Borderline Personality Disorder: 8 Ways Families Can Worsen Symptoms
Do you know someone with borderline personality disorder (BPD) who seems to worsen when an overly emotional or argumentative family member creates a problem, pushes a boundary, or becomes upset? Have you yourself experienced this unhealthy pattern?
Sadly, I have seen this pattern in so many families. In fact, there was a time, shortly after beginning my career 7-8 years ago, I became completely burned out by perplexing family dynamics in the lives of my clients diagnosed with BPD. I soon realized that unhelpful or negative communication styles were often at the core of these complex families.
This article will discuss the challenges families can create for the loved one diagnosed with BPD. Visit my website for ways to maintain appropriate boundaries and support a loved one.
It can be very disappointing and overwhelming for someone diagnosed with BPD to recognize symptoms or behaviors in their own family. It can be even more disappointing when families lack the knowledge necessary for helping a loved one recover or develop helpful skills. Well-meaning families may find that they are unable to help their loved one because of:
- Poor knowledge of more appropriate ways to relate to others
- Lack of knowledge of BPD symptoms and environmental influences on coping with mood wings or symptoms
- Generations of untreated symptoms that worsen with time and become the family “norm”
- Refusal to seek help because “it’s just how she/he is.”
A common scenario of complex BPD-like family dynamics may include a mother and daughter relationship. A mother with un-diagnosed BPD symptoms may attempt to help her daughter (who has been officially diagnosed with BPD) cope with her marriage but not see how her inflammatory statements, aggressive behaviors and attitude, and mood swings could actually result in her daughter “learning” unhelpful communication styles or patterns. Mother’s attitudes, behaviors, and mood swings can also begin to erode the daughter’s pattern of emotional expression, possibly leading to a worsening of symptoms. Can you think of a similar situation from your life or a situation you know that may be similar to this pattern? If so, what unhealthy patterns did you notice?
It is important that families explore better ways to communicate with a loved one who has been diagnosed with BPD. It is also very important that families become more open to exploring how unhelpful and negative patterns of emotional expression can negatively affect loved ones. Sadly, not all families are aware of negative patterns of interaction and would benefit from an outsider (therapist, friend, coworker, extended family member, spouse, etc) pointing it out.
Some of the ways families can exacerbate or “worsen” patterns of unhelpful communication styles is by:
- Exaggerating situations: Some families can exaggerate situations their loved one is experiencing just by raising their voice, offering their unhelpful perceptions, or gossiping. Have you ever had an argument with a spouse or friend and shared the details of the argument with an overly emotional or “passionate” family member only to later realize that perhaps that was a bad idea? In families where BPD traits are strong, it is very likely that emotionally-charged situations will become exaggerated. Having someone who can take a more objective, neutral position on a matter will be significant to keeping things calm.
- Refusing to seek their own help: Families who have a history of BPD symptoms will most likely ignore treatment and see unhelpful patterns of behavior as “the norm.” I have seen families where great uncles or aunts and or great grandparents exhibit strong symptoms of BPD but refuse to seek help because the family has decided to refer to the person as “difficult” or “hard to get along with.”
- Triangulating and pushing boundaries: In families where BPD-like symptoms are strong, triangulation (i.e., getting multiple people involved in an incident to get feedback or support) and pushing boundaries are frequent occurrences. Triangulation can be both intentional (i.e., with the goal of creating chaos) or unintentional (i.e., with the goal of getting multiple opinions or feedback). It can be difficult to determine when triangulation and pushing boundaries is unintentional because once the ball gets rolling, many people within an emotionally charged family respond negatively. Again, having an objective, less emotional outsider examine what is going on can be helpful.
- Playing into the loved one’s emotions or “games:” I often see this happen in therapeutic settings where an adolescent is the client diagnosed with BPD traits. A manipulating or very emotional teen may be able to “encourage” her mother to agree with her, see things from her perspective, or abandon family values just by saying or doing all the right things. This is not, however, to say that all individuals with BPD display these kind of behaviors. But there are some who do and it’s important we understand how they operate.
- Forgetting to control their own emotions: Families who are conditioned to expressing emotions in a certain way are not going to be able to change right away. Changing unhelpful patterns of behavior or emotional expression may take years to restructure. If a parent is unable to control his or her emotions, the child is going to struggle as well. In cases like these, it is important that the parent(s) or adults in the family learn to control their reactions, behaviors, and unhelpful communication styles so that they can model better behavior to the child. Even more important is that families begin working on the home environment and improving behaviors because a loved one in therapy can worsen if they return to a family environment that is unhealthy.
- Getting overly involved in the loved one’s healthcare: Sadly, there are families that are unable to respect the personal space of someone receiving counseling or other psychiatric services. For example, a parent or guardian who has a son diagnosed with BPD may want to know what he talks to his therapist about on a weekly basis. If this young man decides to keep his session discussions private, this can trigger the parent or guardian to react in unhelpful ways (especially if the son does not open up to them). This only further reinforces the son’s reasons for keeping things private in the first place. It can also create stress on the part of the provider who may want to respect both the parent and the son’s wishes. It can be very complicated when families react emotionally to the legal and ethical boundaries of mental health care.
- Being confrontational with healthcare providers who are trying to help: It is common knowledge among mental health professionals in many roles within the field that families can be one of the most difficult groups to communicate with when treating an individual with BPD. Most families are well-meaning, loving, and caring. However, if boundaries are weakened for some reason, are not built appropriately by the mental health professional from the start, or are fluid, things can go downhill really fast. It is important that mental health professionals react calmly and peaceably to families who are seeking care for a loved one. It is also important that families maintain respect of the providers who are doing their best to help and support the family. Open communication, respect, and boundaries are extremely important in these cases.
- Arguing with the loved one, yelling, or becoming aggressive: Believe it or not, some families can react to the individual diagnosed with BPD in such a negative way that the individual feels they are getting worse and not progressing in treatment. Unhelpful communication styles, overly emotional approaches to challenges, and poor boundaries can all make an individual (who is attempting to recover and develop new skills in counseling) feel defeated and overwhelmed. Families must be cautious of how they interact with each other.
What has been your experience with this topic? Do you have a story you’d like to share? Feel free, as always, to post your experience below.
I wish you all the best
Allen, M. D. (2011). The family dynamic of patients with borderline personality. PsychologyToday. Retrieved from, https://www.psychologytoday.com/blog/matter-personality/201109/the-family-dynamics-patients-borderline-personality.
Gunderson, G. J., & Berkowitz, C. (n.d.). Family Connections. Borderline Personality Disorder Family Guidelines. Retrieved from, http://www.borderlinepersonalitydisorder.com/family-connections/family-guidelines/.
Hill, T. (2017). Borderline Personality Disorder: 8 Ways Families Can Worsen Symptoms. Psych Central. Retrieved on March 21, 2018, from https://blogs.psychcentral.com/caregivers/2017/05/borderline-personality-disorder-ways-families-can-worsen-symptoms/