Jenny Macfie, Ph.D., Department of Psychology, University of Tennessee Knoxville
It’s amazing what you can discover if you
actually look
When it comes to the “scientific”
literature about what causes borderline personality disorder (BPD) and other forms of self-destructive and self-defeating behavior, readers of
my blogs know that I think genetic influences are way overemphasized and the effects of dysfunctional family dynamics
and child abuse ignored as much as possible.
In my clinical practice, I see dramatic evidence that the effects of the family dysfunction on
behavior are often passed down from one generation to the next. A few studies have also looked at this, and in every case supported this viewpoint.
Two more recent
studies support my views in general about what creates the disorder.
Jenny Macfie and others, following
the work of Karlen Lyons-Ruth described in a previous post,
actually watched the interactions
between children aged 4-7 and their mothers with BPD (“A Mother’s Borderline
Personality Disorder and Her Sensitivity, Autonomy Support, Hostility,
Fearful/disoriented Behavior, and Role Reversal with her Young Child,” Journal of Personality Disorders 31(6): pp. 721-737, 2017).
The pairs were given a task
with the following instructions: “This puzzle is for your child to complete,
but feel free to give any help your child might need.” A researcher presented
one puzzle at a time in order of increasing difficulty. Mothers who did not have the disorder and
their child were also given the task. All interactions were observed and
scored.
Mothers who had BPD “demonstrated
significantly less sensitivity and autonomy support [supporting the child’s
efforts to solve the puzzles without the assistance of the parent], more
hostility, more role reversal, and more fearful/disoriented behavior in
interactions with their children than did comparison mothers.
“Role reversal” is the child taking
care of the mother instead of the other way around. In this study they
specifically looked at mothers deferring to their child’s demands, the pair
acting like playmates (for example, child abandons task and the two run around
the room rather than the mother setting limits), and mothers taking the child’s
attention away from the task by demanding signs of affection from the child.
There was no group of mothers with
other personality disorders so we do not know if the researchers results are
specific to mothers with BPD.
In a second, unrelated study, Pierre
Eric-Lutz and his colleagues looked at the effects of child abuse on the
expression of genes that control the development of the brain (“Association of
a History of Child Abuse with Impaired Myelination in the Anterior Cingulate
Cortex: Convergent Epigenetic, Transcriptional, and Morphological Evidence,” American Journal of Psychiatry 174 (12), pp.1185-1194,
2017).
Epigenetics refers to the process by
which environmental influences turn genes on and off. Most genes in a cell are
not operating at all at any given time. Epigenetics ties environmental and genetic
influences together in ways that a lot of people in the various mental health
field either seem to be unaware of, or consciously ignore. The anterior cingulate
cortex is a part of the brain heavily involved in making decisions regarding
what to do in various social situations.
Without going into the authors’
methodology, which was quite sophisticated, the study found that individuals
abused during childhood showed significantly decreased expression of a large
collection of genes involved in myelination of cells in that part of the brain.
Myelination is process which markedly changes the level of functioning of brain
cells that are part of so-called white matter.
Once again, we find that one of the main purposes of the genes that create the brain in human beings is to make humans exquisitely sensitive to the social environment.