Improving Family Functioning to (Hopefully) Improve Treatment Efficacy of Borderline Personality Disorder: An Opportunity Not to Dismiss

People having intimate relationships with persons suffering from borderline personality disorder (BPD) - for instance, members of their family - are likely to be involved in stormy, roller coaster relationships. Thus, they may feel overwhelmed by extreme, unpredictable feelings and situations, even when they do not suffer from any mental disorder or have no problems with mentalization. As a consequence of living with a BPD relative, family members often experience an emotional and financial burden, and may blame themselves for their relative's illness or for not being able to do more to help. This can lead to emotional pain including anxiety, guilt, anger, frustration, despair, and hopelessness. Available evidence suggests a possible usefulness of family interventions for relatives of BPD persons. Starting from these background considerations, a qualitative review of the published literature on family interventions for relatives of BPD persons was carried out. The main findings concerning specific contents and available effectiveness data of psychoeducational family interventions, family skills training, and mentalization-based family programs are reported, in the perspective of 3 family intervention scenarios: (a) taking care of the family of origin of the BPD person; (b) taking care of the new family that the BPD person has started; (c) helping the BPD person to be an effective parent.