A Matter of Personality

From borderline to narcissism

Borderline Personality Disorder: Meet the Parents, Part I

What Parental Behavior May Lead Children to Develop Borderline Traits?

Rosie the Riveter
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I have always been fascinated by the phrase, “I love (him or her) to death.” I know it's supposed to mean a lot of love, but the choice of words is a bit odd, is it not?  And then there's the fact that the statement is usually followed by a “but.”  As in, “I love him to death, but he drives me nuts!” So exactly what is the phrase supposed to mean? 

Do persons making the statement feels that their feelings for others are so toxic that they could kill them, literally or figuratively?  Well, sometimes, but not usually.

Does it mean that the lover-to-death thinks they will literally smother the object of their affections?  That answer maybe getting a bit closer to the heart of the matter.

A clue as to the real meaning of the statement is the "but" part that usually follows.  Aha!  Ambivalence is rearing its ugly head. A therapist might say that the person has an intrapsychic conflict or mixed feelings towards the significant other (or an approach-avoidance conflict if the therapist is a behaviorist. Sorry CBT'ers, but it's the same thing).

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A non therapist might say the person has a love-hate relationship with the Other.

In an earlier post, I opined that the basic problem in the "borderline" family (one that produces offspring with borderline personality disorder [BPD]) is that the parents in such families see the role of being parents as the end all and be all of human existence, but all the while, deep down, they either frequently hate being in the role of parent or see their parental role as being an impediment to their personal fulfillment. 

I also explained how the person with BPD develops the Spoiler role in response to the double messages that this emotional conflict leads such parents to give off to their children.

It's all well and good to try to understand the behavior of the individual with BPD in terms of a response to parental problems, but that just kicks the question of an explanation for the disorder back a generation. In order to fully understand BPD, we have to ask, "What on earth makes these parents so damn neurotic that they compulsively have children and then covertly resent them?"  

(Neurotic, for those who forget, means conflicted).

If the parents are not patients themselves, the only way for a therapist to get to the bottom of this is by helping the patient with BPD to construct a family genogram. A genogram is sort of an emotional family tree, and is a mainstay of the type of family systems therapy designed by family therapy pioneer Murray Bowen.

Murray Bowen
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Using historical figures and geneology records as illustrations, the book Genograms: Assessment and Intervention by Monica McGoldrick and Randy Gerson describes how genograms can be constructed . 

However, the genograms as described by Bowen therapists are, in my mind, incomplete. They concentrate on which relatives were over-involved or under-involved with which other relatives, and whether these relationships were hostile or friendly. IMO, this leave out an awful lot of important information. Two individuals may easily have a hostile and enmeshed relationships with each other over one area of functioning, say work or love, and yet still be very distant, friendly or complely uninvolved with one another over a different area of functioning.  


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In other words, these genograms omit the content of the family squabbles.  When the content is added to the genogram, one can then look for the historical experiences of the family that may have led to the creation of the family dynamics that are taking place in the present.

While I have indeed seen the parents of adult children who exhibit BPD in therapy and traced their genograms, I have also coached patients with the disorder themselves to construct their family's genogram. We try to go back as far as we can to figure out what family experiences led to the parents' conflicts.  Sometimes the story goes back more than three generations and we may lose the historical scent, so to speak, in that no one alive knows what happened way back whenever. Usually, however, certain patterns come to the fore.

In Part I of this post, I will describe the one most common major issue seen in the genograms of patients with BPD, and the resultant behavior patterns, that I have discovered lead individuals within a family to develop a severe conflict over the parenting role. In Part II, I will describe some of the other ones.

All of these issues may seem very common everywhere, and indeed they are. Most families that face them do not produce emotional conflicts significant enough to create BPD pathology in offspring.  Rather, the issues in families that do have been magnified signficantly by an interacting tableau of historical events impacting the family and the individual proclivities of each and every family member and descendent. 

I will not describe the details of the magnification process here, but a full explanation can be found in my book, A Family Systems Approach to Individual Psychotherapy.

The most common cause of conflicts over the parenting role stems from cultural rules regarding gender role functioning. Over the last century the opportunities open to women to explore their interests and ambitions have gradually expanded, and having a lot of children certainly puts a damper on their ability to do this. If a woman came from a family in which the women were very bright and had a natural proclivity for being ambitious career-wise, this would often create difficulties for them since they lived in a male-dominated culture that was at best unfriendly to female career ambitions.  

To demonstrate how this might play out in a hypothetical family, I often discuss the evolving role of women in the United States since World War II. During the war, when all the men went off to fight, women in the United States entered the workforce in large numbers for the first time - in order to build the airplanes and tanks. This phenomenon came to be known as "Rosie the Riveter."  

Some women found the experience of a career exhilarating, but when the war ended, they had to go back to just being wives and mothers once again. The U.S. government even made propaganda films thanking the women for their important work, but then encouraging them to go home to get barefoot and pregnant once again.  I have seen some of them; by today's standards they are positively jaw dropping. But effective.

The Rosies did what they were told, and that is why we had the baby boom.

Fast forward twenty years. The daughters of this generation came of age in the sixties, when the women's liberation movement had started in earnest. Women were more and more torn between the earlier gender role requirements and the new cultural opportunities and expectations, and some women (as well as some men) did not make the transition very smoothly at all - for a variety of reasons. 

One common reason: the Rosie the Riveters, having had a taste of the career world, would vicariously live through the career aspirations of their daughters. However, at the same time they would be extremely envious of them as well as reminded of and frightened by their own repressed - and unacceptable to both them and their spouses and parents - ambitions.

Having children could easily bring the whole craziness to a head for some families. Even today, large numbers of mothers feel very guilty about not spending as much time with their children as they would like, and they are often criticized at every turn by their own parents as well as the Phyllis Schlafly's of the world.  (Phyllis Schlafly was a career woman who made a career out of bashing career women). 

Phyllis Sclafly
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In doing genograms, one can often see just how far a family's operating rules in the present lag behind our current cultural norms.  In anthropology, this problem is called cultural lag. The cultural progression in Western nations, which is mimicked within certain families, was thus: First, women really could not have careers at all.  If they did, it tended to be in disreputable careers like show biz.

Next, they could have careers, but only when they were single. Even then, their choices were limited to mostly teaching, nursing, and secretarial jobs. Next - and this is where many families with BPD members are stuck - they could only have careers, but only if they had not yet had children. Then, they could have careers even if married with children, but they had to give priority to the husband's career.  Last, both men and women were entitled to the same freedom.

Gender role confusion and conflict can, given the right combination of ingredients, create a nasty intrapsychic conflict over the very act of procreating.  

In Part II of this post, I will look at the rest of the historical factors and patterns that can create such a conflict: Deaths and illnesses, financial reverses, religious demands, parent-child role reversals, being the eldest child in a traditional family, and having children to "save the marriage."

David M. Allen, M.D., is a Professor of Psychiatry at the University of Tennessee and author of the book How Dysfunctional Families Spur Mental Disorders.

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