Self-harm and attempted suicide in daughters with Borderline Personality Disorder: an interpretative phenomenological study exploring the experiences of parents

Background: Borderline personality disorder (BPD) is a complex disorder, characterised by instability of affect, interpersonal relationships, self image and behaviour. Recurrent self-harming and suicidal behaviour are common amongst individuals with the diagnosis, and the literature has historically placed an emphasis on parents‟ role in the development of the disorder. Despite this, with the emphasis on community support for individuals with a diagnosis of BPD, parents are frequently relied on to provide a significant level of care to their child and to manage their self-harming and suicidal behaviour. Aim: The aim of the study was to explore parents‟ experiences of self-harm and attempted suicide as displayed by their daughters, who have a diagnosis of BPD. Method: A qualitative approach was adopted and seven parents (five mothers, two fathers) were interviewed. Interpretative Phenomenological Analysis was used to conduct an in-depth analysis of the verbatim interview transcripts. Results: Three super-ordinate themes were identified, including lack of control, blame and burden, and loss and isolation. These themes, along with their associated sub-themes, were identified through analysis and interpretation of the parents‟ narratives and are discussed in detail. Conclusions and Recommendations: The analysis indicated that parents‟ felt powerless in response to their daughters‟ behaviour, and that this sense of powerlessness was compounded by healthcare professionals‟ obligations to maintain patient confidentiality. Exclusion from their daughters‟ treatment and care led parents‟ to feel they lacked the necessary skills and knowledge to support their child, and many spoke about feeling angry, frustrated or exhausted. Parents‟ accounts suggested that over time they felt that health professionals increasingly involved them, with many accessing available services. Relationships with friends and family appear to have been affected, as have parents‟ life plans. To cope with the difficulties faced, parents‟ described using multiple coping methods. Despite the majority of parents‟ voicing that their daughters‟ were self-harming and attempting suicide less often, if at all, ongoing worry and self blame was evident. Although the findings are specific to the sample, they provide an insight into parents‟ experiences and emphasise the importance of collaborative working and parents receiving up-to-date information and practical advice, as promoted by modern policy documents. Additionally it appears that parents would benefit from health professionals being proactive in involving them and signposting available services and organisations. It is hoped that the findings will act as a driver for future research, for instance, little is known about the experiences of parents from other cultural backgrounds. Furthermore, exploration of parent and child experiences, and health professionals‟ attitudes towards parents, is needed