Today's guest blog is from Dr. Margaret Cochran, a psychotherapist in private practice in San Jose CA. Dr. Margaret Cochran is the host of ‘Wisdom, Love and Magic,' a weekly broadcast available at webtalkradio.net that has the distinction of being the number one mental health podcast on iTunes. I had a most delightful interview on her radio show several weeks ago: I urge you to give it a listen. Her website is www.drcochran.com.
Challenges and Solutions for the BPD Parent
Let's be honest: living with borderline personality disorder (BPD) is not fun in equal, but different ways, for either the person with BPD or those who love, live with, or otherwise come into contact with him or her.
Dr. Margaret Cochran is a psychotherapist in private practice
If you're an adult, you have some choice about how much contact you have with a high functioning, "invisible" borderline,
the type most prone to acting abusively and not respecting your limits. But young children don't have that luxury. To them, a high conflict parent is a fearsome god whose inconsistencies make the world a scary place.
When they grow up, scars inflicted on these children by an unstable emotional environment linger. It can be tremendously difficult for adult children of high conflict parents to trust and have normal relationships. But as you will see later in the article, there is hope.
Children with BPD parents are not often discussed in therapeutic circles. In fact, they are often marginalized and forgotten about in the face of the overwhelming clinical demands of those with BPD.
Today, however I am going to talk about these children of high conflict parents, whose needs are so often overlooked by the clinical community.
Adult children with high conflict borderline parents fall into two categories, those who also have BPD and those who don't. Now, I know some professionals you talk to will insist that an individual can't have a personality disorder as a child because they don't have a personality before they are 18.
Well I'm here to say "it ain't so', and recent revisions to the Diagnostic and Statistical Manual (DSM) contain guidelines on the matter. In fact the famous McLean Hospital even has a Dialectical Behavioral Therapy unit for borderline adolescents.
More and more the data with regard to BPD is lining up on the nature vs. nurture side of the debate. And, by the way, nature is also winning with things like narcissistic personality disorder, bipolar disorder, depression, and schizophrenia among others. They are all "heritable," meaning they can be passed on genetically.
So what does that mean exactly? Well, it means you can have a BPD parent raising either a BPD child, a non-disordered child, or, in the case of a multiple sibling family, both. Certainly the effects of these various interfaces will end up looking different.
But the bottom line is the same: a mother or father's mental illness may have a profound effect on their child's development, including an increased risk of the child developing the same disorder. And this tragedy is being overlooked.
For example, a recent study done by Hobson et.al. shows that maternal borderline personality disorder is associated with dysregulated mother-infant communication. And this study, among others, provides some of the first empirical evidence for a link between mother's BPD symptoms and youth psychosocial outcomes. A BPD diagnosis is still often most associated with women, and, unfortunately, there are no studies about fathers of which I am aware.
So what's the answer? As usual, in cases like these what needs to be done is pretty straightforward, and what can or will be done is another matter entirely. Bottom line; the needs are the same for BPD children as for non-disordered children. They both require the following:
2. Emotional consistency
3. Calm, even handed behavioral correction techniques
4. Age appropriate boundaries, limits and expectations
5. Age appropriate verbal and physical support
6. Age appropriate nurturing
7. Age appropriate intellectual stimulation and play
8. And more patience, patience, patience.
Looking at this list and thinking about the characteristics of BPD adults one can clearly see some potential problems.
When a BPD parent is caring for children, what you have is essentially have a child raising a child. In fact, other than the play and intellectual stimulation pieces, a BPD parent is going to have a difficult time with the above list.
Here's the good news!
For many folks with BPD who know about their disorder and are willing to work on their skills in therapy, much progress can be made. This is where psychotherapy, parenting classes and the support of their non-disordered parenting partner comes in (for the purposes of this discussion we are not going to tackle the topic of two personality disordered parents).
Unfortunately, however, there are still some therapists who insist it is a bad idea to tell someone with BPD that they have it. This needs to change so that those with BPD and their families can take advantage of the tremendous amount of psychological information currently available.
The most important key to success for the BPD parent is the consistent and judicious use of 'time out.' Not so much for the child in this case, but for the BPD parent.
When things start to overheat emotionally, the high conflict borderline parent needs to step away and give him or herself time to regroup. It is important that this be framed for the BPD adult as a form of self nurturing and that they understand that the child is not winning the ‘argument du jour'.
Now, every parent can benefit from ‘time out.' But the borderline parent will need more thoughtful, supportive and stepwise training in how to implement it and make it work because of their "emotional deregulation," meaning that they become angry more easily and have a hard time soothing themselves. Not only are their emotions more intense, they are slower to dissipate.
Those with a more severe form of the disorder may not respond to parenting guidance. In these cases, there needs to be more stringent outside intervention from Child Protective Services and/or court ordered supervision during visitation that will keep both parent and child emotionally and physically safe.
Parenting is a daunting task at the best of times for the wisest and most stable among us, and it presents special challenges to an individual with BPD. With parenting education, encouragement and support in setting reasonable boundaries, and help and direction in learning about adult 'time out' as a self nurturing and self soothing process, the BPD parenting experience can be a much more positive and constructive one for all concerned.