Help! My daughter (or son) has borderline personality disorder

This post is part of the series Personality disorders

Other posts in this series:

  1. Personality disorders (Pd’s) and why we need to know about them
  2. Help! My girlfriend has Borderline Personality Disorder
  3. Help! My boss is a narcissist!

Parenting is challenging. Every parent (hopefully) wishes to raise their child into a successful adult. Someone who can be self-reliant and live life to their full potential. Someone who can find happiness and growth in a solid relationship, and then effectively parent their children in the future.

Borderline personality disorder traits can be traced back to early childhood. The disorder has a strong genetic component. There are brain abnormalities detected on neuroimaging. All of this is evidence that borderline personality disorder is a disorder of the brain, not just a psychological disorder. Salient features of this disorder are:

  • Emotional dysregulation (extremely unstable moods). Flipping between joy and suicidal desperation before breakfast is not uncommon.
  • Fear of rejection (even if this “rejection” is an age appropriate push towards encouraging autonomy). I remember one mom telling me that she told her 14 year old to remember to pack her tennis bag.  This was met with “you always do it for me. Don’t you love me anymore?” and an episode of her daughter cutting herself.
  • Rage. This rage can be directed inwards, in the form of self-harming and suicide attempts, or outwards towards anything or anyone in her line of fire.

When this is what you are dealing with, then the aims of parenting are radically modified to just getting through the day.

Matters are made worse by the constant allusion that as the parent, this is all your fault. Your friends and parents say that you must set limits and keep your boundaries. Your daughter regularly tells you that you are a terrible parent. The psychiatrists say that borderline personality disorder is highly heritable. The psychologist says that there was some kind of trauma. Maybe a major trauma, maybe the continuous trauma of you being misattuned to your child’s needs. It is possible that they are all a little bit right. But actually, they know nothing of the challenges that this kind of parenting presents.

Your self-esteem gets eroded, you get depressed. Your resources are greatly diminished by the cost of all the therapy, psychiatric care and special schooling needs. You are constantly called away from work to deal with some crisis. You and your spouse are at loggerheads; sometimes it feels as if your daughter is deliberately pitting you against each other. (She is). The other children complain that there is no time or energy for them and they are probably right.

If this not only has a familiar tone to it but a blasting crescendo, then you and your family are being held hostage by borderline dynamics. There is hope. The first step would be to know what you are dealing with and be realistic in trying to manage it.  A  child with borderline personality disorder needs specialised parenting. It is less important wondering who is to blame and more important to identify who can help.

Fortunately, when realistically dealt with, there is a lot of help available. There will always be emotional instability and chaotic relationships, but there can be a reduction in the constant abuse and high-risk behaviours. When the noise of borderline personality disorder is contained, then those glimpses of a warm, passionate child can be given a chance to grow.

Borderline personality disorder often coexists with depression and other mood disorders, eating disorders and substance abuse. Psychiatrically treating these mental illnesses with medication can go a long way to stabilise things.  A therapist well versed in borderline personality disorder can help both you and your child. One therapeutic method that has had considerable success is DBT (Dialectic Behaviour Therapy).  DBT tries to teach a person how to logically look at thoughts and behaviours, instead of becoming flooded and overwhelmed with emotions. It has the added component of trying to teach the practice of mindfulness, the ability to be fully present. Tall challenges, to be sure, but when worked hard at can be of enormous benefit to both the patient and their family.

Fortunately, where I practice in Cape Town, I can make referrals to very effective DBT practitioners:

  • Robert and Janine Boulle  (
  • The Glenbrooke Practice (

If you want to get started right away, download “Stop walking on eggshells: Taking your life back when someone you care about has borderline personality disorder” by Mason and Kreger (available on Amazon or Takealot).

Growing a child with borderline personality disorder is an intense, wild journey. When the noise of borderline personality disorder is contained, then those glimpses of a warm, passionate child can be given a chance to grow.



  1. Everyone has some of those characteristics some of the time, just not as a pervasive theme or behavioural strategy. I for one get very upset at perceived unfairness before I have verified my perception. I’m also pretty sure that all of us had more than one or two such characteristics as a child. Who hasn’t subconsciously played off one sibling or parent against another or gone from serene to a tantrum and back again in the space of an hour? Luckily we’ve mostly outgrown that sort of “bad” behaviour, which makes me wonder if there is an evolutionary explanation to Borderline Personality disorder. Some characteristics ways of perceiving and reacting immediately that were adaptive to infants and young children in a highly competitive environment in the past have somehow persisted into teenage years and adulthood, reshaping and re-programming several neural circuits in a way that is now maladaptive.

  2. The latter, when juvenile traits are selected so that they persist into adulthood is quite common, especially in domesticated species. Such traits are known as neonatous. Most of us humans for example can’t digest milk sugar as adults, but those of us who have pastoralists as ancestors have retained the activity of the enzyme, lactase, into adulthood so that we can.

    The bigger question is why are some of the most functionally debilitating psychiatric disorders that have such a strong genetic component such as schizophrenia, bipolar and borderline personality disorder are not simply selected against and eliminated from the genome? The other option when genes can’t be eliminated is to shift their expression to the end of life when they can’t interfere with our reproductive years and yet these disorders strike us in our prime. Moreover they are at a stable 1, 3 and 1,6% global prevalence respectively, so they are not a result of culture. So what is going on? Perhaps the genes involved are too vital or protective to simply get rid of.

    Maybe something akin to what goes on with sickle cell anemia might account for just part of the story. A single copy (monozygotic) of the gene that causes the disorder has a protective effect against malaria and so is selected for in malaria infested areas but two copies (dizygotic) of the gene leads to the disorder. But natural selection can not select against the dizygotic condition without selecting against the monozygotic allele.

    Sorry for such a long reply but there is a lot more that can be said about evolutionary psychiatry.

Leave A Reply