By Maureen O'Dougherty
After navigating a close relationship with someone who lives with borderline personality disorder (BPD) — and meeting dozens of people navigating similar situations — I developed an interest in better understanding the disorder. To broaden my understanding, I read the existing literature about BPD, completed a NAMI Family Connections class and participated in a peer support group.
As an anthropologist, I also took an interest in hearing other perspectives. So, I conducted research, which entailed in-depth interviews with people who have a family member with BPD.
Between my own support group experience and hearing the experiences of families who sought help, I have collected a wealth of information that I would like to share with anyone who may be looking for guidance.
I’ve learned that it often takes time for family and friends to fully digest the complexities of BPD. Figuring out how to best support the treatment and recovery of a person with BPD can be a complicated process and loved ones may find themselves in social misunderstandings.
Parents I interviewed often felt that “no one” in their communities knew anything about BPD. As a result, they were tasked with navigating uncomfortable social situations in addition to caring for their children.
As one mother said, “Nobody really understands borderline behavior unless you’ve lived with it. Otherwise, they think you’re just bad parents or you’re lying, you’re making it up.” A father noted, “There seems to be a belief that everything falls in line when you do things right as parents. There’s an idea of ‘best practices.’”
Unfortunately, parents operate in a context of unforgiving cultural norms: judgments about not properly raising their kids and punishing social norms of parental self-sacrifice with no time limits. As a result, parents of individuals with BPD lose much of their social life; there is little time for it while providing vigilant care and navigating stigma.
Accessing appropriate education and support, however, proved to make a difference. While attending the 12-session NAMI Family Connections course, I noticed that participants first arrived in a beleaguered state struggling to understand their distressed loved one. By the end, most became more self-assured, thanks to our deepened understanding of BPD, our newfound skills for positive interaction with loved ones and the constant reminders to take care of ourselves.
This outcome is not surprising, as a wealth of studies underscores the benefits of peer support groups. Participants often realize they are not alone in their difficulties, and they can connect with others who understand without judgment. Moreover, attendees learn ways to simultaneously aid their loved one’s recovery and their own well-being.
Taking part in monthly follow-up BPD support groups has also proven to help people become more effective communicators and problem solvers — with institutions and with their loved ones with BPD. For example, one support group participant learned not to take a health insurance provider’s denial of residential treatment for their loved one as a final answer.
As for managing relationships, parents reported learning how to better manage tense conversations with their children. One issue that parents often found bewildering was how “anything” could provoke an argument. They registered that popular parenting techniques and verbal responses often backfired. A woman with a background in health care described her daughter’s emotional sensitivity as akin to “burn patients who are so sensitive. I try to remember how painful it is for her being in her skin, how life is so hard for her.”
In support groups, however, attendees practice how to improve communications with individuals with BPD. Naturally, there is a learning curve; participants will patiently coach one another on “radical acceptance.” They come to see their loved ones’ actions not as manipulative, but as a reflection of their inability to ask for what they need. Attendees also learn to relate to the emotional basis of the words or action; for example, they learn to relate to their loved ones’ anxiety rather than getting upset with their seemingly rash decisions.
One woman I interviewed offered pointers handily capturing many suggestions from the NAMI course and support group.
One of the most difficult issues parents face is how to “launch” their young adult toward self-sustaining adulthood, or if that’s not possible, accepting the responsibility to take care of their child long-term. Stepping back in caregiving (with a safety plan in place) could spur the person with BPD to develop greater independence in their path to recovery.
Still, I have found parents only reduce caregiving if another critical demand emerges — perhaps if a son or daughter’s substance use or disordered behavior is too upsetting for younger siblings or if there is marital discord or another serious health issue. Listening to peers about these trials, and being heard, is itself an immense benefit of peer support.
Going to the monthly meeting via Zoom or in an in-person setting signifies entering and creating a community of mutual aid, where participants can safely talk through culturally, morally and emotionally harrowing decisions. To my surprise, peer support groups also provide comedic relief. Such moments of humor provide space for peers to air the challenges they face and relate to one another.
Hearing one another’s stories, weighing different approaches, being reminded of self-care — and at nearly every meeting, laughing over some farfetched situation or observation — is both heartening and beneficial.
Maureen O’Dougherty is a cultural anthropologist conducting research on the intersections of culture and mental health. Her current project investigates families’ experiences with borderline personality disorder. Maureen received her doctorate from the City University of New York. She is a faculty member at Metropolitan State University (St. Paul).
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