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10 - Assessment and treatment issues when parents have personality disorders

from Part II - Comprehensive assessment and treatment

Published online by Cambridge University Press:  09 August 2009

Eia Asen
Affiliation:
Marlborough Family Service, London, UK
Heiner Schuff
Affiliation:
Marlborough Family Service, London, UK
Michael Göpfert
Affiliation:
Webb House Democratic Therapeutic Community, Crewe
Jeni Webster
Affiliation:
5 Boroughs Partnership, Warrington
Mary V. Seeman
Affiliation:
University of Toronto
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Summary

Many disturbed parents referred for parenting assessments do not present with acute mental illness, but with severe, emotionally unstable, borderline personality disorders. Here we usually find a persistent identity disturbance; self-damaging impulsivity; marked reactivity of mood; a pattern of unstable and intense interpersonal relationships; frequent displays of anger; chronic feelings of emptiness; transient paranoid ideation and dissociative symptoms. In our view the major underlying problem of this unfortunate condition is one of disconnectedness. We see this as profound difficulties of establishing and maintaining connecting relationships of mutuality (see Adshead et al., Chapter 15). These difficulties present both internally, that is, between parts of the self, and externally, in relation to partners, children and others – including therapists. Whilst there is usually plenty of observable powerful interacting – or ‘acting out’ – going on, this does not lead to a mutually connecting way of relating. Such individuals show levels of extreme emotional sensitivity and fluctuating affective states. These can provoke at times overinvolved or profound distancing behaviours. The primary concern is not about relating and negotiating with others, but about how to regulate and control one's own feeling states. There is a considerable preoccupation with the experience of others – including children – being able to trigger powerful and problematic feelings. To cope with this the parent often uses angry defences against being emotionally vulnerable. This can take the form of self-hate or attack on child, partner or helper.

Type
Chapter
Information
Parental Psychiatric Disorder
Distressed Parents and their Families
, pp. 139 - 158
Publisher: Cambridge University Press
Print publication year: 2004

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References

Asen, E. (2000). Working with families where there is parenting breakdown. In Family Matters, ed. P. Reder, M. McClure & A. Jolley, pp. 227–36. London: Routledge
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Schuff, G. H. & Asen, K. E. (1996). The disturbed parent and the disturbed family. In Parental Psychiatric Disorder: Distressed Parents and their Families, ed. M. Göpfert, J. Webster & M. V. Seeman, pp. 135–51. Cambridge University Press

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