Abstract
The pediatrician and psychoanalyst Donald Winnicott said: “There is no such thing as a baby, there is a baby and someone.” This statement captures the reality that a human baby cannot exist on its own. To see the infant as an individual completely separate from its caregiver misses the essential nature of the child’s utter dependence on another person.
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References
American Academy of Child and Adolescent Psychiatry. Retrieved December 17, 2012, from http://www.aacap.org/cs/root/facts_for_families/parenting_preparing_for_adolescence
American Psychiatric Association. (2003). Practice guideline for the assessment and treatment of patients with suicidal behaviors. American Journal of Psychiatry, 160.
Black, D. W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: Prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, 226–239.
Cooper, J., Kapur, N., Webb, R., Lawlor, M., Guthrie, E., Mackway-Jones, K., et al. (2005). Suicide after deliberate self-harm: A 4-year cohort study. American Journal of Psychiatry, 162, 297–303.
Fruzzetti, A. E., Shenk, C., & Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007–1030.
Goodman, S. H. (2003). Genesis and epigenesis of psychopathology in children with depressed mothers: Toward an integrative biopsychosocial perspective. In D. Cicchetti & E. Walker (Eds.), Neurodevelopmental mechanisms in psychopathology (pp. 428–460). New York, NY: Cambridge University Press.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.
Gunderson, J. G. (2001). Borderline personality disorder: A clinical guide. Washington, DC: American Psychiatric Press.
Hoffman, P. D., Fruzzetti, A. E., & Buteau, E. (2007). Understanding and engaging families: An education, skills and support program for relatives impacted by borderline personality disorder. Journal of Mental Health, 16(1), 69–82.
Hoffman, P. D., Fruzzetti, A. E., Ellie, B., Neiditch, E. R., Penney, D., Bruce, M. L., et al. (2005). Family connections: A program for relatives of persons with borderline personality disorder. Family Process, 44, 217–225.
Klonsky, E. D. (2009). The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect regulation. Psychiatry Research, 166(2–3), 260–268.
Klonsky, E., & Muehlenkamp, J. (2007). Self-injury: A research review for the practitioner. Journal of Clinical Psychology, 63(11), 1045–1056.
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: The Guilford Press.
Miller, A., Rathus, J., & Linehan, M. (2007). Dialectical behavior therapy with suicidal adolescents. New York: Guilford Press.
Newman, L., & Stevenson, C. (2005). Parenting and borderline personality disorder: Ghosts in the nursery. Clinical Child Psychology and Psychiatry, 10, 385–394.
Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339–363.
Norden, K. A., Klein, D. N., Donaldson, S. K., Pepper, C. M., & Klein, L. M. (1995). Reports of the early home environment in DSM-III-R personality disorders. Journal of Personality Disorders, 9, 213–223.
Paris, J., & Zweig-Frank, H. (1997). Parameters of childhood sexual abuse in female patients. In M. C. Zanarini (Ed.), Role of sexual abuse in the etiology of borderline personality disorder (pp. 15–28). Washington, DC: American Psychiatric Association.
Rajalin, M., Wickholm-Pethrus, L., Hursti, T., & Jokinen, J. (2009). Dialectical behavior therapy-based skills training for family members of suicide attempters. Archives of Suicide Research, 13, 257–263.
Sharp, C., Green, K., Venta, A., Pettit, J., & Zanarini, M. C. (2012). The incremental validity of borderline personality disorder relative to major depressive disorder for suicidal ideation and deliberate self-harm in adolescents. Journal of Personality Disorders, 26(6), 927–938.
Walsh, B. (2006). Treating self-injury: A practical guide. New York: Guilford Press.
Walsh, B. (2012). Treating self-injury (2nd ed.). New York: Guilford Press.
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Marino, M. F., Lewis, R. E., Williams, A. A., et al. (2000). Biparental failure in the childhood experiences of borderline patients. Journal of Personality Disorders, 14, 264–273.
Suggested Reading
Aguirre, B. A. (2007). Borderline personality disorder in adolescents: A complete guide to understanding and coping when your adolescent has BPD. Beverly, MA: Fair Winds Press.
Aguirre, B. A., & Gillian, G. (2013). Mindfulness for borderline personality disorder: Relieve your suffering using the core skill of dialectical behavior therapy. Oakland, CA: New Harbinger.
Hollander, M. (2008). Helping teens who cut: Understanding and ending self-injury. New York: Guilford.
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2006). Dialectical behavior therapy with suicidal adolescents. New York: Guilford Press.
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Appendix: Family Therapy Script
Appendix: Family Therapy Script
Amanda is a 16-year-old adolescent who presented to our residential DBT program after being kicked out of her boarding school for self-injury which, in turn, precipitated a suicide attempt. Her parents were furious at her as they had “pulled strings” to get her into the school, and she in turn was furious with them as during her brief hospitalization after the suicide attempt they had gone into her room and “they read my journal.” The parents admitted they were terrified that she would kill herself and angry that she was keeping to herself and that she had a “secret life” that included drug use and sex with boys and girls. The family and Amanda have been oriented to family therapy and have committed to do the treatment. This is their first family session.
Therapist: We have an hour and a lot to get through. I want you each to set a goal for this session and then if we have time at the end we can deal with other stuff that might come up. When each person talks I want the others to listen and not interrupt. I’ll be the referee and make sure that everyone has more or less equal time, agreed? Amanda you go first.
Amanda: I want to know why they read through my stuff. It is none of their business.
Mother: I want to know how long this cutting business has been going on and if she is doing it for attention.
Father: I want Amanda to know that we are not going to put up with her behavior any longer and to get all the work we went to get her into the school.
Therapist: OK I want you all to work with the idea that each person is doing the best that they can at every given moment and yes we all can and must do better. Also I want you to consider that it is not in any of your interests to intentionally make life more difficult for anyone else. That is unless you woke up this morning intending to do so! In other words I want to make sure that you all can work with being curious rather than certain.
Amanda: Yea, I can do that, but they can’t.
Father: You see what I mean. That is disrespectful and we won’t stand for that.
Therapist: If we agree that each is doing the best they can then Amanda can you accept that your father will try and Father can you accept that in this moment Amanda is doing as best she can given that this is her first family meeting in months.
Father and Amanda nod.
Therapist: Amanda go ahead.
Amanda: So OK it’s none of their damned business what I write in my diary, so why do they have to go through my stuff?
Therapist: Did you ask them?
Amanda: No.
Therapist: Can you?
Amanda: So why did you go trough my stuff? Why did you read my diary?
Mother: Honey I am so sorry. It’s just with all your cutting and suicide we were so worried about you and we were worried that other people were influencing your behavior that you had fallen into a bad crowd?
Amanda: Bad crowd? You mean like your so-called friends who get drunk every weekend at our house?
Father: That’s it I won’t stand for it. One more disrespectful comment and I’m done.
Amanda: You see I told you he couldn’t do it.
Therapist: OK now everyone let’s slow down and take a breath. Remember the goals you set at the beginning of the session. If all you do is argue, you go back to the pattern of behaviors that got you here in the first place and you’ll never reach your goals. Father, by insisting on Amanda behaving in a certain way and threatening to walk out to get her to do so you lose an opportunity to understand Amanda’s perspective, and can lead to what we term invalidation as it implies that she is capable of doing something that might come easily to you. Amanda by going after your mother in the way that you did it takes you away from your goal of wanting to know why they read your journal. Can we all agree to get back to sticking to the goals, unless of course you want to change the goals!
Mother: That makes sense. I know that we are running out of time and I am terrified about the cutting. Is it just for attention?
Therapist: Amanda how long have you been cutting?
Amanda: 9 months.
Therapist: Mother can you see how if she was doing it for attention, keeping it hidden for 9 months would be a lousy way to get attention? Self-injury in various forms is common in BPD and there are very few experiences that are more frightening, confusing, or worrisome to parents than when a child self-injures. It must be terrifying to think that all you want to do is protect your child and you can’t prevent the harm she is doing to herself. Amanda can you help you mother understand more about the cutting and how it helps you? When was the last time you cut?
Amanda: 3 weeks ago.
Therapist: What was going on then?
Amanda: My dad was on my case about how he had done everything to get me into school and how I had screwed everything up. Then what happened. I got really angry.
Therapist: Was it just anger?
Amanda: Well I was sad just before that but it quickly turned to anger.
Therapist: Then what happened.
Amanda: I went to the bathroom and cut myself.
Therapist: Why did you do that?
Amanda: Because I felt better after I cut.
Therapist: Parents, what you see as a problem, the cutting, for her is a solution to the problem of how she feels in the moment. So cutting is both a problem and a solution to the problem. Amanda’s task is to learn other solutions to intense emotions and your task is to get more curios about her experience without judging it. We still need to answer Amanda’s question of why you read her diary but I want to get to dad’s goal….
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Aguirre, B., Hobbs, J., Hollander, M. (2014). Working with the Parents of Children and Adolescents with BPD. In: Sharp, C., Tackett, J. (eds) Handbook of Borderline Personality Disorder in Children and Adolescents. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0591-1_25
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