Fostering validating responses in families

Families and family interactions can play a role in the development (vs. prevention), maintenance (or remediation), and treatment of borderline personality disorder (BPD); and, having a family member with BPD can have a significant impact on family functioning. This paper reviews a transactional model for the development and maintenance of BPD, with implications for treatment, particularly from the perspective of dialectical behavior therapy (DBT). The paper also describes a subset of DBT interventions specifically developed for work with couples and families to turn the destructive "inaccurate expression/invalidation cycle" into the constructive "accurate expression/validation cycle," which is illustrated by a case example.