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Borderline Personality: Fixing Someone Who Is Not Broken

How does a therapist help someone who always "needs" to be fixed?

Key points

  • Family members of people with borderline personality sometimes face a paradox—continuously trying to “fix” a loved one reinforces to them that they must remain "broken."
  • The same dynamic can take place in therapy. 
  • Therapists can address this by validating evidence that the patient is smart, capable, and able to improve. 
 Catch 22 by Eli Christman, C.C. by 2.0
Source: Flickr: Catch 22 by Eli Christman, C.C. by 2.0

​​​​​​For therapists such as myself who also write about borderline personality disorder (BPD) for the general public, there are several ironies that make it a damned-if-you-do, damned-if-you-don’t proposition. In one of my recent posts , I discussed the issue of how someone describing what parents are doing with their children can make those parents feel even more guilty than they already do, when guilt is what has been driving their problematic behavior in the first place. Therefore, they can get even worse.

A similar issue can take place when adult children who have BPD read my discussions of family dynamics. For the role of spoiler that they are playing, part of what drives it is often their parents’ insatiable and unceasing efforts to “fix” what’s wrong with them. Because to all outward appearances, these parents seem to want or need to continue to try to fix them, their adult children must remain “broken.” The people with BPD also think this about their sometimes-narcissistic romantic partners, who are also constantly trying to fix them—while seeming to feel that they are God’s gift to them. The more the partners try to do the fixing, the more they reinforce their mate’s spoiling behavior.

So guess what happens when an individual with BPD comes to see a therapist? The therapist’s whole purpose is to “fix” what’s wrong with their patients! How can therapists not end up inadvertently enabling their patient’s spoiler role? It’s sort of like coming to see someone whose goal is to “make you independent.” Can someone really be independent if another person is making them do something?

In therapy, the way around this is for the therapist to validate the ample evidence their patients offer (even while sometimes pretending that this is far from the case) that they are smart and capable, and that “their” problem is not a personal defect, but trying to figure out an enigma. They are trying to come up with a way to solve an almost-impossible-to-solve problem: the conflicted, ambivalent dynamics of their family members.

Doing something equivalent to this when writing for the public is a rather devilishly complicated proposition. Even spelling out what I am saying here with disclaimers doesn’t always work because it’s easy for someone coming from a borderline family to see that as a ruse to lull them into a false sense of security.

Another reason writing like mine might make persons with BPD feel helpless is that, if family members were to read my stuff and figure out what they are up to, then people with BPD might no longer be able to successfully pull off the spoiler role. They would become less powerful because I gave away their "secrets."

Nonetheless, facing the truth is the only thing that can set free everyone involved in family dysfunction. Dysfunctional roles only stabilize families (homeostasis) over the short run. In the long run, they prevent the resolution of ongoing issues.

So there is hope, especially if more therapists who understand family dynamics become available. I would love to see potential patients create a high demand for therapists who can help them identify interpersonal triggers and find ways to avoid the typical negative consequences of speaking up—rather than just focusing on what is going on inside their patients’ heads.

Facebook image: Dmytro Zinkevych/Shutterstock