How to Manage Holidays When a Family Member Has BPD

The DSM-5 defines “borderline personality disorder” (BPD) as a pattern of instability in personal relationships, intense emotions, poor self-image, and impulsivity. It is fortunately uncommon, with an estimated prevalence of just 1.6 percent, according to the NIMH.

But how many of us can claim to have never had a time in which an important relationship was disappointing, when anger or sadness erupted, when our self-image suffered, or when we said or did things on the impulse of the moment? Frequently, those moments of regression, whether acted out or internalized, have been triggered by comparing our real relationships with idealized images and unmet expectations.

Whether one is “stably unstable” and has BPD or has rare episodes of what a colleague jokingly referred to as a “brief, reactive borderline personality disorder” the holidays are a time when images of the idealized family life may collide with reality and create heightened emotional vulnerability. We humans tend to be happiest when reality lives up to expectations, so it should not be surprising that the inflated expectations of the holidays can be a setup for disappointment and unhappiness. If your family, like most, can be a bit wonky from time to time, how can you find the fun in dysfunction?

This week on my podcast, I interviewed Dr. Daniel Lobel, a practicing psychologist and noted author of four books on BPD in the family. Lobel stated that optimally, one can anticipate that a family member with a personality disorder such as BPD may regress in a disruptive way at a family gathering and take pre-emptive steps to head off problems. For example, holding an event at a restaurant or inviting non-family members to attend may encourage everyone to be on their best behavior. Another strategy might be to have the event at the home of the disruptive person so that the family can leave if the dynamics deteriorate.

Dr. Lobel described how a scenario with, for example, a difficult parent might unfold and suggested the type of firm, clear language an adult son or daughter might respond with:

“‘We’re not going to talk about family issues that go way back. We’re not going to compare ourselves to anyone else. We’re here to have a good time. So either we go back to the table, we have another round of turkey or roast beef or whatever you’re eating on that day. Or maybe we’ll bring out the dessert. Let’s just move on from that and talk about kinder things.’

If the parent persists, the boundary will have to be restated with words like, ‘No, we’re not going to do this now.’ And probably at this point, the adult child should ask the mother to go into another room so as not to involve other family members and also so as not to humiliate her.

And then if the mother says look, ‘I’m upset,’ then one might say, ‘Look, why don’t you go to another room, or if you’re that upset, go home. We’ll see you again on another occasion.’”

As helpful as it may be to define what must stay outside one’s personal or family boundaries, it is at least as important to pay attention to the quality of what occurs inside the boundary of a relationship or an event. A family member’s heightened sensitivity to being kept on the outside of family boundaries may start with feeling that what occurs inside is impoverished and disappointing. Whether someone is generally mentally healthy or generally dysfunctional, the desire to be loved, valued, and respected is virtually universal.

In organizing a family event where discord is possible, then, a plan to “keep it short, but make it fantastic!” may help all family members enjoy the celebration of being together.

To hear the entire interview, listen to They’re Driving Me Nuts! on your preferred podcast platform or go to www.theyredrivingmenuts.com.