borderline personality disorder families
borderline personality disorder parents
borderline personality disorder spouses and significant others
psychodynamic, cognitive therapy
paul markovitz, patty pheil
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Borderline Personality Disorder Families:  Thoughts and Advice

by Patty E. Fleener M.S.W.

To Parents of those with Borderline Personality Disorder

How many of you have seen the movie "Ordinary People" years ago? A young boy is in therapy with a psychiatrist and he is experiencing grief over his brother's death. I think one of the best parts in the movie is right before the session is over, the psychiatrist says to the boy "let yourself off the hook." The boy insists "what do you mean? Come on, please tell me." All the psychiatrist says is for him to think about it and that the session was over.

This is what I want to say to you, families of those with borderline personality disorder (BPD), and I will say it as loudly and as clearly as I can - LET YOURSELF OFF THE HOOK! I want you to say this to yourself again and again and again until you are free.

Some of you instantly know what I mean and some of you are still wondering what is meant by that statement as that young boy did. He didn't understand what the psychiatrist meant at the time until he allowed some feelings out he wasn't aware he had - feelings that were hidden deep inside, causing so much pain.

Later in the movie, the pain comes out. He telephones his Dr. in the middle of the night and they meet in the office. He is finally able to describe the accident that he and his brother were involved in - where his brother died and he survived. What feeling was this young man holding on to that hurt and hindered his life so much? GUILT! He felt he had not done enough to save his brother. He wondered if could have done something differently, could it have saved his brother? He felt he was a terrible person for not saving his brother and he felt guilty that he was the one alive and not his brother.

So, my message to parents is LET YOURSELF OFF THE HOOK. Why should you do this? How can you do this? Do you deserve this?

Paul Markovitz, M.D., Ph.D., a key person in the BPD field, feels that it is almost conclusive that borderline personality disorder (emotional intensity disorder)  is caused by genetics. He does state that the parent's own disorders could be involved in how the child is raised but we are looking primarily at genetics. the research says the risk of a BPD mother giving birth to a child with the BPD is 5 times more likely that a parent without the BPD?

If you are experiencing guilt over your child having the BPD, isn't knowing about the genetic links enough to assist you in stopping your feelings of guilt? Did you do the best you could while raising your child? Did you make mistakes? Of course you did, I did. We all make mistakes as parents no matter if we had some disorder we dealt with while raising that child or whether we had enormous baggage ourselves from our own lives and or families of origin. We simply did the best we could.

Did you cause physical, emotional or sexual abuse upon your child? Were you yourself abused as a child? If these are the case, your best course of action now is the get all the help you need for yourself to be a happy and productive adult, work on those abusive issues and if your child is young and you honestly feel your presence is a danger to that child, please reach out and call the child protective services agency where you are. If you love your child, you will want to keep them safe while you are working out your own issues. Remember, there are no bad people - only people that need help.


If your child is already grown, and you inflicted abuse, as I said, please get some medical and therapeutic counseling for yourself. Work hard on being a happy and productive adult that your child will see as a role model and it will show your child that they too can be happy as well.

In the meantime, guilt will keep you stuck. If it makes you feel better, hit yourself over the head forty times with a pillow and let it go. If you are a spiritual person, ask God to forgive you. 

I strongly recommend that you ask your child to forgive you. This action will not only help free you but your child as well. It will demonstrate to your child that you actually acknowledge that what did happen to them was not their fault and that they were clearly abused. Let them know they didn't deserve it. Give them a reason if you can. Tell them you are sorry, only if you are. It is up to them whether they forgive you or not. That is not your business. If you are not forgiven; perhaps in time…

If you are a parent saying "but I didn't abuse my child!," I hear you. Many parents simply did not abuse their borderline children. Case closed.

What can you do for your child? If your child is still not an adult, your first goal is of course to get an accurate diagnosis of ALL their diagnoses. As Leland Heller, M.D. says "All disorders need to be treated." Then comes medical treatment which can take some time to fine tune it to fit your child. What is key here is having your prescriber someone who really is updated in treating this disorder. You don't want to waste time on someone who is telling you there is no help, or is not aware of the correct medications used to treat this disorder. During this time, get your child into some kind of psychodynamic therapy, cognitive therapy or DBT (dialectical behavior therapy). If your child attends talk therapy, make sure your child is kept in the present, not in the past.

If your child is grown, are they aware they may have this disorder? Have they been evaluated? Are they in denial? If your child is not wanting help, there is absolutely nothing you can do but to go on with your life and be a happy person. You need to remember you are powerless over your child and their illness. For those of you who saw the movie "The Matrix," do you remember Morpheus repeatedly saying "I can show you the way, but you yourself must open the door." This is the same with your adult child.

I can hear you saying "but my child is in so much pain and they engage in self-mutilation or self harm and their life is in a crisis. How can I just let go? I hurt so much!" Yes I hear you. I hear you very clearly and I know the extent that hurt is, inside of you. However my advice remains the same. Perhaps this is a time for you to get some counseling to help you with the pain you are experiencing. You clearly need support. I also urge you to read "New Hope for Borderline Personality Disorder." It has an excellent family section.

Remember also that splitting is part of the borderline disorder. Splitting is when the borderline sees a person as either all good - white, or all bad - black. There are times where you will be in the white and times you will be in the black and you probably won't understand "what you did" to make your child distance you. You may not understand "what you did" to make them rage at you. Remember, we are talking about a medical disorder your child has and this disorder has an effect on their moods, their thoughts, and their behaviors. What borderlines feel, they feel it more deeply that you do. The limbic system in the brain is affected and regulation of mood is impaired.

If your child is still raging at you, has extreme mood swings, depression, constant anger, etc., though I am not a doctor, that tells me they may not be treated medically. If they are on medication, they need to return to the Dr. for a medication evaluation.

Borderline Spouses or Significant Others

Much of the above applies in this same situation, except that you have the option to leave your borderline if you feel you cannot cope.

I am hoping you will understand that there IS hope for your partner and your relationship. They key however is if your partner is out of denial and ready to receive medical treatment and therapy. Do they realize they have a problem? 

How can you help your partner? Remember always he/she is not a bad person, that they truly have a medical disorder they do not deserve and that they are not their illness. When they rage, leave. Don't argue back. Remember that you cannot control their rages or their mood swings or their thought patterns, etc. You are not in control. You cannot control whether they self-mutilate or not. You are powerless and knowing this and remembering this will help you tremendously and will hopefully free you. However give your partner all the love and support they need that anyone with a major medical disorder would need. They suffer and they suffer tremendously. Their level of hurt is severe, so severe that borderlines will do almost anything to relieve the pain.

If your partner's behavior is in anyway hurting your children you need to take steps to protect them. If your partner does not appear to want help and you feel that the relationship is toxic for you, you need to think about yourself and what is good for you. There comes a time if we cannot help our partners if they don't want help, that we need to get the focus off of them and back onto themselves and what we need to do to take care of ourselves. Evaluate your own level of codependency. Perhaps reading some of Melody Beattie's books on codependency will help you. My favorite is "Codependent No More." Honestly it changed my life.

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self harm, self-mutilation, self mutilation