Parenting a child with a mental health disorder often feels difficult, stressful, and confusing. Without support and guidance, many parents are unsure how best to help their child or how to cope with anxiety and worry.
Parenting a young person with borderline personality disorder can be particularly distressing. Self-harm and suicide attempts are common among young people with BPD who are not receiving treatment- events that are incredibly difficult for any parent. BPD is also associated with intense emotions and reactions that can be hard for families to navigate.
However, while many parents experience anxiety about parenting a child with BPD, there are ways to make family life less stressful and more manageable. Effective treatment supports young people to recover from symptoms and lead fulfilling lives. At the same time, family therapy and parenting interventions can teach parents strategies to manage interpersonal situations within the family, as well as their own emotions and well-being.
Parent Experiences of Borderline Personality Disorder
Parenting a child with BPD can involve distressing experiences – especially if they are not receiving treatment. These might include incidents of self-harm or suicide attempts or tensions between family members. Parents also sometimes struggle to balance offering support while not reinforcing behaviours.
A 2008 study interviewed families whose close relatives had BPD, including parent-child relationships. They spoke about:
Stress and Trauma
Parents sometimes speak about the stress and worry caused by their child’s self-harm or suicide attempts. They describe emotional strain, difficulties sleeping, and exhaustion. They may feel like they are on high alert, constantly fearful of news that they have harmed themselves.
Without support, parents may develop traumatic stress disorder when a young person seriously injures themselves. Some have suggested that hospitals may let young people return home too early, leaving parents to handle the situation. Parents may feel unprepared and worry that their child is unsafe without further oversight and support.
Responsibility and Support
Some parents speak about the struggle to support and care for their children without reinforcing self-destructive behaviours. They may have received unclear messages from health care professionals about how much support to give, without understanding what it meant in practice. The notion that attention can sometimes reinforce self-destructive behaviours may be valid: but it is a very complex idea that requires extensive instruction and support from professionals, something that many parents do not receive.
Other parents find it hard to balance their own needs and the needs of other family members with those of their children with BPD. This can also lead to tensions with partners or other siblings, who feel like their needs are secondary to the young person with BPD.
Navigating Healthcare Systems
Some parents face challenges navigating public healthcare systems and their various services. They often feel that different services don’t communicate with each other or work together: that, as parents, they don’t adequately understand the role of each service in treatment as a whole. Some parents also desire more knowledge, understanding, and support in their day-to-day caring roles.
Judgement and Stigma
Some parents feel like healthcare professionals judge or blame them for their child’s experiences. They may imply that their parenting style caused their child to develop BPD – or that their current parenting helps to sustain it.
These judgements can be very distressing and de-moralising for parents who are trying their best to support their children.
How Can Effective Support Help Parents of Children With BPD?
Much of the anxiety, distress, and challenges experienced by parents of children with BPD relate to inadequate professional support or problems in the healthcare system. Effective support and guidance can alleviate some of the stress and worry that parents experience while helping them to parent in a positive and supportive way.
Effective support for families of a young person with BPD may include:
- Family therapy or parenting interventions that offer support with day-to-day parenting and family life, teaching parents useful skills, sharing detailed information, and giving personalised day-to-day advice
- Family therapy or other interventions to help members navigate other relationships that may be strained, such as between partners or other siblings
- Community-based support and assistance, such as day programs and group activities for a young person
- Psychotherapy for family members to help them manage anxiety, stress, and other kinds of psychological distress, including trauma therapy
- Recognition from healthcare professionals of the challenges that parents face and the extent of the care, time, and effort they give to their children
What Types of Family Interventions Are Available to Support Relatives of Individuals with BPD?
According to a recent review, there are currently four main types of family interventions for families of individuals with BPD. These approaches were largely developed as part of evidence-based programs for BPD, so they are coherent with the broader treatment plan.
They are:
- Family empowerment interventions
- Family psychoeducation for family members
- Interventions based on skills training
- Mentalisation-based interventions (that support family members to understand the mental states behind each other’s actions)
Rather than seeing the family as the cause of BPD symptoms, these approaches instead understand the importance of parents and other family members in the recovery process – as a source of respect, recognition, and empowerment.
How Can Residential Treatment Help?
Residential treatment programs can offer young people with BPD a safe environment surrounded by professionals providing different kinds of support. It can be an opportunity to partake in therapy and other interventions in a calmer space, without the usual triggers of daily life.
Spending some time in residential treatment can also help families of young people with BPD. When a young person is in residential care, families can take a break from the intensity of caring and focus on their own self-care (and their other relationships). It can also be an opportunity for families to learn and develop new parenting skills with more focus and energy, helping them support their children when they return home.
The Importance of Support
Effective support – for both the young person and their family – is fundamental for parents of children with BPD. Interventions, therapy, and professional guidance can help parents understand how to care for their children on a day-to-day basis, handle difficult situations, and look after themselves.
Community support programs for young people and residential treatment also take some pressure and responsibility from parents while providing opportunities to relax and focus on themselves. And, ultimately, with effective treatment and support from loved ones, young people can recover from the disorder, leading independent, fulfilling, and productive lives.
