(2009 October Newsletter)
Melvin W. Wong, Ph.D.
Introduction
The purpose of this presentation is to introduce the concept of “First-born-daughter (FBD) complex, a pseudo-borderline coping style.” This constellation of characteristics of the FBD was derived from Chinese women. (FBD is most commonly manifested in the personality structure of the first-born, but it is also found in women of any birth-order who were brought up under analogous parenting dysfunctions.) They were in deep emotional turmoil while this author was providing psychological services to them. These services go beyond the scope of psychotherapy, including psychiatric emergencies, acute in-patient psychiatric services, forensic evaluations and expert testimonies (in family law) as well as through speaking engagements for the public.
While most of the characteristics of the FBD complex may carry a negative connotation, when the FBD is not under stress, she can be quite functional (the quiet borderline?) It is important to point out that the FBD complex is an ineffective coping style which impairs effective interpersonal relationships and intrapersonal functioning. This complex may overlap some of the features of the borderline personality disorder as described in the DSM.
Positive Qualities
1. Exceptional independence in carrying out personal responsibilities. Such as the ability for a retired woman to operate a sandwich shop single-handedly in a busy financial district such as San Francisco.
2. Exceptional dependability in carrying out a task delegated to them. They do their assignment very conscientiously, meticulously, laboriously and effectively without delay.
3. They are excellent with the care of young children due to extreme cautiousness.
4. They are excellent crafts-people and they love to do things with their hands.
Psychopathology
1. Ineffective interpersonal style due to overly concrete in their perception of the world and events that surround them. They lack the luster of interpersonal subtlety that is important in the development of relationships.
2. Overly rigid with their perception and they are less able to shift mental sets to deal with a changing environment. A heightened sensitivity towards justice and fairness. High anxiety level & stress proneness.
3. They are not able to adjust effectively with social isolation. This characteristic is dependent on the level of functioning of the FBD. The lower the level the more problems with social alienation, being alone, fear of abandonment, and the overwhelming dread when having to face the evening by themselves.
4. They don’t necessarily do well academically. Usually they would do exceptionally well in early grade school years but their performance would slip when their family responsibilities became too demanding for them.
5. Emotional liability with an underlying dysthymic mood and restricted affect.
6. The overwhelming sense of meaninglessness and emptiness. Suicidal ideations are common with FBD’s.
7. The co-dependent behavior on a significant other. Heightened awareness of shame and guilt.
8. They don’t do well with separations because they have unresolved grief and bereavement issues from their family of origin.
9. The have an intense fear of rejection.
10. They have ambivalent feelings towards significant male love-objects.
Etiology of the FBD
1. The traditional Chinese belief that values males more than females and the mother’s worth on having a first-born son are the precipitating factors.
2. Mothers of FBD are usually FBD’s themselves. They have not accepted themselves and they were not able to bring up FBD’s effectively.
3. FBD mothers usually became too enmeshed with their daughters and they projected what they didn’t like about themselves and their fears and insecurities as women onto their FBD’s.
4. FBD’s became their mother’s confidant and counselor at an young age. There was role-reversal and confusion.
5. FBD’s became their younger siblings’ surrogate mother and care-giver. There was gross experience of splitting.
6. There is usually the lack of a happy childhood because FBD’s have to care for her siblings at a young age.
7. The lower functioning FBD’s are those who have suffered multiple interpersonal traumas, losses and rejections. It is not uncommon for low functioning FBD’s to develop the full borderline personality disorder.
8. It is typical for FBD’s to have reduced impulse control and they may contemplate running away from home to escape injustice and they would have chronic suicidal ideations. Self-mutilations and suicide attempts are also common.
9. They were disappointed with their fathers and their brothers. They felt that their fathers had betrayed them.
10. They have been emotionally and physically abused. The use of shame, divisiveness, splitting, favoritism, nepotism and threats of separation and dread are commonalities in their upbringing.
Treatment Summary for FBD’s
1. Through interpersonal and intrapersonal reconciliation by forgiveness and restoration of relationships.
2. Through the use of effective parenting skills on their own FBD’s. Such as the use of unconditional love.
3. Through the realization of their childhood aspirations.