Relation mère-fille dans le trouble de personnalité borderline : recension systématique des écrits et analyse phénoménologique interprétative de dyades dont la fille adulte présente un trouble borderline
Borderline personality disorder (BPD) can be conceptualized as a disorder of interpersonal relations and of representations of self and others. On one hand, people with BPD often express their extreme distress in a particular relational context. Consequently, professionals and relatives of these people are negatively impacted by their BPD. On the other hand, unstable and polarized representations of self and others would explain the distress and behavioral manifestations of BPD. A major factor in the development of the child’s representational world, the parent-child relationship (PCR) therefore appears to play a predominant role in the development of BPD. The present thesis aims at understanding better how adults with BPD and their parents experience the PCR. Three secondary objectives stem from this general objective and lead to the two studies described hereafter: (a) Taking stock of the actual empirical basis of knowledge on the PCR in BPD, (b) Reconcile contradictory findings identified in the literature, and (c) Facilitate the emergence of new perspectives. The first study is a systematic review of 40 empirical articles about the PCR in BPD, based on either the perspective of the child, parent or family. BPD participants consistently reported a much more dysfunctional PCR compared to normal controls. Comparisons with participants presenting DSM-IV Axis-I and Axis-II disorders were however a lot less consistent. Low parental care and high parental overprotection may represent a general risk factor for psychopathology; at the opposite, parental inconsistency appears to be more specifically associated with BPD. The second study proposes an innovative method in this field, that is a qualitative dyadic approach. Eight dyads, each consisting of an adult female with BPD and her mother, were recruited through community resources. Each participant was individually interviewed about her actual and past mother-daughter relationship. Verbatim transcripts were analysed following the interpretative phenomenological analysis (IPA) guidelines. The eight daughters’ narratives were generally convergent and depicted the mothers as inherently vulnerable and/or weakened by many hardships encountered over the last decades. As for the mothers’ narratives, they could be divided into two types: 1) invalidating and warding off psychological distress and 2) being overwhelmed by and giving in to psychological distress. An explanation to the first study’s contradictory quantitative findings is provided. Moreover, a dynamic conceptualization of results, comprising a continuum and a metaphor, is proposed and discussed.The three following ideas summarize the main conclusions of this thesis. First, the relational adversity experienced by adults with BPD and their parents can take many forms. Second, it is essential to consider temperament and its unique interaction with parental behaviors in order to understand the various developmental trajectories leading to BPD. Third, parental inconsistency is a PCR aspect which appears specific to BPD and should be more investigated in the future.
Recherche qualitative Borderline personality disorder Parent-child relationship Mother-daughter relationship Systematic review Interpretative phenomenological analysis Qualitative research