Family therapy

[Our abuse recovery guide]

Does anybody here have experience of family therapy with a BPD family member participating?

my mom has started going to therapy with my sibling. they have had huge relationship issues, of course mainly due to the BPD, but to be fair not only. She wanted to find a way to get him helped by someone, and at the same time she needed some help to cope with the situation, and so she has thought about this. I was very supportive, but now am a bit worried.

he of course has started selling this therapy as "the therapist finding incredible everything that happened to him" (which I know might even be true as the therapist building a connection), he seems to basically want to just use this to put her into bad light and I know how he can trigger people by spinning and manipulating, making you go mad. So just worried in the end he will only manage to make mum seem like she's exhaggerating and will end up with no help at all...

not sure what to expect really, and it is quite a tough period, just spent the day arguing as he has done things in my name without even asking only to then paint himself as the savior of the world...

[Strawberry29]

Does anybody here have experience of family therapy with a BPD family member participating?

my mom has started going to therapy with my sibling. they have had huge relationship issues, of course mainly due to the BPD, but to be fair not only. She wanted to find a way to get him helped by someone, and at the same time she needed some help to cope with the situation, and so she has thought about this. I was very supportive, but now am a bit worried.

he of course has started selling this therapy as "the therapist finding incredible everything that happened to him" (which I know might even be true as the therapist building a connection), he seems to basically want to just use this to put her into bad light and I know how he can trigger people by spinning and manipulating, making you go mad. So just worried in the end he will only manage to make mum seem like she's exhaggerating and will end up with no help at all...

not sure what to expect really, and it is quite a tough period, just spent the day arguing as he has done things in my name without even asking only to then paint himself as the savior of the world...

[kells76]

Hi Strawberry29;

I've read a wide range of experiences here, for how therapy/counseling can go with a BPD family member (total disaster through meaningful improvement). As each pwBPD is a unique individual, it's hard to say "therapy always goes like this with a pwBPD".

Therapy is frequently a long-term process (years vs weeks), whether BPD is involved or not. It's taken me a couple years to get more comfortable with my T, and it's still hard for me to be totally transparent with her. Any "snapshot" of one or two sessions might not be indicative of the entire trajectory of the process, or the final destination.

When there's a serious mental illness involved, it's even more important to remember that what one participant says about how one session went isn't the absolute determination of how things have gone and will go.

A bigger question for me is about boundaries.

It's your sibling and your parent in therapy, and if I'm reading correctly, you aren't in those sessions. Tell me a little more about your involvement. I wonder if it's uncomfortable stepping back and saying "you know what, that's their stuff, not my stuff"...?

Do you think you might be being drawn to a role on the Karpman triangle?

I'll be interested to hear your thoughts  

[Strawberry29]

Thanks kells, helpful as always!

I have made it clear that I don't want to be involved in this at all! My brother asked me twice if I wanted to contribute and I kindly declined explaining that I was very happy that it was finally a professional to have to deal with their relationship, instead of me as it's been the case for ages before I learnt about triangles etc.
He still sends me thousands of messages about every single thing related to this, but I am always neutral/ supportive but uninterested in giving opinions about it. I always just say things like "I am very happy you and mum are doing this, I hope it will help your relationship".

I totally get it that it can take time, and that not everyone is the same. I think I just wanted to hear experiences from people to understand how likely it is that somebody with BPD that is not under treatment can benefit from family therapy vs ruin it. In teh end it's their decision to go, so just curious about it, I suppose. We'll see how it goes...

[kells76]

I have made it clear that I don't want to be involved in this at all! My brother asked me twice if I wanted to contribute and I kindly declined explaining that I was very happy that it was finally a professional to have to deal with their relationship, instead of me as it's been the case for ages before I learnt about triangles etc.
He still sends me thousands of messages about every single thing related to this, but I am always neutral/ supportive but uninterested in giving opinions about it. I always just say things like "I am very happy you and mum are doing this, I hope it will help your relationship".

What would it be like to end it at "I kindly declined" and not explain more to him?

What would it be like to not even reply neutrally when he messages you about therapy?

It sounds like you're in the driver's seat here -- curious if you've considered declining to respond at all when your sibling goes fishing for engagement. Right now, at least from my point of view, it looks like he's getting rewarded with engagement when he talks about therapy. But I might be seeing that wrong.

I totally get it that it can take time, and that not everyone is the same. I think I just wanted to hear experiences from people to understand how likely it is that somebody with BPD that is not under treatment can benefit from family therapy vs ruin it. In teh end it's their decision to go, so just curious about it, I suppose. We'll see how it goes...

I've seen various outcomes. When my H's kids were in therapy many years ago (ages ~8 & 10 or ~9 & 11 or so), their T did work with Mom, and she was able to be more cooperative (or, at least, less uncooperative) with H during that time. I think the T was able to get buy-in from her by not shaming her and helping her to feel like the T was on her side. Ultimately it benefitted the kids for a little while. When therapy ended for the kids, Mom became less cooperative and more hostile -- kind of regressed. I heard she did individual T for a bit but that ended when the T started questioning her narrative of the divorce with H (long story). I'd call her untreated, with little to no insight into her behavior.

My H and I did marriage counseling for a while and described our FOO's in sessions. Our MC suspected that H's mom could've been described as BPD in the past. She did do some therapy (maybe EFT?) and also currently has a strong moral compass. She still has what I see as pointless conflicts with one of her daughters, and does bicker with her H in front of us sometimes, but is nowhere near the stuff the kids' mom does. She has insight into her past behaviors and has apologized for them. I'd say she's generally recovered.

Our MC also suggested that my mom may have BPD traits. My mom has said she has a cPTSD diagnosis (childhood abuse survivor). My older sister remembers her raging and breaking things; I don't have any memories of that. My mom still had major conflicts with that sister even when my sister was an adult. My sister stopped contact with both my parents a few years ago and is getting counseling for herself. My mom can generally relate well to the rest of us, seems to have a consistent sense of self (lifelong friends), and has apologized for things she's done in the past. She has been in counseling for over 25 years. I think she's still kind of on the edge emotionally but isn't overtly hurtful to me or my younger sister (sometimes there's a dynamic where my dad tries to get me to "rescue" Mom but I'm getting better about declining).

When I was in my teens, I was in treatment for an eating disorder. Family therapy was required. It went okay-ish. I don't remember any huge breakthroughs; I think the goal was to reset communication in our family (I didn't really talk and was resistant to talking). I did learn to engage some more and remember asking my mom more about her family. I'm not sure either of my parents made huge strides in engaging with me, but FT didn't make things worse.

Hope those examples fill out the picture for you a bit more.

[Strawberry29]

Super helpful, thanks for taking the time to write a very comprehensive reply kells!

Sounds to me like based on your experience, it is still worth a shot, without putting too much hope in it.

Yes, might be that I should give him even less engagement around that. I think if it gets too stressful I might just take your suggestion. 

[Notwendy]

Just my 2 cents here. There is no way I'd consider therapy with my BPD family member. It would be a waste of time and money. BPD mother has had all kinds of therapy, none of it worked for her as she just can't perceive her own part in relationship issues.

This relatioship is between your mother and brother. Adding you becomes a triangle. IMHO, I'd let them deal with their own relationship issues.

[Notwendy]

From reading Kells posts- there is a place for family therapy- to look at the dynamics and best help the other family members to cope/support the person who they are concerned about. With something like an eating disorder, the person needs help and the family does as well- as this is a scary situation for them. They want to help but they also have to know how to help in the best way and not be enabling too.

It also depends on the age of the person. A child/teen is still a minor and living at home. An adult may be in a different situation. If children are involved - that is a consideration.

The red flag for me in this situation is that the brother is fixated on something external to his own issues as a solution. You know it's not. This looks like Karpman triangle dynamics.

[Strawberry29]

Thanks Notwendy,

late reply as I just came back from visiting my family (although as usual my sibling did not show himself for the whole time and just spent his time hidden in his room, texting to blame us for anything that he thought we were not doing as we should have...)

My worry is exactly that he is just focusing on something external from his own issues, as usual. My only hope is that at some point he told me he was ready to go on his own to therapy if mom did not want to go with him (she always wanted to, but had to postpone a couple of times for actual issues, which he saw as excuses because he always sees himself in others). So he did seem convinced to go, outside of including mom...

Anyways, I had a brief chat with my mom about this when I was there, and she said she indeed needed this for herself. She seems to like the new therapist, and she's hopeful this can do something for her at least.