problematic family members (as described in Jeff Young's book, "Reinventing Your Life")? It would seem that this could avoid many of the risks of trying to confront the family members directly.

    1. Hi anon,

      I think writing a letter can sometimes be a good way to break the ice, especially for relatives who have been estranged for a while, but the letter still has to be worded carefully.

      Like anything else, there are pro's and cons to letters. A letter does give the other person time to reconsider their response after their initial reaction, although it also gives them more time to make mischief (such as by involving other relatives).

      Having an immediate give-and-take and directly seeing the other person's emotional reactions would also be missing.

      If violence is a concern, there is always the telephone.