Issues in infant--parent psychotherapy for mothers with borderline personality disorder

Mothers with Borderline Personality Disorder (BPD) and their infants have been largely neglected in the research literature. This is of concern, given that clinical reports indicate that mothers with BPD have difficulties with sensitive and empathic parenting and that their children are at risk of attachment disorganization. There is little available evidence on the use of interventions with this group of parents despite clinical need. This article describes our experiences in the use of an attachment-focused psychotherapy known as Watch Wait and Wonder for improving the interaction between mothers with a BPD diagnosis and their children. A case example is provided to illustrate one mother's response to the therapy and to highlight specific issues in clinical intervention for this group of parents and possible modifications of approach.