The Role of Intergenerational Trauma in the Perpetuation of Childhood Maltreatment

A new study examines the role parent borderline pathology plays in the perpetuation of childhood maltreatment.


A new study, published in the Journal of Development and Psychopathology, investigates how childhood maltreatment is transmitted across generations and the role that traits associated with “borderline pathology” play in this transmission. Researchers from Washington University in St. Louis and Northeastern University collected data from over 900 participants about childhood maltreatment. Results of the intergenerational study suggest borderline personality pathology may be a risk factor for non-specific childhood maltreatment.

“Because borderline personality pathology is associated with both exposure to childhood maltreatment and risk factors for its perpetuation, we expected that it would mediate childhood maltreatment continuity across generations,” write researchers, led by Sarah Paul at Washington University in St. Louis.

(Photo Credit: Joshua Green)

Maltreatment during childhood is common and widespread, leading to an increased risk of amplified stress, self-injury, mental health concerns, and even structural changes to the brain. It is notable that maltreatment of children tends to run in families, which is often referred to as the intergenerational transmission of childhood maltreatment (ITCM). That is to say, a child is more likely to be maltreated if their parents were maltreated in childhood.

As Paul and colleagues point out, little is known about the factors that contribute to the continuation of ITCM. Borderline personality pathology (BPP), as examined in the current study, is, “Characterized by pervasive emotion dysregulation, impulsivity, distress intolerance, inconsistent appraisals of others, feelings of isolation, and unstable interpersonal relationships, is a promising potential contributor to ITCM.” Further, a study outlined in the article suggests, “90% of patients with borderline personality disorder were exposed to childhood maltreatment and that they were more likely to be exposed than patients with other personality disorder diagnoses.”

“Both retrospective and prospective data reveal that maltreatment during childhood is strongly associated with BPP and that this relationship remains even after accounting for other forms of psychopathology (e.g., depression) related to both early life stress and BPP.”

The purpose of the current study was to explore the relationship between BPP and ITCM. Researchers recruited families from the St. Louis Personality and Aging Network (SPAN) study, which included 364 parents and their biological adult children. Through self-report measures, researchers examined rates of childhood maltreatment and the presence of BPP. In addition, they conducted clinical interviews with all participants, obtained information about personality, and collected other relevant covariates.

Results of the large inter-generational study further support childhood maltreatment as being common across generations. Further, the study suggests parental rates of BPP may be a risk factor for increased ITCM. “Parent borderline personality pathology was positively associated with their own prior exposure to maltreatment during childhood as well as their children’s exposure.”

“Consistent with theoretical models hypothesizing that childhood maltreatment plays a causal role in the development of BPP and associated evidence relating stressful family environments and predispositions for emotion dysregulation to the development of BPP, our findings show that maltreatment is associated with BPP development. In turn, the expression of BPP is associated with a heightened likelihood that one’s children are exposed to abuse or neglect,” write Paul and colleagues.

While the study does not suggest all individuals with BPP will perpetuate childhood maltreatment, it does highlight an important systemic characteristic of the pathology. The study suggests a framework for understanding ITCM that may assist in targeting interventions. The author concludes:

“Providing treatment for borderline personality pathology in the context of parenting and development may help interrupt the continuity of childhood maltreatment and related health problems across generations.”



Paul, Sarah & Boudreaux, Michael & Bondy, Erin & Tackett, Jennifer & Oltmanns, Thomas & Bogdan, Ryan. (2019). The intergenerational transmission of childhood maltreatment: Non-specificity of maltreatment type and associations with borderline personality pathology. Development and Psychopathology. (Link)

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Jessica Janze
MIA Research News Team: Jessica Janze is a doctoral student in the Counseling and School Psychology program at the University of Massachusetts Boston. She has a master’s degree in counseling psychology and has worked primarily with children impacted by psychological trauma. Jessica’s research interests include the impact of mindfulness in early education, emotional regulation, and the role contemplative practices play in mental health.


  1. The primary reason that child abuse is associated with Borderline Personality disorder, as are all the “affective and psychotic disorders,” is because our “mental health” workers cannot bill insurance companies for helping child abuse survivors, unless they misdiagnose them with one of the insurance billable DSM disorders.

    And the reality is that covering up child abuse has historically always been, and still is today, the primary actual societal function of our so called “mental health” workers.

    I have no doubt child abuse does occur within families, however it also occurs outside the home. And I have no doubt that, since our society has a group of multibillion dollar, primarily child abuse covering up, “mental health” industries. Whose child abuse covering up crimes have also functioned to aid, abet, and empower the pedophiles and child sex traffickers for over a century now. So our society now has serious pedophile and child sex trafficking problems, even according to world leaders, and the ethical within the “mental health” industry.

    Perhaps, the “mental health” workers should get out of the child abuse covering up business, since it’s illegal anyway. And rather than making assumptions that your made up, “invalid,” and “unreliable” DSM disorders cause child abuse. Perhaps our society should get rid of the child rape covering up “mental health” industries, and go back to arresting and convicting the child abusers, pedophiles, and child sex traffickers?

    Although since misdiagnosing child abuse survivors is approximately 80%, or so, of our “mental health” industry’s business, getting out of that illegal business, will likely be a hard thing for our child rape covering up “mental health” workers to do.

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  2. No. The concept of borderline is a false paradigm.
    It is basically used by psychiatry as payback for being an uppity patient. They know it is a death sentence to those that carry in terms of how one is seen in the medical world.

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  3. ….so-called “mental illnesses” are exactly as “real” as presents from Santa Claus, but NOT MORE REAL….psychiatry is a pseudoscience, a drug racket, and a means of social control. It’s 21st Century Phrenology, with potent neuro-toxins. Psychiatry has done, and continues to do, far more harm than good….

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  4. Reading this article made me feel so hopeless. At least the comments so far have reminded me that there are people who know the truth.
    By the time I was diagnosed with borderline personality disorder at 38 (after I failed a series of ECT treatments according to the psychiatrist), my son was in his late teens. I had first encountered the mental health system at age 16, when the board of education of my public school system paid for me to see a psychiatrist once a week because I had dropped out of school due to hopelessness. This psychiatrist dropped me the day I graduated because she stopped getting paid by the board of Ed. She knew my parents were not going to pay for treatment. I made my first suicide attempt a year later using the full bottle of Elavil that she left in my possession. My stomach was pumped I was treated terribly and I was sent home back to the same abusive environment that cause me to overdose. Several months later I was pregnant with my son. Had I known that I had this so-called borderline pathology, tragedy could have been avoided. But psychiatry as always fell down on the job. The hypotheses presented in this argument based on new science? These things are blatantly obvious and have been for decades. This article really makes my blood boil.

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  5. I agree with the other commenters that mental illness is a social construct. Childhood trauma is real and its effects are real and yes it is passed down from one generation to another. Trauma is something that the mental health profession has failed miserably at treating. I can’t even say failed, because they haven’t tried to treat it. They ignore it. I have a borderline diagnosis and I have been denied trauma therapy for 35 years. The psychiatric profession has drugs and behavioral therapy for people with childhood trauma. They do not address the trauma. They deny or ignore the trauma (DBT: the past is irrelevant. Just learned skills) and blame the person who has been traumatized and they re-traumatize them and call it treatment. Both the drugs and the therapy made things so much worse for me, for 35 years.

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    • Hi Kate, You are so right! The mental health profession does ignore and/or deny trauma and would rather just blame the victim. Lots of commenters know this and lots of the professionals who write blogs on MIA also know and acknowledge this. I hope you are doing better and I hope you read Dr. Caplan’s recent blog as it is about concerns with articles (like this one) that give credibility to spurious DSM labels.

      I am almost finished reading The Body Keeps the Score and this sentence sort of spoke to me “Trauma constantly confronts us with our fragility and with man’s inhumanity to man but also with our extraordinary resilience”. Just remember how resilient you are. Take care.

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      • Thank you, Rosalee. You say the best things. 🙂
        That is really just what I needed to hear. I’m so glad for this website. It’s one of the only “places” where I don’t feel I’ve gone mad.
        I did read Dr. Caplan’s article, thank you. It was very good. I have finally decided I never want to be called borderline again. I reject the diagnosis.
        I heard Dr. Van der Kolk speak once…at a borderline personality conference at Yale. If only there were more like him. I had a so-called trauma informed therapist once. One day I tested the waters by describing to her an interaction that went on between my parents every day when I was a kid. It was bizarre, I’ll admit…but she was a trauma therapist. She became completely silent and said very little the remainder of the session. The following week in session, sort of out of the blue, she blurted, “That thing that you told me about your parents last week…that was ridiculous!” She sounded so angry. I didn’t know if she was angry at my parents for what they did or angry at me for telling her about it. A couple of months later, I was dealing with severe hypertension after being put on Parnate. The prescribing psychiatrist and all of the other doctors I saw about this sudden stroke-level hypertension told me it had nothing to do with the parnate and it was caused by age. My blood pressure went from completely normal to stroke-level during the week or so I was taking parnate. They were trying to tell me that I had aged that much in a week. They finally told me to go see a cardiologist. He did a stress test and then because he couldn’t find another reason and didn’t want to attribute it to the parnate, because you know, doctors, they stick together, he said, “Welcome to your forties, you have hypertension.” I found out later that one doctor wrote in my chart the reason for the hypertension was that I hadn’t followed the restricted diet for parnate. That was an absolute fabrication. So, being very upset about all of this and the idea that now I would have to be on multiple blood pressure meds for the rest of my life, I was speaking about the whole situation to this therapist. She was quiet for a long time and then she said, “You inherited very poor coping skills from your parents.” I asked her what she meant, and asked how did that relate to what I was telling her about my blood pressure? Was I doing something wrong? If I was doing something wrong maybe she would tell me what it was that I was doing wrong so I could fix it. She wound up kicking me out of her office before the session was over. So not only could she not handle hearing about the trauma that my parents had inflicted on me, she stored that info in her therapist brain and later used it as a weapon against me.
        I have so many memories like this that float around in my head all the time. Sometimes I come up with snappy answers I should have said, only I’m ten years late.
        This one psychiatrist who was, well, useless, like most of them, when he was deciding what drugs to add to my regimen, I pointed out to him that I had recently experienced 3 family crisis: the death of my oldest brother, a meeting with my other brother during which he told me he molested me as a child in reaction to something my mother had done to him, and my son having a breakdown. I told the psychiatrist, “maybe what I am experiencing is not depression but grief.” He said, “But don’t they teach you in DBT to just let it go and move on?”
        This was maybe six years ago. I was thinking about it today and thought, I should have said to him, “Right, so then what do I need you for?” and walked out.
        Maybe at some point I’ll be able to think about something else, go back to my artwork. I guess I must be resilient though, because I’m still here.
        Sorry for the ramble. Thank you for the support. I am doing a little better. I’m getting out more. I just really miss my cat.

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        • I been thinking about your cat situation, Kate. They have those gravity-fed dispensers for food and water. I have 2 cats and it’s almost two weeks from full to empty for the food. I’ve never let the water reservoir get below 1/2 because one of my cats is a messy eater and drops crumbs into it, but they have ones that actually circulate/filter the water. We keep 2 litter boxes for them- they prefer the one by the door, so that one gets icky first, and then they move on to the one in the bathroom.
          If you were able to do these things, do you think you’d be able to take care of a cat again? That way, kitty would be lonely but otherwise un-neglected even if it did take a few days for someone to come be your back-up.

          I so want you to have your kitty back. Our animal companions give us so much love, comfort, and make it all bearable. You need that; you deserve it. It saddens me to think of you doing without.

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          • Thank you, Lavender Sage. What happened with Kodi was kind of a complicated situation. I’d had him for a couple of years when I surrendered him a few months ago. I’d adopted him at age 7. He had a hard time making the adjustment to living with me after being in the same home, with a family, his whole life, and during the time I had him we just had one stroke of terrible luck after another. I did start to feel like we were under a curse. I don’t trust my neighbors, at all, for reasons I won’t get into, but that plus not having any family or, at the moment, even a friend, it’s just hard. I feel like it would be irresponsible to adopt.
            Kodi had 3 serious incidents during the 2 years he was with me (swallowed a lot of ribbon, needed surgery, almost died; then, fell of the deck and broke his leg; then jumped into a bathtub that had wet sealant in it which dried into his paw fur and the vet had to shave the fur to get it off) and over time I think the vet started to have serious doubts about me and my ability to care for Kodi. When I was taken to the ER, not knowing how long I would be there, I contacted my landlord who took Kodi to the vet for boarding. When I was discharged from the ER (Crisis Intervention Unit or Crisis Escalation Unit depending on your PoV), I was not okay… I’d been shot in the ass with something…it was one of the most awful CIU experiences i ever had, and that’s saying a lot. I was just a shell of myself and that is when I called the vet and she suggested I surrender Kodi, so I did. The truth is that I am so isolated and Kodi is highly social – he likes people coming and going, needs stimulation – that I felt it was unfair to keep him with me. I thought he could do much better than me, have a better home, with a family. I thought I was doing the right thing. I just decided to take the vet’s word for it that I should surrender him.
            The part that is so hard for me is that, all these months later, they still haven’t placed him. He is still living at the vet. I sent an email about a month ago offering to take him back. They never answered me. So, as much as I would love an animal companion I don’t think it would be responsible, at this point. I’m also not convinced the curse has lifted. I know that sounds paranoid but the past couple of years it’s just been a sh*t storm, one thing after another.
            Thank you for your thoughtfulness.

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        • Wow, THAT was a “trauma informed” therapist??? I think they missed the boat by a pretty wide margin, there. It goes to show again that training and qualifications don’t mean much in this world of contradictions and power trips. Finding a person who actually cares enough to get to know you is the real winning game, and there is no guarantee or necessarily even improvement in odds that a person with a degree or training in “trauma-informed therapy” will be that kind of person for you. It absolutely disgusts me to hear this kind of story – thanks for sharing it and good for you for seeing what was really going on!

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        • I hope things settle down Kate and in the future you can somehow get your cat or a new kitty. The feeding suggestions LavenderSage mentioned sound like they could be helpful. Did the shelter clean up their act or did it get closed down?

          So sorry you had to endure such lousy therapists on top of everything else you have endured. These so called professional people have no people skills and no compassion. It’s impossible to comprehend how they ever get into these positions. People who have survived such horrible encounters within the mental health system are actually the people with the most resilience. Wishing you the best, hang in there Kate.

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          • Thank you, Rosalee. Maybe someday I’ll have another cat. I keep hoping to hear from the vet that they found a new home for Kodi. They said they’d let me know. He’s not that easy to place because he’s 9 now. It breaks my heart. Sometimes it seems there is no right decision. I know they take good care of him but he is caged most of the day.
            I wonder also why some of these mental health workers wind up in these positions. At the local hospital most of the staff seem to have lived very sheltered lives. I was there for surgery for a badly fractured and dislocated ankle about a year ago. I live in a building where the landlord is compassionate and he rents to people, like me, who might otherwise have trouble finding any housing. The women who live in the two apartments near to mine barely leave their apartments. Just before I fractured my ankle last year one of these women asked me to take care of her cats while she went to visit her father. I went into her apartment twice a day and took care of her cats. This woman never told me that she had a serious bed bug problem. After taking care of her cats for the week, I also had bed bugs in my apartment. I had brought all of my clothes and sheets etc to the laundromat to get rid of the bed bugs and all the clean laundry was piled in the living room when the EMTs arrived to take me to the hospital for the fracture. I made the mistake of being honest with them. I told them that the laundry was piled in the living room because Id just taken it to the laundromat because of the bed bugs. They were openly disgusted and started making jokes about it. When I got to the ER no one would come in the room that they put me in because of the bed bugs, for about half an hour. After the surgery I was in the orthopedic ward where the nurses all hated me. I heard one of them say to another one, “I heard she had bed bugs when she came in.”
            It made me so angry. If you live in a house that’s not connected to any other houses and you have your own washer and dryer, your chances of getting bed bugs are much lower. But they used this information about my having bed bugs as another bit of ammunition against me. I wound up thinking that they were spoiled and must have had really easy lives. I guess they wound up thinking that I was dirty.
            This is the same hospital where I was in the CIU a few months ago. I asked for a ride home when they discharged me. They said my insurance didn’t cover it. They told me to call someone for a ride but I didn’t even have my phone with me so I wound up walking home in the dark. No compassion. I hope I never wind up at that hospital again.

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          • Kate, I feel so bad for you, you help out the neighbor and then that happens. From my experience with a snooty young psychiatrist I learned whatever I said to try explain my situation ‘can and will be held against you’ or twisted into something entirely different to suit her speculations.
            I think it is safer not explain anything to these people. Hold your cards close to your chest, right!

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  6. In other words, people who are abused as kid are more likely to abuse their kids than those who aren’t. The old cycle of abuse idea. Hardly groundbreaking research here. The disturbing part is that everyone in the field doesn’t already know that childhood abuse is behind much of what is called “mental illness.” Treat kids better and “mental illness” will be reduced. But oh, that’s “blaming the parents,” isn’t it? Safer to blame the kids’ brains.

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  7. I would like to apologise to the author of this article for the tone of my earlier comments. I’ve been in a bad place, and the subject matter hit very close to home. I completely agree with the premise that these types of problems are passed down through generations. My son cut me (and the whole family) out of his life 6 years ago, and I don’t blame him for it. The whole family is deeply dysfunctional.
    I said in the earlier comments that the article made me feel hopeless and angry. Closer to the truth:. I was feeling hopeless and angry at the time I read the article, and I reacted. I do apologise for that.

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    • It’s nice of you to apologize here, however IMO, I feel that you had no need to, since the article writer seems to support label giving. And no, I won’t apologize for calling it as I see it.
      Katel, I think you had your very normal alarm bells go off when you read this, and rightfully so.
      The article wants to differentiate between “mental illnesses” as if psychiatry is not proposing that ALL “mental illnesses” are generational, hence the “research” into “genes”. Dysfunction can begin many generations ago, and NOT due to “mental illness”. It could easily have been a brain injury or just being an abused peasant on a farm, as far back as hundreds if not thousands of years. It could have arose out of an orphaned child which society rejected.
      They did the monkey study and the rat study which showed them in real time that they are NOT dealing with “mental illness”, or any disorder. People are living out exactly the hurts that were supplied and the parents were simply a vehicle.
      IF indeed BPP existed (it’s invented) then no shrink would feel that he should hurt you further and brand you as an unwanted Jew was in the holocaust.
      I read of late that you had seen a grim face on the psychiatrist. It was not grim, it was the guilty face of a liar. You only dealt with further hatred and control when you met the “mental health professionals”. The hopelessness you felt was a warning that what you are in is the wrong thing.

      The label accomplished what it was meant to do, to spank you for being you, so that you would withdraw further.
      There are so many really crazy people out there, and I speak not of anyone diagnosed. I speak of truly crazy mean and nasty, the ones who hide and never would consider themselves “ill”. They have blind confidence, which really hides behind a very fragile ego.
      Imagine a law comes along that decrees psychiatry a hoax? What happens then? You will see very damaged egos crumble, with no other possible job in sight….since their “model” is kept up ONLY by opinion, prejudice and the present times we are in. It is all an illusion.

      My house was FULL of kids, friends of my kids, we had the cream of the crop kids, money and power and neurotic parents. The kids are mostly in the “health industry” and I know how red they turned when angered. These professionals can NEVER “come out”, just how dysfunctional their homes were, and how they were ultimately just formed and pressured, and forgot who they were as little kids.

      I’m not sure what pathology drives psychologists, therapists and psychiatry to elevate themselves over others to the point of totally trying to ruin someone.
      Just don’t accept it, and I know the difficulty in that. Look for your dignity and pride, it’s in there somewhere. If you are born without arms, you cannot ever throw a punch or defend yourself, but not having arms is not an “illness”, nor a “disorder”, although it can cause you grief and even grieving. So the very last thing a person without arms needs is to be told they have no arms, and be teased or scolded for not being able to fight in the ring.

      And to add Katel, “it” is only their opinion. Their opinion that people and their lives are “mental illness”, opinion and pretences that this can be quantified and labeled. The DSM is invented. Cancer/diagnosis was discovered.
      The DSM and it’s lying ilk, has caused MANY people nothing but hardship.
      Distress, challenges and suffering are real and we do not need politicians to sick nasty dogs on the suffering.
      Psychiatry is that nasty dog. It should never have been adopted.

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  8. Thank you, Rosalee. It took me a long, long time to learn never to trust them. In my 35 years as a patient, there were a few therapists along the way that helped me. Maybe 10% of the treatment providers I saw helped me. The rest of them did a lot of damage. In a way, that 10% wound up making things worse for me because it kept me going back. The one therapist I had at the IOP DBT program who helped me was always trying to impress upon me that I need to give people the benefit of the doubt and he tried to make me give this to other treatment providers who had already hurt me. in this program, it was mandatory that patients have an outside, individual therapist because the IOP DBT program is an 8 month program and then you’re out. So they want patients to be working with a therapist while they’re in the program so that they have that when they leave the program. But almost all these outside therapists were worse than useless. The woman who talked to me about my very poor coping skills that I inherited from my parents…she was an outside therapist.
    “Let’s apply the benefit of the doubt skill in this situation,” he would say. The end result was, after giving the benefit of the doubt to people who didn’t deserve it and being badly hurt, I got furious at the one guy who did help me the most. I was so angry at him for making me put my trust in people who didn’t deserve it. When those people hurt me I took it out on them but also on him. I still feel badly for that but it was a pretty impossible situation.

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    • You as a client should NEVER have to give the “benefit of a doubt” to your supposed caretakers/helpers. It is THEIR responsibility to figure out what is helpful, or to admit that they don’t know how to help. It infuriates me (though it’s not surprising) to hear the staff telling YOU that you need to understand and take care of the staff who are supposed to be there to help YOU. I find it disgusting.

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      • Yeah, there were a lot of things that I went along with…that I wish I hadn’t. This same therapist said something to me about a therapist who turned out to be “in over her head with you,” as he stated it, and when he said it I sort of tacitly agreed. Now I think back on it and I think, was she/were they in over their heads with me? Or was I in over my head with them? They’re supposed to be the experts.

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        • Yes, they are supposed to be the experts, which is the main problem. I have always felt I was the most helpful when I was the most humble and least expert-like, just talking one human being to another. No one is an expert in another person’s life!

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  9. I was reminded of this article today. I wish they would do a study on how the mental health system causes intergenerational trauma. My family is a textbook case. I’d be happy to be interviewed about it. There was severe trauma and dysfunction going on in my household for years before I presented to the system as suicidal. I was treated like a spoiled brat looking for it attention. No help for you, brat! It was documented. Police at our house, both of my brothers hospitalized with psychosis on multiple occasions. There was no help then. I guess I was supposed to find it on my own but I had no idea how to navigate the world, I had no skills, there was no internet. I think overdosing on a bottle of Elavil seemed to me like the most clear way to either ask for help or be done with it all. But I didn’t get either. I didn’t get help and I didn’t get released from the pain. And 20 years later, when I have my own money, I have my own insurance, they do electric shock on me and then tell me it didn’t work because I had borderline personality disorder. My son was almost fully grown at that point. In the interim, I asked for help so many times and never got so much as a parenting class. The sickness in my entire family destroyed his childhood.
    My adult son is in terrible pain and I am very worried about and frightened for him. He has expressed to me that he has been suicidal for long periods of time and is currently. He has tremendous physical pain, chronic.
    He says he learned it from me, the suicidality, and I know he is right. He tells me things lately about the way I behaved when he was a child, things that I had blocked out, and they are awful. Where was the system, before and after I had my son? Before and after, I begged for help over and over again and was repeatedly mocked, abused and dismissed. I blame myself. I also blame the system and several so-called treatment providers whose faces and tones of voice still haunt me. The nurse on the locked psych ward when I was pregnant, reminding me that I was a little b**** every time there was no one else in earshot. They were so cruel. It’s beyond hubristic for anyone in the system to even publish a study like this and implicitly give the system a pass. They should be asking, what is our part in this? What is our systemic pathology? How do we treat people who are suicidal? Do we ask them what’s going on at home? Do we ask them what has happened to them to make them feel that way? No but we’ll do a study about how borderline pathology gets passed on to another generation. Give me a break!

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