Josh Clark

It takes basically a biological substrate for BPD.

Usually your prefrontal cortex hasn't developed in a certain way.

And so your executive function isn't functioning like an executive should.

That gets joined together with a trigger, usually mistreatment, whether it's abuse, neglect, invalidation by your parents as a kid.

And you put those things together and very often it results in what you'd be diagnosed with later as BPD.

I know, and doing parenting right sounds like a waking nightmare to me.

Doing what?

Parenting right?

Parenting correctly, yeah.

No.

I can't imagine the exhaustion along combined with the fear of just misstepping once or twice and then there you go.

You screwed your kid up for life.

Yeah, and I don't think Linehan's idea is that it just takes one or two missteps.

It takes like a parent who is a genuinely bad parent.

Very frequently they have BPD themselves, and that is a real challenge to parenting well in and of itself.

But you don't have to have had a parent with BPD to develop BPD.

But typically it's a parent that is not at all meeting your needs, especially emotionally.

Right.

And I say we take a break and we'll come back and talk about how you would be diagnosed with BPD.

What do you think?