Borderline personality disorder: a symptom of the family system

The present article explores the Bowen family systems theory (BFST) view that a mental disorder such as borderline personality disorder (BPD) is not a dysfunction occurring within an individual but a maladjustment of the family emotional system. A case study is presented illustrating how the emotional process moves between individuals within a family system so that when relationship processes become severely compromised, one member absorbs more of the stress, becoming vulnerable to acute symptoms. It is proposed that the use of a BFST approach with a client presenting with panic anxiety and low mood may have contributed to the lowering of symptom intensity for a sibling of the client. It appears that the client's work on her part in the relationship disturbances between her, her mother, father, and sister contributed to decreasing BPD symptoms in her sister and an improvement in overall family functioning. Therefore, the differentiating effort of one family member seemed to have a ripple effect on the whole family system. Shifting the theoretical lens from an individual-medico-diagnostic one to a BFST one sheds light on how all family members are expressions of a family organism and players in the symptoms emerging in one.