Working With Families & Young Adults With Borderline Personality Disorder (BPD) – Part IV

Borderline Personality Disorder, Families and Solutions

Parents of young adults with Borderline Personality Disorder, BPD Traits and Co-occurring Conditions are typically frustrated and feel helpless, even hopeless, about the possibility of change in their families by the time we see them here at OPI Living’s specialized OPI Intensive.

Parents have endured so many years in an atmosphere of family polarization and chaos trying to respond to limited options proposed by their young adult that it seems almost impossible to see a way out.

It is hard to accept the fact that your gifted, attractive child is “stuck,” that he/she is looking at the world through the eyes of a much younger person who may still believe that goals are magically achieved, that this brilliant child is frightened to accept the responsibility of moving forward in our imperfect and ever-changing world.

These families are in need of a respite. Everyone needs to pull back, accept their limitations and work toward appreciating each other. The family’s focus needs to be on compromise and breaking the pattern of responding to polarizing options in an atmosphere of fear and obsessive control.

Yes, this is an ideal goal. And yes, it is extremely difficult to accomplish this goal alone.

The Trap

Most parents realize how infantilizing and disempowering it is to their young adult with BPD when they try to make decisions for them. But many times, only chaos ensues when they fall into the trap of allowing their young adult to set the parameters and options for negotiation.

This is because the young adult with BPD or Borderline Traits often makes decisions based on an unconscious black-and-white thinking style that produces only limited options based on limited perceptions. When parents reject their ideas as being imperfect or unrealistic, the young adult gets confused and angry, feeling invalidated. The ability to achieve compromise quickly dissolves.

Helpful Note To Parents

1.    Most problems have many solutions, but none are perfect.

A far greater issue we all need to recognize is that each solution comes with its own unique imperfections. Each option is probably disagreeable to somebody. Nothing is perfect. What is important to understand is that everyone must give a little in order for a situation to be resolved.

2.    Parents can’t get involved in a “control game” where there is one absolute winner and one absolute loser.

Everybody loses in an atmosphere that doesn’t promote options. When parents rise above the atmosphere of tension and polarization, they are able to consider all solutions to a problem. By coming from a loving and compassionate heart—but with a matter-of-fact, non-emotional and non-judgmental tone—an atmosphere is created where anxiety is reduced and the probability of compromise is heightened.

3.    Parents must discuss reasonable options and decisions ahead of time and be united in their presentation, agreeing on a reasonable set of goals and consequences for their young adult.

The young adult with BPD, first and foremost, is a human being. He/she is naturally compelled to achieve his/her objectives and is quite sensitive to any difference that may exist in parenting styles and objectives.

Sometimes, when they point up disparities and insufficiencies in parental goals, they may be right. But the parents’ overall goal is to achieve compromise while maintaining a united front. Many points of view can be incorporated into a final solution.

Helpful Note To Young Adults

1.    Try to open yourself to small moments when you can be really free to experience true joy and happiness in your life. This often overlooked goal is vital because it will help you to do several things:

a.    Break the cycle of internal and external isolation so you can begin to develop a greater sense of self-confidence;

b.    Move beyond seeing life in a black-or-white way so you can start developing patience, tolerance and compassion for yourself as well as others;

c.    Recognize that success doesn’t happen magically, all at once. Success only occurs incrementally, one small achievement at a time.

2.    When you can move beyond the feeling of hopelessness that many young adults with BPD have, your world will start expanding. You will discover that nothing is perfect but it doesn’t matter: You still can move forward in this reality where failure is only one more step in the right direction.

In Conclusion

At OPI Intensive for men and women ages 17-28 with Borderline Personality Disorder, we know it takes a team of professionals and a village of supportive peers utilizing multiple approaches and opportunities to help parents and young adults with BPD achieve the above goals.

Over many years, we have developed the expertise and resources needed to provide a comprehensive program:

1.    By helping young adults learn vital Dialectical Behavior Therapy (DBT) and Mindfulness skills so they can begin experiencing incremental successes that allow them to move forward in the real world where they can discover a life worth living;

2.    By helping parents realize that BPD is not a life sentence. Today, more than even a few years ago, there is hope. For example, Blaise Aguirre, MD, assistant professor of psychiatry and Medical Director of the Adolescent DBT center at McLean Hospital in Belmont, MA, suggests that our understanding of BPD is, “progressing from a strictly psychodynamically based construct to a neurodevelopmental disorder with roots in the genetics of the child, the child’s temperament and the environment.” (Psychiatric Times, May 2012)

If this is true, then perhaps a neurologic imbalance amplifying anxiety in these young adults is altering their perception of available options and choices, and it becomes thereby easier to understand how they may become overwhelmed and experience greater intensity of reaction to the ambiguity and complexity of decision making in our complex world.

In this series of articles I’ve written on, “Working With Families & Young Adults With Borderline Personality Disorder,” I have tried to present a greater understanding of how we can meet the challenges BPD presents to all of us, including:

• Part I – Compromise, The Middle Path And Psychotherapy;
• Part II – The Strategy of Compromise: Achieving the Most Favorable Outcome for Young Adults with BPD and their Families;
• Part III – Borderline Personality Disorder, Families and Anxiety Management;
• And this final installment, Part IV – Borderline Personality Disorder, Families and Solutions.

In the end, understanding and addressing Borderline Personality Disorder is a process that helps us…

• Appreciate the complexity of life, while recognizing that;
• The need for control and perfection only creates an atmosphere of frustration, mistrust and polarization where nobody moves forward.

For additional information about how families can address BPD and BPD Traits with a young adult, I urge you to read the other articles in my series on Working With Families & Young Adults With Borderline Personality Disorder (BPD).