The Essential Family Guide to Borderline Personality Disorder

by Randi Kreger

  • deal with the social stigma of having a mentally ill person in your family

  • lose contact with family and friends

  • worry about being responsible for keeping your family member alive and healthy

  • have your spirituality tested—some people question their religious faith or their ability to see life as promising and good

  Different types of relationships pose different challenges. The following stories, which are composites of actual family members, display the similarities and the differences of various relationships involving someone with BPD.

  Parents and Grandparents

  Parents of those with BPD receive a double whammy: the anguish from having a disturbed child; then, when they search for help, the shame and shock when most professionals hold them responsible for their child’s suffering.

  Jill was a beautiful baby. “I looked at her and I could feel the tug at my heart,” says Kay, Jill’s adoptive mother. Grade school wasn’t easy for Jill; she clung to Kay like rubber cement, refusing to get on the yellow bus: “Don’t make me go, Mommy! Let me stay with you!” She had a hard time making friends, and teacher after teacher complained of her being uncooperative. The school counselor was certain that Jill would most likely grow out of it. But she never did.

  At fourteen, Jill became introverted and rebellious. “We thought it was just adolescent rebellion, but she never came out of it,” says Kay. Years of misery followed: drinking, rebellious friends, and skipping school. Jill’s screams of defiance were punctuated by slamming doors and flashing anger. She dated a boy who slammed her into her locker, leaving bruises up and down her arms. She yelled at her parents and demanded they get off her back.

  As soon as she turned eighteen, Jill moved in with an equally rebellious girlfriend, the friend’s hard-drinking mother, and the mother’s drug-dealing boyfriend. The mother moved out of town, leaving the two girls and the boyfriend alone in the apartment. Jill’s new boyfriend, Sam, quickly moved in.

  A few months later, Jill announced that she was pregnant. Her parents rallied to her side and met Sam, the child’s father. Jill and Sam wanted to get married, so Kay quickly put together a lovely wedding. Jill was radiant.

  After baby Alicia was born, Jill seemed grateful for her parents’ love and support. Alicia quickly became the joy of all their lives. But then Jill felt restless again and rebellious; she began seeing other men behind Sam’s back. When she met Trevor, she divorced Sam and married her new love just a few months later. Cozying up to her parents, Kay and Doug, Jill convinced them to pay for another wedding. Then Jill ignored them the entire day of the wedding. She had no photos taken with her family, only with Trevor’s family. She called them her “real” family now.

  Jill started using her daughter and stepchildren to control her parents. For example, one day Jill told them they could spend time with Alicia only if they took her husband’s two boys as well. Kay and Doug agreed. After all, they wanted to establish a relationship with their new step-grandchildren, too. But even though they treated all three children equally well, Jill raged at them for showing favoritism toward Alicia. “You’ll never see any of the children again,” she threatened.

  Kay and Doug found that it was much easier to see Alicia when she was visiting her father, Sam. They knew that Jill wouldn’t like it, but they felt they had no other choice if they were to have a positive and loving relationship with their granddaughter. Unfortunately, when Jill found out about the visits she became so enraged that she accused Sam and Doug of sexually molesting Alicia. Careful examination by a doctor and psychologist found no basis for the accusation, and the charges were dismissed. The psychologist recommended counseling for Jill, but she refused.

  Kay and Doug are now in the process of getting court-ordered visitation rights so they will still be able to have some relationship with Alicia. “We don’t want to abandon her because I think she’s already had a lot of emotional damage from the things Jill has subjected her to,” Kay says. “I think we are the only people in her life who show her constant, unconditional love.” Their only hope is that the court will see through Jill’s lies. Yet they know how convincing she can be.1

  Partners

  Richard met Laurie at a party and was immediately taken by her stunning brown eyes. After dating for eighteen months, Laurie began pushing Richard toward marriage. Her demands for his time and attention grew steadily until she became almost threatening.

  Not long after the couple married, Laurie announced that Richard should spend more time with her and less time with his friends. He did to keep her happy. “She kept exploding over things, and it was always all my fault,” he says. “I twisted and turned to please her, but it was never enough. I’d move out. She’d go into her ‘I’m going to kill myself’ song, and I’d come back and try to make it better.”

  After two years, he told her that perhaps they should separate for a while. He recounts what happened next:

  She started screaming at me about me wanting to divorce her so I could sleep around. She said really ugly things about how I couldn’t “make her happy.” I was so devastated that I just stood there with my mouth hanging open. Then she picked up a plate and threw it at me. It hit the wall. I picked up my gym bag and left.

  I was staying with my parents and Laurie called me there all hours of the day and at work to get me to come home. Finally, she started threatening to kill herself if I didn’t come back. I gave in and moved back, sure my love could heal her. Then she became pregnant. When she suffered a miscarriage, she blamed me because she said I didn’t love her or the baby. She said that this was how God was punishing me. My self-esteem had dropped so low that I was struggling at work and drinking a lot. I was spending more and more time away from home with my friends so I could avoid her anger and her rages.

  I vowed to get the hell out. Laurie said that she felt terrible about what she had done. She was so sweet and seemed so sincere. She promised to change. She said how sorry she was and kept telling me that no one would ever love me as much as she did. We made love that night and conceived our son.

  The day my son was born was one of the happiest and most difficult days of my life. When Michael was two weeks old, I came home from work to find the locks changed. Laurie screamed at me through the door that I would never see my son again and that she was going to have my parental rights revoked. I drove to a friend’s house and sat on the front steps trying to figure out what to do next.

  Laurie contacted a therapist who specialized in family and child sexual abuse. She convinced the therapist that I posed a threat to my son because of my “abhorrent sexual behavior” and the therapist wrote a letter to her attorney suggesting that I be placed on restricted, supervised visitations.

  Early one morning, Laurie dropped Michael off at the sitter and said she had to go to work. She never showed up. She began calling everyone she knew and telling them that she was killing herself. After a six-hour search, paramedics found her in a hotel room trying to overdose. She survived and was put into psychiatric care. Her diagnosis was borderline personality disorder.

  My attorney filed for immediate, temporary custody of Michael. It took two and a half years and a lot of money, but I finally won full custody. Laurie is now on supervised visits with our son. She has been on medication and in and out of therapy for the past five years. I wish her the best, because that’s what’s best for my son.2

  Children

  Kellie wrote (but never sent) this letter to her borderline mother, Ruth.

  For most of my life I have been afraid of you. It is almost like I grew up with two mothers: the Good Mother and the Bad Mother. The Good Mother is very supportive and nurturing. She encourages me to get better at chess, stands up for me, worries about my future, and tells me she loves me.

  But when the Bad Mother appears, everything the Nice Mother does gets wiped away. The Bad Mother’s anger is out of control, ’cause she can only feel better once she has destroyed. I’m thirteen or
so and the Bad Mother doesn’t like the way I eat. She thinks it’s impolite. She tells me, “You’ll never have any friends if you eat like that.”

  I’m a teenager and once a week I am supposed to take out the trash and clean my room. Sometimes I don’t and it’s okay. Then sometimes the Bad Mother comes out and screams and yells and rages because the trash overflowed and egg yolk hardened on the floor. She tells me what a jerk I am and says I can’t watch TV for a week. “You’re ruining the family,” she screams at me.

  When I grow up, I try desperately to find someone who will love me. I keep on re-creating my relationship with my mother by choosing men who ultimately reject me. When my husband gets irritated at me and doesn’t want to talk, or if he says no when I initiate sex, I am convinced he no longer loves me and we argue. When I return to reality, I don’t understand what made me doubt his love. But I keep testing him ’cause I just can’t stop.

  Siblings

  Perry Hoffman, PhD, who is cofounder of the Family Connections program of the National Education Alliance for Borderline Personality Disorder, says that parents and siblings tell her that having a borderline sibling can be devastating.

  The parents of an eighteen-year-old borderline daughter just told me that their other daughter, who is fifteen years old, has been so traumatized by her older sister’s nonstop verbal barrage they are seeking psychiatric treatment for her.

  Some siblings take on an enormous amount of responsibility and end up being the caretakers of their borderline sibling. They make life decisions based on the fact that they have a relative with BPD. For example, I’ve heard some siblings say that they will never have children of their own because the disorder may be passed on, and they don’t want a child of theirs to suffer the way their borderline sibling has suffered.

  Siblings also worry about the impact the borderline sibling may have on their marital relationship. They’re unsure of how to explain that the entire family is organized around the ill child’s behavior.3

  Specific issues siblings face include

  • losing out on a great deal of their parents’ time and attention.

  • feeling guilty and wondering if they did something to cause their sibling to be ill.

  • fear of bringing their friends home.

  • fearing for their own safety and the safety of their parents.

  • feeling enormous pressure to be good to make up to Mom and Dad for the problems caused by the borderline sibling.

  • problems with self-esteem. “I didn’t have much self-esteem until I went away to college and got away from her,” Mary says about her sister. “At college I got some positive attention, and I really used that to build a sense of self-esteem.”

  • dreading family gatherings and holidays because their sibling’s behavior is usually disruptive, dampening the celebratory mood.

  • being influenced by the friends, sometimes from a rough crowd, of the borderline child.

  Other Relationships

  Stepparents have tremendous problems dealing with family members and ex-spouses with BPD. This is especially true with women in second marriages when their husbands have children from a previous marriage and an ex-wife with BPD. These women are the main support for their husbands, who are usually embroiled in terrible conflicts with their ex-wives about their children. They see the suffering of their husbands and stepchildren and are drawn into the morass. Many become a target of a vengeful ex-wife.

  Friends and extended family members who support the immediate family member of the BP often end up on the roller coaster, too, if only because they’re holding the family member’s hand. These relationships often become strained because of disagreements about how to handle the chaos that BPs can ignite.

  BPD in Society

  Borderline personality disorder is a complex mental illness that has far-reaching effects. It’s common for people with BPD to suffer from depression, substance abuse, eating disorders, and other serious co-occurring mental health conditions. The disorder can underlie domestic abuse, high-conflict divorce, lost work productivity, sex addiction, gambling, self-harm, criminal behavior, and more. In this way, it’s more than a ripple in a pond; it is a tsunami, an undersea earthquake that sends ninety-foot waves miles past the shore and destroys much of what’s in its path.

  Despite its far-reaching and damaging effects, BPD is largely unknown and frequently ignored—especially compared to more publicized yet less common conditions such as anorexia and bipolar disorder. Because of its complex, multifaceted nature, BPD is likely the most misunderstood and stigmatized mental illness listed in the Diagnostic and Statistical Manual of Mental Disorders (more about that later). The vast majority of clinicians haven’t been trained to treat people with BPD, resulting in misdiagnosis and improper treatment. It’s common for clinicians to miss the diagnosis in higher-functioning patients and drop lower-functioning patients because the clinicians haven’t been able to set proper limits.

  But over the last decade, a lot of progress has been made. The widespread belief that BPD is always caused by childhood abuse is being challenged by sophisticated brain scans of BPD patients that reveal that the brains of people with borderline personality disorder function markedly different from those without the disorder.

  This research has been key to putting BPD on par with other brain disorders, helping to bring about a wealth of new resources, including nonprofit organizations dedicated to helping patients and families, providing education, and bringing in research dollars. It’s also been a compelling reason why other public and private mental health organizations have begun making BPD treatment part of their mission. Public attention has blossomed with more than a dozen new books on BPD, features in the New York Times and O, The Oprah Magazine, and even characters with BPD on television and in the movies.

  Key Principles

  Keep these principles in mind as you read this book. These thoughts need to become a permanent part of your mind-set when dealing with someone with BPD.

  To Help Your Family Member, You Must Help Yourself First

  Your intuition may tell you that it should be the other way around—that the health of your relationship is dependent on your family member’s willingness to get help, and your job is to ignore your own needs and concentrate on fixing the other person. Wrong.

  People spend years trying to please their borderline family member by twisting themselves into a pretzel to avoid conflict. Even if it works, the price is high. Family members suffer from depression, isolation, helplessness, low self-esteem, sleep deprivation, and even physical illnesses (especially adult children of people with BPD). Predictably, the relationship begins to degrade, which is exactly what family members are trying to avoid.

  This means that, paradoxically, the long-term health of your relationship partly depends upon your willingness to look after your own needs, such as taking time away, setting limits with love, and having a hearty life of your own separate from your borderline family member.

  This curious paradox is many family members’ undoing. They may hear it but not believe it; they may have lost the ability to take care of themselves (or never had it to begin with); or they may be unwilling to accept that giving, giving, and giving some more is just not helping the situation. Of course, that doesn’t have to happen to you.

  BPD Thoughts, Feelings, and Behaviors Are Not Different, Just Exaggerated

  We all have traits associated with borderline personality disorder. At times, we all let our feelings overcome logic, blow things out of proportion, and act impulsively in ways we later regret. If we didn’t, we wouldn’t be human.

  Two key differences between what is “normal” and what veers into personality disorder territory are extremity and frequency. When these traits, thoughts, feelings, and behaviors become so intense and so frequent they greatly interfere with jobs, relationships, and other aspects of daily life, one or more personality disorders may be present.

  You Can Improve Your Life Even If Your Fam
ily Member Doesn’t Change

  Right now, you probably feel trapped, confused, and powerless. But it doesn’t have to be this way—at least to the extent it is right now. It may seem hard to imagine, but by the time you’re finished with this book, you’ll have learned tools and techniques that will enable you to feel better and more in control of your life regardless of what your loved one does or doesn’t do. You control your own destiny much more than you think you do, though it takes learning, planning, and practicing.

  It Takes Only One Person to Fundamentally Change a Relationship

  It takes two to have a relationship. But each person is in charge of 50 percent. Right now, you may think that your family member has power over you and can “make” you do and feel things you don’t want to do and feel. This is false. When you take more control of your own reactions and make decisions true to yourself, the dynamic of your relationship will change.

  Borderline Personality Disorder by the Numbers

  Some of these statistics, provided by the National Education Alliance for Borderline Personality Disorder, were derived through research of borderline individuals within the mental health system or other institutions.4 It does not include the hundreds of thousands (probably millions) who do not seek treatment and are a large focus of this book.

  Prevalence in Adults

  • Officially, four million American individuals have BPD (2 percent of the general public). Cutting-edge research is showing that this number is much higher.

  • BPD is more common than schizophrenia.

  • BPD is twice as common as the eating disorder anorexia.5

  • Twenty percent of people with psychiatric hospital admissions have BPD (more than for major depression).

  Suicide and Self-Injury

  • Ten percent of adults with BPD commit suicide.

  • A person with BPD has a suicide rate 400 times greater than the general public.

  • Thirty-three percent of youth who commit suicide have features of BPD.