Refusing to go back to DBT

[Think About It...]

I need help again.  Isn't there always something. . .

Daughter came home from DBT last week saying that she was NOT going back. 

Up until this past week daughter has gone to DBT faithfully every week (except the one week when she was in the hospital).  I can attest to the fact that she is really trying and that she is doing the best she can.  She has had an excellent relationship with her individual therapist, and I was so thankful for that.

Well, last week she came home saying that her therapist was very "invalidating," that she didn't understand daughter, and that she wasn't going back.  She skipped group because of whatever happened in her individual session.

This is what I heard:  the therapist sounded as if she was trying to move daughter forward. . . asking her why she wasn't going to job club. . . why she hadn't followed through on her plans to volunteer. . . telling her that she has to be a "willing participant" in getting well.

Daughter tried to tell her that she IS doing the best she can, that she IS using her skills when she is having anxiety and panic attacks, that she isn't ready for a job yet.

Therapist kept repeating like a broken record "you have to be a willing participant." 

Daughter got so frustrated and angry that her therapist "wasn't really listening to me."  She said that she can validate, sure, but that it is rote and mechanical, and that she is not really hearing her. 

So, I listened and validated daughter's feelings for about a half an hour.  I was doing well.  Daughter knew I sincerely understood her feelings.

Then I took a risk, which backfired on me. 

Daughter had been reading Get Me Out of Here, a book about a borderline who has recovered.  One night last week (in the middle of the night) I noticed that she was up reading.  Daughter was so glad that I had gotten up, because she desperately wanted to talk.  She told me that this book had made her realize how badly she has treated everyone "my whole life."  She talked about how she does paint people black, that she always has.  She cried and told me how sorry she was for all the stress she has caused me.  This is just a very short version of our late night conversation.

Well, in our conversation about not going back to DBT, I recalled our conversation about her remorse for painting people black.  I thought maybe she understood.  Dumb me. 

So I said, very gently, "Is it possible that you are painting (ind. therapist) black right now?"

OK, you all know her reaction.  Explosion.  I haven't seen her rage this way for a long time.  She left the room.  We haven't been able to talk about this since, and now I don't know what to do.

Help!

Barb

[Barb0224]

I need help again.  Isn't there always something. . .

Daughter came home from DBT last week saying that she was NOT going back. 

Up until this past week daughter has gone to DBT faithfully every week (except the one week when she was in the hospital).  I can attest to the fact that she is really trying and that she is doing the best she can.  She has had an excellent relationship with her individual therapist, and I was so thankful for that.

Well, last week she came home saying that her therapist was very "invalidating," that she didn't understand daughter, and that she wasn't going back.  She skipped group because of whatever happened in her individual session.

This is what I heard:  the therapist sounded as if she was trying to move daughter forward. . . asking her why she wasn't going to job club. . . why she hadn't followed through on her plans to volunteer. . . telling her that she has to be a "willing participant" in getting well.

Daughter tried to tell her that she IS doing the best she can, that she IS using her skills when she is having anxiety and panic attacks, that she isn't ready for a job yet.

Therapist kept repeating like a broken record "you have to be a willing participant." 

Daughter got so frustrated and angry that her therapist "wasn't really listening to me."  She said that she can validate, sure, but that it is rote and mechanical, and that she is not really hearing her. 

So, I listened and validated daughter's feelings for about a half an hour.  I was doing well.  Daughter knew I sincerely understood her feelings.

Then I took a risk, which backfired on me. 

Daughter had been reading Get Me Out of Here, a book about a borderline who has recovered.  One night last week (in the middle of the night) I noticed that she was up reading.  Daughter was so glad that I had gotten up, because she desperately wanted to talk.  She told me that this book had made her realize how badly she has treated everyone "my whole life."  She talked about how she does paint people black, that she always has.  She cried and told me how sorry she was for all the stress she has caused me.  This is just a very short version of our late night conversation.

Well, in our conversation about not going back to DBT, I recalled our conversation about her remorse for painting people black.  I thought maybe she understood.  Dumb me. 

So I said, very gently, "Is it possible that you are painting (ind. therapist) black right now?"

OK, you all know her reaction.  Explosion.  I haven't seen her rage this way for a long time.  She left the room.  We haven't been able to talk about this since, and now I don't know what to do.

Help!

Barb

[John Galt]

Barb,

I am sorry but I do not have help.You can lead the horse,right? Thats the problem.My wife explodes the same as your daughter and my choice is to going to be to take my kids and leave.It will not be that easy for you,sadly.

I think it really is 2 steps forward ,one step back and even sometimes 2 steps forward,11 steps back.Thats the real sad part,

Good luck,
Marc

[momoftwo8589]

Barb,?  I wish I had words of wisdom for you.?  I have been there, the "I'm not going back to therapy" place, and tried like you to get DD to see that that isn't a viable solution.?  

I've also had those conversations that you spoke of.?  One was extremely tearful, she was in the hospital (again) and there was a new mom in there with her that had lost an infant and subsequently tried to hurt herself, thus ending up in the psych ward.?  DD called me and was nearly hysterical telling me how terrible this woman was suffering and that she was "sooooooooo sorry" for ever putting me through all of this, that if this woman felt that bad over a baby "she hardly knew" that DD couldn't imagine how much she must be hurting me by doing all of this.?  I listened and waited for her to stop and take a breath and then tried to tell her that I was ok, that she should (there's that bad word) worry about herself, and work on herself, and she then got mad that I didn't understand how sorry she was feeling, and hung up on me.? ?  I never quite know what phrase or turn of words will "set her off" and I guess I am still walking on eggshells most of the time even though I try to use the methods that I have read about and heard about here.?  

I don't know how helpful, if at all, that was, but know that others have been there and we know you're doing your best too.?  It's just so hard to watch our kids (no matter how old they are) struggle with such intense pain that we can't do anything about.?  I spent a year in therapy myself after the almost ex and I split, and I finally got to a place in my head where I could say, "it's not my problem and I can't fix it for him."?  That is so much easier to do with a spouse, or SO, than it is with a child.?  A parent is wired to try and fix everything for their child and when we can't, it rips our hearts into little pieces every time.?  Thus my tag line - putting the pieces back together daily - because that's what I feel like most days.?  We keep the super glue industry in business.?  

You're in my prayers, and your DD too. 

[justmom]

((Barb))

It's hard.  I've read and re-read your post ... full of my own self doubts here are my thoughts...

One thought was the T sees more  in your D than she can, right now.  T is right .  But maybe D is right too..  She seemed to be learning skills and applying them so quickly and good it may be that T think D can keep moving at that speed.  D knows the next skills/ steps are hard for her.  Feeling pushed made her want to stop it all.  So it is about her feelings and feeling being able to do the next skill/step

It is hard to remember that Therapist are people.  They can make  mistakes, misjudge, have a bad day and on and on.

This isn't as clear as I wanted it to be...so I'll stop here and hope others can add


Remember to have faith in yourself and D

Justmom

[Barb0224]

I just pulled something out of my pocket, literally, and before I do anything rash, I thought I would throw this by all of you, too.

Last week daughter gave me her therapist's card.  I just noticed it in the pocket of my bathrobe.  On the card is not only a phone number, but an email address.

What do you think?  Should I try to contact the therapist? 

[Barb0224]

P.S.

Justmom,

I think you are right in your assessment of the situation.  I think therapist does want to push daughter toward change, and I think daughter is scared of this part and afraid of possible failure (again) if she moves before she is ready.  You are so right that she has made many positive changes already and that this one just might be moving too fast.

Do you think I should just keep validating her feelings?  Is there anything I should or can do to help her to see that she needs to continue DBT? 

Thanks for your input; as always, I appreciate your wisdom!

Barb

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[Cagey]

Barb - NO - do not call or email her T - it is a breach of trust and confidence if you do it without her consent or prior knowledge.

[Cagey]

Ok so what do we have here ?

A BPD young woman in therapy who is probably ready or nearly so to take the next step. Very scarrrrry. For everybody emotionally invovled with her. I kinda think the explosion could have been expected because it is 2 steps forward and 1 back and old habits/reactions are hard to get rid of. Especially during times of stress.

We have just started into the most stressful 45 days of the year. For many reasons, but the top 3 are Thanksgiving, Christimas and the long winter months being cooped up with no money especially due to the first 2. It's hard on everyone, but especially more so on people with mental health problems.

Add to this your daughter's situation - frustration with feeling like she is not being heard at therapy, fear of moving on, no job? no money? etc. How much more could she take before exploding? Inwardly or outwardly?

So where are we? She exploded. It's going to happen. It's done, it's over. Let's go on from here.

What does she need from you that you are not already providing? Don't know for sure, but I am thinking more peace and comfort. Continue to validate and problem solve with her. Stop nudging her towards change for a while. I am thinking what she needs most from you right now is a soft place to fall back to and just plain old acceptance. She needs you to be her mommy and not her T.

I would strongly encourage her to stay in therapy. It's just so hard to get yourself back into that mode once you are out to agree with a choice by her to stop. But you can agree with her stopping everything else for a while - like job hunting etc. It will take some of the stress off her and let her focus her remaining energies on therapy. Once the Christmas hoopla has died down, she may be in a better place mentally to work on some external things.

I love Christmas and I hate it. It can be the best of times and the worst all wrapped up in the same big present. And I am relatively sane  and know what it is doing to me! I know my daughter has a really bad time in October (our Thanksgiving and Dad goes away hunting) gets a little better until the beginning of December and then will hit bottom around mid-December. It happens every year. I don't try and change it - I just come up with coping strategies for ME so I can continue to live around it.

Hope I have made some sense of all of this.

Hang in there Barb - you are doing great girl - we are here for you.

Cagey

[Barb0224]

Cagey,

You definitely hit the nail on the head.  About everything.

A BPD young woman in therapy who is probably ready or nearly so to take the next step. Very scarrrrry.

Yup.

We have just started into the most stressful 45 days of the year. For many reasons, but the top 3 are Thanksgiving, Christimas and the long winter months being cooped up with no money especially due to the first 2.

Yup.

Add to this your daughter's situation - frustration with feeling like she is not being heard at therapy, fear of moving on, no job? no money? etc. How much more could she take before exploding?

So absolutely right.

OK, so keep validating her feelings.  Give her a soft place to be, acceptance.  I can do that. 

But Tuesday is DBT.  Am I just too anxious about that?

I would strongly encourage her to stay in therapy. It's just so hard to get yourself back into that mode once you are out to agree with a choice by her to stop. But you can agree with her stopping everything else for a while - like job hunting etc. It will take some of the stress off her and let her focus her remaining energies on therapy.

The problem is, she hasn't been looking for a job.  She hasn't been doing anything except go to therapy.  And she is having a hard time staying in her apartment in the city, so as soon as therapy is over she comes home and spends 5 days here, 2 days at her place.  The therapist was pushing her about that too.

Thanks for your insight.  And for saving me from doing that rash thing I suggested. :-\

Barb

[Cagey]

But Tuesday is DBT.  Am I just too anxious about that?

Probably. Problem is that we, as "sane" adults, forsee all sorts of problems and disasters that most likely just won't happen anyway. But as Moms we worry about them just the same.

Ask yourself honestly - what's the worst thing that can happen and how would you handle it? Once you have it figured out you can stop worry about it.

One more thing -- to encourage her to stay in therapy I would take a stance along the lines of if you don't go you won't be able to tell this T how you really feel about him/her and how you are not being heard there. You may end up regretting not taking that opportunity later in your life. And what about the next person who goes to this T and doesn't get heard? Perhaps you telling him/her will open their eyes and even if you don't get the help you need from them and need to find another T, the next person might.

It's kinda of a back door to staying in therapy - giving them a reason other than helping themselves to go "one more time".

Cagey

[Barb0224]

Thanks, Cagey.  I will let you know how it goes.

[blondie]

Barb, one thing I would suggest thinking about...each of us, BPD or not, have days/weeks we doubt ourselves, or are just off 'kilter'.
JUst one of those weeks we all feel not up to par, or on edge.

Maybe she had one? On top of all the other stressors she has?
She is being so faithful to her therapy and working so very hard for herself. She has maintained this for a long time now, and doing such a fantastic amount of work on and for herself.

Maybe she just needs a slight rest from the foreward pace, or an extra week to adjust to some new ideas, and find the courage to move foreward again.

Support her, validate her, and let her work out the problem with her therapist.
I would bet she will have a different outlook by the next therapy session, or have thought it through and be ready to talk to her therapist about her fears, as she has been doing so well.

Hang in there and big ((huggers)), Barb
Pat

[Grandad]

Barb:
     I respectfully disagree with Cagey about contacting the therapist, although she is, as usual, insightful about possible ways to encourage your daughter to go back to therapy.  My analysis is that the confidentiality and physician-patient privilege is between your daughter and the therapist.  If you email info to the therapist, there is no breach.  The therapist, if she is as good as my daughter's was, knows where to draw the line and may be able to give you some usefull advice without crossing it.  The goal is keeping your kid in a helpful therapy program, and I wouldn't be too worried about the nicities.  If she doesn't get better, what future does she have?

[JR]

Barb, I'm sorry for the 'hiccup' you're experiencing with your daughter's recent perception of what's going on in her therapy. I can feel your frustration and fear that this is 'it'. I sincerely hope it is not, but I also do not believe the outcome totally rides on how or whether you 'fix' it. Your daughter has come a lonnnng way, with your guidance - and so have you, right along with her progress.

[In fact, it just occured to me that that may be a perspective to share with her - that you both are learning and growing in good ways, and it has a lot to do with her 'doing the work'. You appreciate what she's doing for herself and the positive effect it has on your growth as a parent. (?)]

As for contacting her therapist...

If you email info to the therapist, there is no breach.?  The therapist, if she is as good as my daughter's was, knows where to draw the line and may be able to give you some usefull advice without crossing it.

The potential problem with this is that some therapists consider any outside information as up for grabs -> T may mention anything Barb shares, inadvertently or with intended therapeutic reasons. I'm thinking that could likely not have a good outcome for the *immediate* Big Picture? Yes, the biggest picture is to help Daughter maintain a course toward functioning, but something *she* may consider a breach could just throw that train right off the track. :-\

I'm thinking that role-modeling (maintaining parent/child trust and allowing D her own degree of patient/therapist dynamic) and going by what Daughter is thinking/feeling/saying - being her [savvy] parent (ie: groping along with those boundaries for yourself the coming days) might just be the superlative thing to do, as precarious as it may be. My fourteen cents on that...

-- to encourage her to stay in therapy I would take a stance along the lines of if you don't go you won't be able to tell this T how you really feel about him/her and how you are not being heard there.

It's kinda of a back door to staying in therapy - giving them a reason other than helping themselves to go "one more time".

I think this is brilliant! ...aFter giving your daughter the support/comfort only you can offer her for the weekend, Barb. I wouldn't bring it up, I wouldn't nudge her, I would just let her 'be'. Even if she asked for your opinion, I might agree with her that the way D perceived her therapist's line of thought their last session would shake you up, too, if you were her. Then subtley try to lead her into her own problem solving... "so what does one do when someone pushes them or hurts their feelings?" They tell them to back off! But, Person A can't tell Person B that if A avoids talking to B. She really owes herself the opportunity to say what she feels.

I imagine (with that good ol' 20/20 hindsight from the backseat!) that your daughter felt 'gained-up on' with your mild suggestion that it might be her end that caused the 'rift' between her and T, in addition to the normal pressures mounting with this time of year (which might be another reason for one to resist the natural urge to quit therapy - during the holidaze? a time when virtually eVeryone is mixed up?).

If you haven't already, Barb, when an opportunity arises, I may apologize for suggesting to her that I knew better than D regarding her painting T 'black' (even though none of us would have any idea that would have had the results it did). It was just a thought, not necessarily what *you* think... you love her and respect her feelings and will support her - even if hesitantly because you're her Mom and don't want her to suffer any consequences from decisions made upon a snapshot in what is actually a journey.

Similarly to what Cagey said... Be her mother; she's scared and doesn't have enough tools to comfort herself in order to see a clear way to make those tough choices. You can help soothe her so she feels able to face her challenges.

I hope my rambling thoughts help a little somehow,
~ jr

[PB3]

Hi Barb,

Sending you tons of hugs...  Just based on what I've learned along the way, I would echo Cagey's comment that you do not want to contact the therapist, by phone or even by email.  You don't want to risk the trust and the relationship that you and your daughter have, and if your daughter feels you are not "on her side" (because even if you email the therapist, you risk the therapist telling your daughter that you emailed her) and then she will feel ganged up on and betrayed by you...

I really like Cagey's suggestion (if she brings it up and asks you about it; otherwise stay silent, as hard as it is...) about why she might want to go back.   

The hardest thing to do, but the thing that is suggested time and time again by my therapist, is to just be a mom, giving love and support and a safe place to be..and not to be a fixer, a therapist, or a suggestion-giver.  Our daughters need to learn that they have the ability to be strong and to take care of things by themselves...and if they get the sense from us that we are worried or doubt that they can do that, then we are just adding to their misery.

I understand completely why you are so worried--I have felt the same way when my daughter threatened not to go to her therapist or her group--but here is where the letting go piece can come in handy.  Read it and reread it!

Sometimes I got the feeling with my daughter that when she stated that she wasn't going to go back to therapy, she was testing me to see if I'd flip out.
I just tried to stay calm and act nonchalant, even though my insides were in knots...

I'll be thinking of you, Barb.  Hope you had a good Thanksgiving in spite of all the uncertainties!

PB

[Grandad]

Barb:
     Having been outvoted on contacting the therapist made me think about the slippery slope we occassionally encounter in our desperation to help our kids.  I felt your concern about losing the contact with a DBT therapist and wondering if there will be another opportunity to even work toward a more functioning life.  You know the status quo will take her nowhere.  The therapist represents hope. 
     My wish for you is that you hang onto hope in some form.

[meryl]

well, grandad- I for one agreed with you regarding what the potential harm could be in contacting the therp. Barb can talk to her about her issues and if the therp is any good and feels it is a conflict of interest let's hope she has the ability to say so!

It would be for myself if I was Barb- not to do some damage to my child.

I think many times we fall into the paralysis by analysis. So what if you make a mistake Barb- surely your daughter can understand we ALL do that?

And I know that they do tend to take them personally- after all, the world really is all about them.

You can have needs too, you know. If I felt the need to get something off my chest to my child's or husband's therp I would do so. Let the 'professionals' worry about how to separate your info from their experience of your daugter.

As for the comment you made to your daugher Barb which caused her to blow like a cannon- well, you hit the nail on the head.

As I say to my bph- life sucks doesn't it? One thing is for sure- when you get it right, and they soooo hate being found out- they blow.

Don't doubt your observation or intuition- learning how to deal with people who have serious issues with reality is incredibly challenging!

Wishing you peace!

Meryl

[mllepuma]

Barb,

If I were in your shoes, I would be shaken up if my kid decided he didn't want to go to DBT therapy any more.  Both of us have seen how it has benefitted our kids.

Sometimes when you feel that you have to DO something, the best thing to do is hang back and do nothing, for awhile anyhow.  Your girl has been through quite a lot lately, but I believe time is on your side.  Let the crisis subside for awhile before doing anything.  She loves you and you have been a safe person for her to be with.  I'm willing to bet she KNOWS that deep down inside.

Jo

[Barb0224]

I want to thank all of you for your input, especially regarding the discussion of whether or not to contact my daughter's therapist.?  You have helped me to sort this out by discussing the pros and cons and all of the ramifications.

I am thinking and absorbing your thoughts.?  All of them.?  You are so wonderful (as always) to help me think through this.

This comment from PB, the same thing most of you were saying in one way or another, seemed to fit where my daughter is at:

The hardest thing to do, but the thing that is suggested time and time again by my therapist, is to just be a mom, giving love and support and a safe place to be..and not to be a fixer, a therapist, or a suggestion-giver. Our daughters need to learn that they have the ability to be strong and to take care of things by themselves...and if they get the sense from us that we are worried or doubt that they can do that, then we are just adding to their misery.

I think daughter is trying hard right now to take charge of her own life, and if I do anything to try to circumvent her own decisions, then I am saying to her that I doubt her ability to solve her own problems, and that does add to her misery.

I'm thinking that role-modeling (maintaining parent/child trust and allowing D her own degree of patient/therapist dynamic) and going by what Daughter is thinking/feeling/saying . . . might just be the superlative thing to do. . .

I think this, too, feels right.?  In looking back, I now realize that one of the problems with what I said to daughter was that I was not only invalidating, but I was talking about something she was doing (painting her therapist black).?  I was doing fine in the conversation when I stuck to validating her feelings. As a supportive mom, I think I need to keep doing that and leave the analysis of what she is doing to the professional.

We haven't talked about her statement that she is not going back to DBT since that last conversation.?  It has been a busy weekend and I haven't been home much.?  That's probably a good thing, because it has given daughter time to think (she's still reading Get Me Out of Here I noticed); it has also given me time to think and to ponder all of your suggestions.

She is talking to me.?  She's not mad any more. When the opportunity arises, I think I will tell her that I have been thinking about our conversation and that I now realize I too had been invalidating and apologize to her for adding to her misery.?  

I will try to reinforce that I see how hard she is trying and that I know that she is a very willing participant in her journey to wellness. . . and that I can see that that was the suggestion by both her therapist and me that hurt the most.

Do you think that is a good way to approach this?

((Hugs to all of you for your caring words))

Barb

[JR]

hey, Barb -

I hope I didn't come across too harsh or too 'know-it-all', 'cause you know I don't have the footing to be that (maybe the chutzpah, but not the footing :)... I am sifting your situation through my own filter, dear lady.

I think it's a huge positive sign that your daughter is still reading Rachel Reiland's story. From what I got from the book, the author relays a whole bunch of her own ups n' downs with her therapist throughout her story of recovery, and yet attributes much of her success to her therapist's adamancy and diligence.

I like the way you've sussed out a sound choice of words and path for talking with your daughter...

I will try to reinforce that I see how hard she is trying and that I know that she is a very willing participant in her journey to wellness. . . and that I can see that that was the suggestion by both her therapist and me that hurt the most.

Just please don't dwell too much over an apology. Your attention to what's going on with your daughter comes from love, and she knows this deep down. Acknowledging and reinforcing sounds like a great pivoting spot.

with caring thoughts,
~ jr