Immigration and Family Dysfunction

The children of immigrants to the United States from traditional societies often get double messages about which cultural norms they should follow, creating serious conflicts.

Do Panic Attacks Really Come Out of the Blue?

It is often claimed that panic attacks are not triggered by specific environmental or interpersonal stressors because they seemingly happen at any time. This is misleading.

I'll Enable You if You'll Enable Me

The concept of enabling in alcoholism is just one example of a much wider phenomenon seen in couples, and it is two-way street. It both connects a couple and drives them apart.

Family Dynamics in Song: "A Boy Named Sue"

Sometimes, writers come up with insights about psychology and family dynamics that seem to escape most practitioners in the field. The song "A Boy Named Sue" is a prime example.

Hateful, Abusive, Neglectful Parent, or Doting Grandparent?

How does someone react if his or her parents, who had been guilty of abusive, neglectful, or invalidating treatment of them as children, dote on their grandchildren?

Inflexible Behavior in Personality Disorders

People who rigidly engage in the same behavior over and over again despite the consequences are often acting out a false self for the sake of their families.

Neglectful Parents and Eldest Siblings

When parents neglect a large brood of children and leave child care duties to the oldest among them, dysfunctional patterns of relationships between the siblings as adults emerge.

Parenting: Opposite Strategies, But the Same Results

Extremes of parenting (such as being overprotective vs not protecting at all) may often lead children to act out in very similar ways -no matter which extreme the parents are at.

Risky Behavior and Victimizers: Two Issues, Not One

A teen passes out drunk at a frat party and is raped. A woman whose husband beats her goes back to him repeatedly, despite having the ability to leave. Lately, anyone who even brings up the subject of risky behavior by people like this are accused of "excusing" the victimizer and "blaming" the victim. Nonsense. Though connected, these are two separate issues, not one.

How I Learned About the Family Dynamics I Write About

In the comments by readers responding to my blogposts about dysfunctional family dynamics, I am often accused of naively believing my patient's "distorted" descriptions of their interactions with their family-of-origin members. In fact, I have observed these processes directly in a variety of ways. I describe those ways herein.

Violent Media Creates Couch Potatoes, Not Violent Youth

How many times have readers read stories about how violent video games and movies are causing more youth violence? Youth violence has in fact fallen as media has become more violent. Many studies only measure short-term aggressive thoughts after watching these things, not actions. In fact, most kids who watch a lot of violent media are couch potatoes, not gang bangers.

Whatever Happened to Assertiveness Training?

Getting mellow and relaxed in response to stress can be a good thing, but it can also lead to staying in a bad situation that might otherwise be fixed, particularly in dysfunctional families. Cognitive behavior therapists used to counsel their patients on how to speak up for themselves, but seem to have forgotten the "assertiveness" techniques they used to champion.

What Makes People Do the Same Stupid Things Repeatedly?

If we assume as I do that they are not mad, bad, or stupid, how do we account for people with personality disorders who continue with the same disastrous behavior patterns repeatedly with the exact same disastrous results? Or who go from one extreme to the other, and still end up at the same place? Could it be that the end result is actually their goal? And why?

Public Faces Vs. Private Thoughts: the Actor's Paradox

Many therapists seem to think that patients behave in their offices in ways typical of how they behave in other social contexts. This is very naive. We all present different aspects of ourselves, and hide other things, depending on the goals we are trying to reach with certain others, or because of loyalty to our family system and its beliefs. We lie even to ourselves.

Childhood Sexual Abuse Taken Out of Context

Child sexual abuse is a big risk factor for a wide variety of psychiatric disorders. But why do some victims turn out one way, others a different way, and still others turn out without any disorders at all? So called empirical studies of child abuse are limited to such variables as who the perpetrators were, what did they do, and how often. There's a lot more to the story.

Relationships Cause Conduct Disorder, Not "Bad Seeds"

To paraphrase a certain politician, it's the relationships, stupid! In order to avoid looking at their own or their family's behavior, both parents and professionals seem to want to think that children can be born as "bad seeds." However, human genes do not work that specifically. It is not toxic people that create most dysfunctional families, but toxic relationships.

Why Patients with Borderline Personality Don't Get Better

People who exhibit symptoms of borderline personality disorder, despite being intelligent and showing no signs of psychosis, persist tenaciously in their troublesome, self-destructive behaviors. They will not stop no matter what other people try to do to get them to. They will not tell you about the horrifying reactions they get from family members when they act better.

Parental Guilt: The Dilemma

Today both men and women worry about short-changing their children because of their both working, and their own parents often feed their guilt. The result is an epidemic of over- and under-parenting in which the needs of the children take precedence over the need of the parents, leading to out of control children who have trouble becoming responsible adutls.

The Culture Wars and Parental Guilt

A massive cultural change that has taken place in a fairly brief period of time has led to the infamous culture wars between the forces of individualism and those of conformity. Gender role expectations have dramaticly transformed. This has led to a massive explosion of parental guilt, which has resulted in problematic parenting practices that lead to impairment in kids.

How Much Should Parents Protect Their Children?

A legitimate question about how much risk parents should allow their children to take, and how protective of their children parents should be has been all but drowned out by extreme emotion.

Do As I Say: Be Oppositional!

Oppositional behavior by children would seem to run counter to arguments in my previous posts that family members often do what they think their families want them to, even at great personal sacrifice. But oppositionality can be more apparent than real. People often act that way to accomodate what they perceive their parents to want and need from them.

Empathy for a Child Abuser?

Empathy for a child abuser? For a child molester? How can anyone be empathic with someone who has done something so terrible? Why would they want to? Do the perpetrators possibly deserve such a thing? For a judge or prosecutor, of course not. For stopping repetitive dysfunctional family interactions that trigger someone's self-destructive behavior? Necessary.

Mixed Messages in Your Family? A Quiz You Can Take

A highly prevalent feature in families that produce an offspring with a significant personality disorder is parents who give their children mixed, contradictory messages about how to behave in certain social circumstances. To see how your family stacks up against other families and to find out what issues your family has, I herein provide a self-administered quiz for you.

Others All Good or All Bad: A Splitting Headache

Ever since they were first described by psychoanalysts, people with borderline personality disorder were presumed to be incapable of seeing both the good and bad in other people simultaneously. While they can indeed act that way, they are actually superb judges of character. They are also thought of as being manipulative, which requires that very ability.

The Power of Ambiguity in Family Communication

All languages have a high degree of ambiguity built into them. Any sentence has at least two possible meanings, particularly within the context of a particular relationship. In sensitive family discussions, hiding one's true motives through the use of ambiguous communication is a frequent occurence. Understanding this ambiguity can help uncover crucial family secrets.

Fear of Success Masquerading as Fear of Failure

People often justify their lack of effort at achieving a desired goal to a fear of failure - as if failure by never making an effort is somehow less of a failure than trying and failing. Why would anyone assume failure before even making an effort? Often, the "fear of failure" is really a fear of success. Their successes may often provoke severe family dysfunction.

Parents Cut Off by Adult Children: Clueless?

A recent spate of letters to advice columnists were written by parents who have been cut off by their adult children, and who complain that they have done little or nothing to deserve having been treated in such a manner. Once the full story about the estrangement starts to come out, however, it usually becomes apparent that they really do know better.

Responding to "Borderline" Provocations: Last Part

Being in a relationship with someone with traits of borderline personality disorder is incredibly challenging. In the last part (X) of this series, I discuss: First, when the recommended strategies are not working, what do you do then? Second, if you react badly only rarely, and you will, the person with BPD will escalate. How do you stop that process?

Treatment Resistant Depression and Borderline Personality

A debate between two academics about whether personality disorders or hidden "bipolarity" is the major cause of depression that responds poorly to antidepressants is dissected in this post. Many doctors seem to accept the absurd assumption that everyone who is moody must have an underlying manic depressive illness. They also seem to think that all depression is the same.

Borderline Provocations IX: Hostile Sounding Comments

Being in a relationship, by blood or romance, with someone with traits of borderline personality disorder is incredibly challenging. In Part IX of this series, I recommend listening to the actual words when someone makes a statement which sounds like a criticism, rather than the tone of voice, because the statement may actually be ambiguous.