borderline-personality-disorder.com
Mental illnesses affect the entire family unit. For personality disorders this effect is especially acute, due to the inherent impairments in interpersonal relationships. Family members are typically the most affected people in the lives of those with borderline personality disorder (BPD). They therefore impact the individual suffering from the disorder in return.
A limited number of therapeutic options are available for the family members of those diagnosed with borderline personality. One of the reasons for this is that family research surrounding mental illness and BPD is limited.
In order for an individual to receive a diagnosis of BPD, a clinician must determine whether a patient meets at least five criteria given by the Diagnostic and Statistical Manual of Mental Disorders-IV. The rate of BPD ranges from .07 to 2 percent, which means that millions of family members are affected by this disorder.
Commonly, family members end up playing the role of case manager. In addition, gender stereotypes lead women to assume the majority of responsibility for a family member who is ill. Suicidal behavior may also be fielded by family members, a job that crisis intervention workers are trained and paid to do.
Researchers have found that the family members of those suffering from a mental illness are at a higher risk for depression. Grief, burden and isolation have been associated with the stress of having a relative with a mental illness. One study found that the largest stressors for mental health providers were patient anger, suicide attempts and threats of suicide. Those three factors are all characteristic of BPD and have a significant impact on loved ones.
As observed by researchers Gunderson and Hoffman, “… families are troubled by the same problems that vex mental health professionals – problems that are even more demoralizing for families.” Sadly, family members are generally so overwhelmed they experience difficulty managing the symptoms of the individual with borderline personality disorder.
Added to this is the fact that family members are untrained for the job. The psychological impact of BPD on loved ones cannot be overstated. Family members may feel traumatized, which limits their emotional reserves to be of aid to their relative. According to the Centers for Disease Control and Prevention, the average individual with BPD attempts suicide 3.4 times during their life, and 73% of those diagnosed have attempted suicide once. A staggering 10% of people suffering with BPD commit suicide.
One dominant theory in the study of Axis I disorders is Expressed Emotion. Studies on Expressed Emotion have found a correlation between family member attitudes and beliefs about the patient and patient relapse. What is interesting about Expressed Emotion in the case of BPD is that the findings are contrary to other Axis I disorders. For BPD patients, the more emotionally involved family members were, the better the patient did over a one-year period. In other words, programs and counseling aimed at helping family members of those with BPD are vital to the patient’s well-being.
A number of programs have been designed to support family members to be emotionally involved with their relative, and to improve the well-being of all involved parties. Programs based off of the stress-coping-and-adaptation (SCA) model and Dialectical Behavior Therapy have proven effective. SCA focuses on the individual’s strengths, resources and adaptive abilities. Adaptive coping is strengthened through cognitive and behavioral techniques, identifying stressors that affect the family member’s life.
Dialectical Behavior Therapy has repeatedly proven to be successful in treating BPD and associated symptoms. When this therapy is used with families of those with BPD, coping strategies, acceptance and change are the focus. The best borderline personality disorder treatment programs teach coping strategies and communication skills, and provide group social support along with a support network for family members of those with BPD.
It is clear that family members deserve and require a support system. If family members are able to balance their lives more effectively, their negativity is reduced. Programs that emphasize observing one’s own limits and the setting of relationship priorities may help family members to develop the skills needed for their roles.