Monday, December 28, 2015

Some Questions Answered About Family Dynamics in Borderline Personality Disorder

"Letters, we get letters
We get lots and lots of letters"

I had an interesting exchange with a reader who asked me some questions about my ideas about the family dynamics of people with borderline personality disorder. I thought other readers may have similar questions, and she gave me her permission to reproduce the exchange in a blogpost. So here t'is, with my answers in blue:

I think my mother has BPD. I am trying to make sense of it, and I am digging into my family's history, to see if I can find a possible cause for her BPD.

The mother of my mother seems to be like the mother in the movie Thirteen, that you commented on in your article. She is always stating she would do anything for her children, but at the same time she sometimes drops things like, 'I sacrificed my life for them." Which pretty much sounds like playing the victim, to me.

It is new to me, that parents who are not physically or emotionally abusive, can also provoke BPD in their offspring. Thank you for attracting my attention to that.  Researching more about this, I read an article that stated that parents who are 'over-involved' can do the same, because they don't allow their children to grow into beings with clear boundaries. Do you agree on this statement? If this is true, than the hypothesis, that BPD patients always have poor attachment to their primary care givers, doesn't stand? 

One last question is: Can patients who have BPD get cured without professional help? I am asking this question, because I realize that I also have had several traits of BPD during the course of my life - although they never co-occurred. Coming to a point where I am realizing that my mother probably has BPD, I am also evaluating my own personality, and if I am honest, I can see that, especially during my twenties, I have had several symptoms, though never more than one at the same time.

Can you please provide me with some clarity ? I would be most grateful. I however will understand if you don't have the time to answer.

In answer to your questions as they apply in general - I am not able to speculate about your situation in particular without having seen and extensively evaluated you and your family situation:

1. The family dynamics of BPD involve the parents being conflicted over the role of having kids. They go back and forth between hostile under-involvement and hostile over-involvement. In a given family, one of these sides may predominate most of the time, but if one waits long enough, the other side shows up.

2. BPD is not a "disease" but a combination of traits by which someone adapts to the above family behavior. Some people have a lot of these traits, some many fewer. The traits can range from very mild to very severe, and severity levels can change dramatically in a short period of time. They can also appear and disappear depending on what is going on in a person's family life at any given moment.

Even in people who show these traits most of the time, many of the traits may start to get better on their own as the person gets older, although certainly not in all cases. Their relationships may continue to be poor, however.  Professional help can be very useful, but whether it's absolutely necessary in every case , the answer is that it depends on a lot of different factors.

Family-oriented psychotherapy is hard to find.  The models I recommend are listed at the end of the post: I'm not sure which ones might be available where you are. In England, the most common one is cognitive-analytic therapy (CAT).

What if no other siblings had symptoms while living in this 'borderline producing family?' Does it make sense to develop symptoms only after having left the parental nest? (Because in this case, the 'spoiler' doesn't develop his behavior to balance the mother's moods: instead she only starts to be a spoiler once married, like my mum ... Then this behavior is of no use? (only to act out own frustrations maybe .. but it is not in the interest of balancing the family system). Does this make sense then ?

(Going to a family therapist in my/my mother's case is a non-option for my mother, so unfortunately I have to kind of figure these things out by myself.)

Again, many possible explanations, so I can't say anything about your situation in particular.

In general, in the type of situation you are describing, the person's spoiling behavior with the new spouse stabilizes his/her parents in some way, but is only needed by those parents when the adult child is in the context of a marriage. Often gender role conflicts and repressed anger are at the root of such a pattern - for example, a daughter might act out the mother's repressed rage about having to cater to her (the mother's) own inadequate husband (the daughter's father or step father). Through the daughter's behavior, the mom experiences vicarious satisfaction of her own rage as she watches her daughter frustrating the daughter's husband efforts to "take care" of her.

If a mother acts in a way that produces BPD in her offspring, is it always the case that the child will become a spoiler? In the particular case of my mother, everyone from her family of birth tells me how "good, quiet, well behaved..." she was. It is like she only started to have BPD symptoms when she got married and had kids. Does that make sense? 

No, not always. In fact, family dynamics are like the proverbial true-false test: nothing happens "always" or "never." There are an almost infinite number of other factors which may alter the developmental course of a child - especially other relationships including the other parent, other relatives, or supportive mentors. There is what they call a "chaos" effect - small differences in initial conditions can multiply into big differences later on. Also, in some families, only one sibling will volunteer and/or be chosen to be "it," while the others remain relatively unaffected. If the "it" child stops playing the spoiler, one of the other siblings may suddenly step into that role ("sibling substitution").  The more severe the parental internal conflict, the more additional siblings will be affected or recruited at the outset.

If BPD is not a disease, how is it that the amygdala in people with BPD seems to be different ?

The amygdala is subject to neural plasticity like many areas of the brain, which means that it normally changes in size and activity as it adapts to the environment - especially the social environment.  It's one of the bases for conditioned responses. See and

Why do almost all of the experts state that BPD is as good as is incurable, even if the patient is willing to cooperate?

"Cure" is a strange word to use since it's not a disease. Borderline traits absolutely can go away, and the relationships of someone with BPD can change for the better, especially with treatment that focuses on family-of-origin behavior.

You say that the traits of BPD sometimes disappear with aging, as they are not needed anymore. But I thought that BPD primarily stems from a fear of abandonment. So I don't see how someone can get rid of this deeply rooted feeling, even when he doesn't live with his parents anymore / is not being abused by them anymore / or maybe they even died. If there is a 'hole' inside you because of non-attachment with your parents, I thought that this emptiness will always be there, and it will just manifest itself by clinging to - pushing away spouses instead of the parents, or the same behavior towards offspring.

The issue of what happens after the parents die is still somewhat of an open-ended question for me.  For some people, they are freed up for the most part, although the "emptiness" never completely goes away. Other people get worse than ever after the parents die, even if other family members do not seem to be feeding into their problems. I think it has something to do with PTSD-like effects. The more obsessive a patient starts out, the more likely they are to obsessively recreate conversations with their parents in their heads. 

I had one patient who got a lot better after seeing the movie A Beautiful Mind. She realized that even though she couldn't stop hearing those conversations in her head, she didn't have to believe them. She discovered the secret of "Acceptance and Commitment Therapy" (ACT) before it had been "discovered" and written about - although I don't think ACT really works if the parents are still feeding into the problem, as they are more powerful in shaping a person's behavior than any therapist.

Are there cases in which a person with BPD manifests traits towards her spouse, but not towards her children? What does it mean?

There are all kinds of different permutations and combinations, and plenty of traits of other personality disorders that can co-exist and come and go with any patient. The family issues that the patient's behavior is designed to solve determines this, and every family is different. The details matter.  The stuff I write about only represents prototypes or the most common patterns.


  1. I have been following your blogs, and would like to thank you for shedding so much light on my dysfunctional family. You frequently mention how the parents of BPD children have an underlying conflict about their role as a parent, or consider their children to be burdensome, which leads to alternating under or overinvolvement. You usually attribute this parental role conflict to subconscious intergenerational gender role issues. Do you think that this is the only possible reason for their internal hostility over their parental role, or do you think it could also stem from ANY type of deep underlying resentment about ANYTHING (such as maybe an injustice in their life such as something like being bullied by classmates, an injustice in the workplace, an accident or crime committed against them or anything else they perceive as a major hurt)? Maybe the periods of over-involvement versus under-involvement and neglect are directly related to the parent trying to heal and make peace with their internal resentment? When they focus on healing themselves, they take a backseat as parents to zero in on trying to solely (and selfishly) attend to their own needs in an attempt to fill the hole, or are maybe too depressed about their underlying issue to be there for the child? When they eventually "cheer up" (temporarily) they try to make up for their absence/neglect by over-parenting, yet the underlying resentment is still not fully healed, and the hostility over it seeps out in the form of abuse? This cycle then repeats as the parent is never truly able to heal or feel whole again. It's as if they have a major chip on their shoulder that is hurting them and makes it difficult to attend to a child, while they themselves are not whole.

    This to me makes sense, when asking whether or not a BPD parent actually LOVES their child... in a way, they really do want to love their child, and do not intentionally inflict harm, but their interpsychic conflict about whatever hurt they have trumps all else, and filling that internal hurt takes absolute precedence in the parent's life. They can't help being a selfish parent, because they don't have a whole self to give. They want to love their child, but they are incapable until they fix themselves first.

    Either way, everyone hurts and I would love to seek counseling to fix my relationship with my BPD mother. I have been no contact for two years to lessen my anxiety, but that nagging unnatural kinship stuff nags at me relentlessly. I don't think no contact, or "trying to set boundaries" work, so I would love to give your method a try. Do you provide online services, or know of a therapist in the Philadelphia area that uses your methods? Are all of the therapists on your list familiar with Unified Therapy? Thank you so much for everything.

  2. Hi anonymous,

    Thank you for your kind words.

    There are several other sources of the core parental conflict that I write about besides gender role issues, although those are probably the most common ones. I list seven other ones in the post

    Not sure the conflict can be caused by resentment over "anything," but being preoccupied with one's own conflicts can certainly create the feeling that kids' needs are making one's life harder.

    Thanks for asking, but sorry, I do not do telepsychiatry by Skype. Even if I did, I'd have to be licensed in all the states where the patients live. The laws have not kept up with the technology!

    I have not had much success in garnering followers for my model, so I wouldn't ask potential therapists about unified therapy per se. The types of therapies on my list share many of the same premises, but techniques vary widely.

    The idea that personality disorders represent a sacrifice of the self to the family system is shared only by a small percentage of family systems therapists, and even they are not familiar with the theory that predicts that, called "kin selection" by evolutionary biologists, and how kin selection shapes the formation of mental models of how interpersonal relationships are supposed to function ("role-relationship schemas").

  3. Ding, ding, ding! I just read your other reasons for the parental role conflict in the other article, and it hit the nail on the head! My mother is from a Catholic family and is the eldest daughter of 7. For years, we have heard how hard her childhood was, because she was forced to wake up hours earlier than her brothers in order to iron their school clothes. I truly believe you are onto something!

    It seems the skeptical children of BPD parents are so caught up in being extremely angry over the actions of their parents, RIGHTFULLY SO, but they are dismissive of your theory because they are hyper-focused on the injustices that have been happening to them. I want to genuinely thank you, however, because I had been the same way as I was coming to terms with the abuse. I feel as though I have been in a deep depression and unable to escape because of the injustices my BPD mother inflicted on my life. I ended up going no contact for over two years and became more depressed. It was hard to snap out of it, even while in therapy. I was obsessively spending 80% of my days harping over this horrible situation, replaying conversations, coming up with ways to fix or change the relationship, trying to make sense of the madness, trying to accept it all... it was awful.

  4. When I began reading all of your blogs, things started to click. I applied your theories to my personal experience and it ALL fits and makes sense! And that means a lot, because I have major trust issues and am most definitely a highly skeptical person, due to my upbringing. Maybe it is because I am extremely desperate to find an explanation for the hell of a life I went through, and am hanging onto your explanations for dear life, or maybe it's because your theories are actually correct. The more I reflect on it, the more I think it's the latter. Your whole idea sounds absurd at first, almost like an "opposites world" where loving someone means to treat them horribly. Very hard to grasp, but once you look deeper and put the pain aside, you can really get to the cause of their BPD behavior, and then not feel so awful about yourself, as this phenomenon is just a natural human response in situations like this. On a side note, I almost wonder if there was ever a study on this relative to wild pack animals who maybe have a "spoiler" in their pack the same way as humans? It's somehow necessary for the survival of the group living out in the wilderness?

    Anyway, as much as I tried to comprehend that my mother's abuse was not my fault, I couldn't help but feel awful about myself. I couldn't shake the guilt and ingrained sense of worthlessness. However, after applying your theories to my own story, I have never felt better with this newfound knowledge!!! I wish everyone would really accept this theory in standard treatment for BPD families. It could save people from so much anguish, just knowing the CAUSE of the BPD parent's mistreatment.

    I have not yet sought treatment with one of the family therapists on your list, which I hope to eventually do, but just this insight from your blogs alone, which goes BEYOND creating boundaries, DBT for the parent, and cutting contact, had made a great impact on my life! I now have compassion for myself, as well as my mother, which was almost impossible before knowing about the kin selection and sacrifice of self theories. However, I do also believe there is a slight genetic tie-in somewhere when certain people are susceptible to becoming the "spoiler" or being chosen as the recipient of the BPD parent's abuse just by being born with highly sensitive personalities.

  5. As I continue to apply your ideas to my own story, every single aspect lines up! For example, there was a time I attempted to have a sit-down discussion with my BPD mother and what I call "enabling" father, after I went no contact and they continued to call, text and stalk me, claiming to miss and love me. Unannounced, I walked into their house after two years, and asked to talk to them in the calmest of ways. You would think that they would have been so happy to see me, as they had been texting me to come around and bring my children because they loved and missed me. Well, before even putting my foot in the door, my mother screamed, told me to leave, called me every bad name in the book, locked herself in the bathroom, refused to let me speak one word while my father literally left the scene and put earplugs in his ears! I was so confused and remained as calm as I could and said I was leaving and would never look back. They then agreed to half-heartedly listen, spew lies and deny as I tried to lay boundaries (which was advised by my well-meaning therapist). I guessed I caught them off-guard and they were ill-prepared to have to invalidate, deny and lie about everything I was saying that was true. It was the oddest scene, but then the unexpected happened. I went to leave, feeling completely confused and unsuccessful at my attempt for change, when both of my parents hugged me and began hysterically crying and fell to their knees in utter pain without saying one word. I was so taken aback and confused. Upon replaying the entire scenario in my mind for months, there was this unspoken message from them to me: "we are sorry we have to treat you horribly, isolate you and push you away, but we love you and this is for your own good." It almost felt as though they were sending me into the military and they were saying their goodbyes. Their pain was real, and I was left completely confused. This occurred before finding your blogs, and now it all makes COMPLETE SENSE! Talk about clarity!

  6. I apologize for the long reply, but the only remaining question I have when applying your theory of the BPD parent sacrificing their child to save themselves, is why do they try to isolate you from other family members, friends, neighbors, etc. with smear campaigns and divide and conquer tactics? I still can't figure it out. They are not trying to save me from these other people, but they also enlist others to push me away and isolate me from everyone, including people we do not know mutually (such as telling horrible lies about me to my husband's family, so that they no longer speak to me either! Even tough my mother has absolutely no relationship with them.) I'm perplexed on that and was wondering your thoughts?

    Overall, I feel much better simply understanding the causes of the madness, but I am still looking to fix the re-establish a healthy relationship. I am pretty certain about the causes of the abuse for three generations back, and I am guessing the next steps would be to have a highly-guided and well-planned meeting with my mother about the causes of her self -hate and why she does the things she does, as well as teaching her about why her mother did certain things to her?...all with the help of a family therapist of course.

    Thank you again for all of the clarity you have helped me to achieve. If I ever hit the lottery, I would emphatically support more research in this area!

    1. Hi Anonymous,

      Again, unfortunately, I can only answer your question by saying that there are a wide variety of reasons why people with BPD might take a particular tact like spreading lies about their own children, and it can take quite a while in therapy (and a lot of information about the parents' relationship to their own parents and beyond) to figure out a reasonable hypothesis.

      I discuss the general issue in the post:

      The parents usually both fiercely desire and are, simultaneously, extremely frightened of the prospect of being forgiven by their children.

  7. Interesting blog, with many valuable insights.
    I have noticed a pattern in the way Borderline Personality Disorder - most often exhibited in women, is addressed versus Narcissism, its counterpoint in men. Although both exist on a continuum, the literature often emphasizes the "victimhood" of the Borderline female while the (typically) male Narcissist is usually vilified.
    I attribute this to a cultural refusal to alter perceptions of women as capable of being abusers, especially when it disturbs our sacred notions about mothers and motherhood.
    I understand many adult children of Borderlines work themselves over trying to "understand" an abusive parent who lacked empathy and insight.
    Perhaps it is just a carry over from a childhood spent avoiding the reality that a parent was incapable of both parenting and loving.
    As adults we can now face this frighening truth without fear of risk to our physical, emotional and psychological survival.