Q. Dear Dr. Markovitz:

Thank you for sharing your time and expertise. I hope to read more of your research articles soon. After sharing some concerns, I'll ask one question at the end. . .

Our seventeen-year-old daughter was recently diagnosed with BPD, so I hate the torment that this disease causes.

For everyone's sake, I'm concerned about how research is reported, interpreted, and often misunderstood. Most statistics regarding past abuse of any kind rely heavily on patient reports. From both my own experiences and Dr. Heller's writings, I believe that people suffering with BPD feel and remember abusive treatment and invalidation. Somehow I don't think I'm alone when I say that I'm deeply hurt by the wording and assumptions in some of the research literature. . .Perhaps falsely accused spouses, parents, and/or others who have loved and lived in torment with someone suffering with BPD should be included in research studies when appropriate. Unwittingly, I suspect that various writings and some mental health professionals have done more to harm than to help all those who are victimized by this disease.

Because of possible impaired memory, rejection sensitivity, and psychotic episodes during dysphoria, I think that extra care should be taken when describing an afflicted person's past environment. A careful description of how a patient perceives the past environment is not necessarily an accurate description of the environment. It might be more humane and helpful to collect statistics beyond patients' reports of mistreatment. I believe that many statistics are highly suspect. I wish that researchers could involve significant others (siblings, especially). I wish a reality-based picture of past environmental stresses (including more than one interpretation of identical events) could be drawn.

It must be incredibly challenging to gather together the needed subjects and resources for a research design. QUESTION: Are you aware of any studies (completed or planned) which incorporate the memories/perceptions of significant others who also were there during
the childhoods of people suffering with BPD?

A. I am not aware of any studies that will do what you need, and what the field needs. They likely never will be done because of funding problems. I totally agree with you on the data and its interpretation. I doubt that the alleged or real abuse causes BPD. Even if it did, it is a pedantic argument. You still have to treat the disease.