This is the final installment in a three-part series that ran earlier this week. The first installment can be found here, and the second here.
by: Julie Beem
As I read further into this article, I saw even more of my daughter’s symptoms of Borderline Personality Disorder:
Unstable Relationships. If, by now, you hadn’t correlated Reactive Attachment Disorder to BPD, you would at this symptom. My daughter’s relationships are stable because WE work hard to keep them that way – after all, she has a relationship disorder. Her developmental problems (also impacted by neglect, abuse, malnutrition) have actually made it easier in some ways to “keep her world small”. But if she wasn’t with us in the tightly structured and consistent environment we’ve created, we know that her relationships would be a mess. That push away/pull close behavior many parents of children with RAD describe is still evident for my daughter. “You’re the best mom ever” and “I hate you” often occur in the same day.
Poor Self-Image. For my daughter, she’s either the best or the worst (there’s that dichotomous thinking again). And she’s constantly putting herself down – “I’m just a stupid baby.” It has been said in front of her so many times that she now says it like an excuse for her behavior – “well, I have poor self-esteem…” “Yes, dear, but who controls the thoughts in your brain…you do.” This has been a tough issue to deal with all along as accepting any positive feedback from us (especially praise) is hard for her. Too much and she then starts bragging and elevating herself as the “best” – expecting the royal treatment. Throughout her whole life this has manifested itself in so many ways – self-harming, lack of hygiene, no concern about her appearance, depression…
Substance Abuse. This is the symptom that I thank God we haven’t had to deal with yet…remember, we’re keeping her world really small. But I can see the likelihood of this happening – substance abuse or some other addiction – something that numbs the pain of being who she is.
But is it all hopeless?
No. The article cites DBT, Dialectical Behavior Therapy, as the gold standard therapy for BPB.
DBT includes four sets of behavioral skills.
· Mindfulness: the practice of being fully aware and present in this one moment
· Distress Tolerance: how to tolerate pain in difficult situations, not change it
· Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
· Emotion Regulation: how to change emotions that you want to change
While I have firmly come to believe that many behavior-based therapies are not the most effective for those with trauma backgrounds, DBT seems to span the gap between general cognitive behaviorists and those who focus on affect regulation, and trauma-sensitive strategies. The challenge for our children with meet BPD criteria (unresolved RAD) is the same challenge they faced when younger, the ability/willingness to do the hard work it takes to address their pain and change their reaction.
So, around here, we’re going to continue doing the same things we have for years– therapeutic parenting strategies and guiding her toward self-regulation (mindfulness, yoga, exercise for example). And I will continue to remind myself that this is a disorder and not really the person underneath – the one I firmly believe who wants to connect with us and experience the family love and relationship we offer.
Borderline Personality Disorder Resources