Q. I have a client who suffers from Depression and BPD. She is seeking treatment but to date has shown very little progress or change. My primary question is in regards to her ability to parent her three small children. She is married but does not get much support from her husband or extended family. The whole family tends to blame external factors for all their problems and has yet to take any responsibility. I am faced with the difficult task of protecting these young children. Have there been any studies done relating to BPD and parenting? What about nurturing? She seems unable to display nurturing behaviors at times. Is this part of the disorder. I have searched for studies regarding these things but have found none to date. Can you point me in the right direction?

  A. I am not aware of any studies on parenting and BPD, but they probably exist somewhere. This area is not my forte so I work mostly on assumptions. Your chances of changing behaviors that the patient does not wish to change are virtually nil. If the children are in danger, you intervene. If they are not, leave them alone.