When Your Daughter Has BPD: Essential Skills to Help Families Manage Borderline Personality Disorder

153 Pages·2017·1.62 MB·English

by  Daniel S. Lobel

“Daniel S. Lobel nails it. In clear language, he vividly depicts the struggles a family
undergoes when a daughter has borderline personality disorder (BPD). Do not think drug
treatments alone will suffice, or that a magical moment will change everything. What Lobel
makes transparent is how necessary sound psychology is and how, properly applied, we now
know enough to expect a happy outcome. Do not be intimidated by psychiatry or your
daughter. This book masterfully lays out how to proceed and what is necessary to grasp.”
—Arnold Wilson, PhD, training and supervising psychoanalyst at the Institute for
Psychoanalytic Training and Research (IPTAR), and lecturer in psychiatry at Columbia
University College of Physicians and Surgeons “Daniel S. Lobel has crafted a practical guide
to help parents deal with an illness that is extremely difficult to treat. He offers realistic,
positive, and compassionate suggestions to maximize success in parenting a daughter with
BPD, and addresses not only her struggles but those of the parents and family as well. It is a
valuable tool for those of us who are trying to understand the challenges we face.”
—Parent
“If your child—whether young or grown—suffers from BPD, you are suffering as well.
That’s because this problem affects the entire family, and requires specialized parenting skills.
Using case examples and an easy-to-understand approach, Daniel S. Lobel has produced a
handbook that can change countless lives.”
Publisher’s Note This publication is designed to provide accurate and
authoritative information in regard to the subject matter covered. It is sold with
the understanding that the publisher is not engaged in rendering psychological,
financial, legal, or other professional services. If expert assistance or counseling
is needed, the services of a competent professional should be sought.
Distributed in Canada by Raincoast Books Copyright © 2017 by Daniel S.
Lobel New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup
Acquired by Jess O’Brien
Edited by Rona Bernstein
All Rights Reserved
Library of Congress Cataloging-in-Publication Data Names: Lobel, Daniel S., author.
Title: When your daughter has BPD : essential skills to help families manage borderline personality disorder / Daniel S. Lobel, PhD.
Description: Oakland, CA : New Harbinger Publications, Inc., [2017] | Includes bibliographical references.
Identifiers: LCCN 2017045792 (print) | LCCN 2017048446 (ebook) | ISBN 9781626259577 (PDF e-book) | ISBN 9781626259584
(ePub) | ISBN 9781626259560 (paperback) Subjects: LCSH: Borderline personality disorder in children--Popular works. | Child
rearing--Popular works. | Self-care, Health. | BISAC: SELF-HELP / Mood Disorders. | FAMILY & RELATIONSHIPS Parenting
General.
Classification: LCC RJ506.B65 (ebook) | LCC RJ506.B65 L63 2017 (print) | DDC 618.92/85852--dc23
LC record available at https://lccn.loc.gov/2017045792
Contents
Introduction 1
1. Definitions and Development of BPD 9
2. Effects of BPD on the Family 27
3. A Primer of Parenting Skills 51
4. Step 1: Stop the Bleeding 67
5. Step 2: End Codependency and Enabling 83
6. Step 3: Healing and Forgiveness 103
7. The New Family Structure 121
8. What You Can Do to Help Your Daughter 137
9. What You Can’t Do to Help Your Daughter 153
10. Transgenerational Effects—When Your Child Becomes a Parent 171
Acknowledgments 187
References 189
Introduction
—Mark R. Banschick, MD, child and adolescent psychiatrist and author of The Intelligent
Divorce
Parenting a child with borderline personality disorder (BPD) presents challenges
well beyond the scope of typical parenting. Standard parenting techniques often
backfire, leading parents to feel that their child and their family life are out of
control. Families of a child with BPD experience tremendous conflict and
hostility, resulting in the parents feeling ineffective while the child suffers and
her functioning steadily deteriorates. BPD impacts the entire family, sometimes
leading to disintegration of the family structure as all family members come to
avoid, and perhaps even loathe, spending time together due to the perpetual
discord. Although many parents reading this book will have already sought
professional help and may have been told that their child has signs of BPD,
others may be seeking information and guidance for the first time. This book
will offer essential parenting techniques that, if used consistently, will restore
control of the family to you, help your child with BPD improve her quality of
life, and reenable your family unit to provide satisfaction and security to all of its
members.
This book is written for the parents of daughters with BPD—those who are at
their breaking point and those who are approaching it. While BPD is rarely
diagnosed in children, the patterns of BPD often begin in childhood. This book
will help you identify the early signs of BPD and differentiate these behaviors
from those of typical children. This is particularly difficult with adolescents due
to several factors. One difficulty in diagnosing BPD in teenagers is that their
personalities are not yet fully formed as they are still in a phase of significant
brain development. Another difficulty is that these adolescents often have other
coexisting conditions including mood disorders, anxiety disorders, eating
disorders, and substance abuse that complicate the diagnosis.
Borderline personality disorder is defined as “a pervasive pattern of instability
of interpersonal relationships, self-image, and affects, and marked impulsivity,
beginning by early adulthood and present in a variety of contexts” (American
Psychiatric Association [APA] 2013, 663). This means that the BPD causes the
individual to experience instability in almost all areas of functioning including
perception, mood, behavior, and relationships. These symptoms often show
improvement with treatment (APA 2013).
In this book I will describe different forms of impairment that occur to
children and families dealing with BPD utilizing dialogue, illustrations, and case
studies compiled from my many years of clinical practice. I will describe
essential parenting techniques that will stop the detrimental effects of BPD on
your child and your family. This book will allow you to gain a better
understanding of specific interpersonal behavior patterns that cause pain and
dysfunction to your daughter and your family and help you to understand why
conventional parenting techniques are not effective—and can sometimes be
counterproductive.
Following is a brief overview of how this book is organized. In chapter 1 I’ll
discuss the behavior patterns and symptoms associated with BPD and how they
affect your child’s functioning. Then in chapter 2 I’ll discuss in detail how the
illness causes your daughter to be hurtful to those closest to her. Once we’ve
explored the effects of BPD on your daughter and your family, we’ll turn to
effective methods to restore healthy functioning to your family. In chapter 3 I’ll
present a primer of basic parenting skills that you will need to apply, after which
I’ll describe a three-step restorative process in chapters 4 through 6. The first
step offers techniques to help you “stop the bleeding.” These techniques
facilitate setting interpersonal boundaries that allow for healthy interaction while
preventing hurtful exchanges between family members. Step 2 focuses on
patterns of enabling and codependency that are often pervasive in affected
families and offers specific techniques to transform these into parenting patterns
that are successful with children with BPD. Step 3 involves the processes of
healing and forgiveness. The essential parenting techniques presented
throughout this book will guide you toward creating a new family structure that
supports healthy functioning and protects new boundaries; this new family
structure is the focus of chapter 7. It’s also important for you to be aware of
realistic limitations on how parents can and cannot help their child affected with
BPD, which will be covered in chapters 8 and 9. Finally, chapter 10 will address
transgenerational effects of BPD.
Identifying the Severity of the Problem
The first step for parents of a child with BPD is to identify the scope and severity
of the problem. Many parents struggle to tell the difference between “normal,”
age-appropriate behaviors and problem behaviors that require special attention.
Some parents get so used to feeling bad about parenting that they assume
everyone feels this way. And some parents are so used to feeling unhappy in
their marriages that when they start feeling bad about parenting, it does not
surprise them or present a red flag.
BPD causes those affected to mistreat the people they are closest to. So how
much mistreatment is reasonable for parents to tolerate from their child? The
answer is none. Mistreatment is defined as treating another in a manner that is
not in that person’s best interest. This includes abuse, which is a strategy
designed to cause pain of some sort to another. Mistreatment, and particularly
abusive behavior, is always destructive to relationships and therefore should not
be tolerated at all. Following are some ways to measure the severity of its effect
on your family:
How often are family events subject to conflict? Sadly, for some
families the answer is “every time.”
How much mistreatment is tolerated by family members? On one end
of the spectrum are families that ignore hurtful expressions by other
family members. On the other end are families that hold each other
fully accountable for behavior and resolve hurt feelings in any
family member as they come up.
To what degree do family members avoid bringing up topics around
the child in order to avoid upsetting her? This is sometimes referred
to as “walking on eggshells” (Mason and Kreger 2010).
How resistant are family members to having family events? Do they
make excuses, or is it a priority in their life?
How open are family members with each other? Frequent conflict and
mistreatment cause family members to have a sense of vulnerability
that inhibits them from speaking freely and spontaneously about
their feelings and opinions.
The greater the conflict, avoidance, resistance, and guardedness in families,
the lower the satisfaction. As these qualities of family life intensify, individual
members become more and more avoidant of family gatherings and events.
Ultimately they may come to loathe family time. If your family is experiencing
these types of behaviors and feelings, then you should consider the problem to
be severe and to require immediate attention. Families that have severe
dysfunction associated with a family member with BPD may be rapidly
approaching complete disintegration of the family structure. This is called “the