The Subjective Experiences of Mothers with Borderline Personality Disorder (BPD) Who Have Completed Mother-Infant Dialectical Behaviour Therapy (MI-DBT)

Abstract

Mother-infant inpatient units frequently receive referrals for mothers with Borderline Personality Disorder (BPD), characterised by emotional dysregulation and interpersonal difficulties. Research suggests that BPD symptoms impair a mother’s ability to recognise and respond to her infant’s cues. This can be detrimental for the emotional and interpersonal development of infants, who require consistent care during the postnatal period. Providing tailored treatments during the postnatal period is critical in preventing an intergenerational cycle of emotional and interpersonal symptoms. Mother-Infant Dialectical Behaviour Therapy (MI-DBT) has produced improvements on quantitative scales of maternal mental health and the mother-infant relationship. While promising, these improvements were inconsistent across scales and mother-infant dyads. Existing qualitative literature indicates that mothers with BPD experience unique challenges and risk factors which may explain these inconsistent results. These experiences are difficult to capture in quantitative scales, highlighting the need for a qualitative approach, guided by the women themselves. As such, this study aimed to explore the subjective experiences of women who had completed MI-DBT. Thematic analysis of interviews conducted before, post and twelve months after MI-DBT led to the development of five themes: (1) ‘Boiling Points,’ (2) Emotional Literacy, (3) Intergenerational Transmission, (4) Low Self-Esteem and (5) Dealing with Disconnect. Overall, the women expressed that their emotional literacy and regulation improved after MI-DBT, subsequently addressing key risks and challenges such as uncertainty around their child’s cues, low self-esteem and fears of intergenerational transmission. This study consolidates previous research on mothers with BPD and provides support and potential modifications for MI-DBT.