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I thought it might be best to start a new thread since my post about getting triggered by uBPDxw morphed into a focus on D11's subsequent eating disorder.  uBPDxw is now heavily trying to insert herself into the situation, so I will definitely be in need of support for how to deal with her as we navigate all of this.  Some updates on that front...

I had sent an update to uBPDxw on Friday regarding latest status at that point, asking if she supported possibly looking into an IOP.  She responded with confirmation that she "enthusiastically endorsed" that option, if not inpatient care.  I sent another update on Tuesday of this week about the weekend having not gone well, D11's weight being down a couple more pounds, and the dietitian was now recommending D11 for medical assessment and probable inpatient care.  I asked if she agreed to work with a particular facility in the area that provides the increased level of care, and she responded with agreement, adding "ASAP."  I followed up a bit later saying I had left a message there, and also updated that D11's T told me she had been in contact with the facility as well and she would be passing along some forms when she received them.

This all seems to have triggered uBPDxw in a big way.  She sent me several follow-up messages, though at least she kept them in the OFW portal.  The first two were focused on demanding that I not tell D11 about possible hospitalization, that I not tell S7 anything, that I confirm D11 is under 24 hour supervision, who is watching S7 through all of this, etc.  When I kept my responses brief and didn't get drawn into that idiocy, she sent a separate message in a totally different tone asking that I PLEASE let her know if she can help, maybe by keeping S7 beyond her custodial time.  When I politely rebuffed that offer with a "Thank you for the offer to help.  I'll be sure to let you know if there is anything," she went back to badgering.

In the meantime, she was in communication with the PC, who sent a message late Tuesday afternoon reminding "us" that both parents must be fully included in communication with providers and all decision-making about D11's care.  uBPDxw had made it sound like I was moving forward with things without her approval, and complaining that I wasn't keeping her in the loop "in real time."  There was a clear expectation that she be copied or conferenced in on every conversation with every provider.  I could not help but respond to the PC that he had issued a directive to us on 4/15 that we not communicate directly unless it is an emergency involving a 911 provider, and that we contain communications to OFW.  I stressed that I had been sending uBPDxw updates through OFW every few days (when it was basic progress updates--I'm not f-ing going to send her daily reports).  I also stressed that she has always had full access to reach out to providers directly, and all I did was initiate preliminary intake paperwork at the facility uBPDxw agreed to work with.

The way the PC had worded it--and the way uBPDxw has been pushing since then--it's like I was expected to have uBPDxw on a conference call with me while providing the intake coordinator demographic information, behavioral observations (already shared with uBPDxw via my updates), etc.  So I have responded that I will do this moving forward, ensuring that uBPDxw will hear what I have to say in detail and have her opportunity to respond.  I have every reason to believe she will dysregulate bigtime--and frequently.  But maybe that's for the best so that these new providers especially can get a full dose of her behavior.

No matter what I send or through what medium, she will not ever be satisfied.  There will always be something that she will criticize, whether it is related to the frequency, immediacy, level of detail, actions taken, tone used, or efforts to collaborate.  Live conversations will be hell on me for sure, and will very likely destabilize the family dynamic that the family T has been working to keep steady.  But OK.  Here we go.

As far as D11 goes, she has actually improved a little on eating this week.  She refused breakfast just before we met with the dietitian on Tuesday.  But following that appointment, which included the dietitian's recommendation for a medical assessment and discussion about possible hospitalization, D11 seemed more willing to work with me on meals.  The dietitian let her provide guided input on what the meal plan for this week would look like, which involves smaller portions since she has been eating so little for so long.  D11 ate a snack, lunch, and the recommended dinner on Tuesday.  She still refuses breakfast each day, but yesterday she again ate snack, lunch, and dinner (even expanding a little on what the dietitian had recommended that time).  Today has been a little low on intake, but I'm still hopeful about dinner.  It will probably not be enough to get her out of inpatient care at this point, but at least she's getting something in her system.


We're set to work on this some during session with D11's T tomorrow.  I definitely want to keep up the momentum and make sure it's being set up and implemented as positive reinforcement.


Thank you for providing this, LnL!  I look forward to reading more about this specific link between the ED and trauma.  I really do think there is some trauma that D11 is dealing with, but her T hasn't quite been able to get there with her.


Yes, I can very much see this in D11...the convergence of years of issues with uBPDxw being compounded by the social isolation of quarantine and watching my mom get so sick so quickly has definitely prompted a cry for help, a plea to feel safer.  I'm all in on that, and doing everything I can.  I just worry that hospitalization will bring its own trauma, but I know those teams are trained and experienced in dealing with that too.

The medical assessment is complete, and now we're basically waiting to discuss treatment options once all of the information can be reviewed by the medical director at the ED facility.  I'm guessing that might take a few days, so my focus is on getting at least some calories into D11 as regularly as possible.

I really want to figure out how to move forward with sole legal custody of D11, too.  I still have an active custody motion out there, and we have been following a temporary custody order that we agreed to back in December.  That temporary order involves Sunday visitations with uBPDxw, which were put on hold for May due to the stress it was putting D11 through.  I'm concerned about her having to endure any time with uBPDxw with this going on...

mw

I think you are doing an excellent job of looking out for D11.  I can't even imagine how hard all of this is for you, but I am impressed by how well you are doing at keeping it together.

I would not want to have ex involved in a call with the providers either, but I think you're right that it might be good for them to see what D11 has been dealing with.  She has a parent with irrational expectations, a complete inability to self-regulate, and a habit of blaming everyone else.  Minimizing the effect of that on D11 is going to have to be a part of all of this.

I hope that you are able to practice self-care, even if it is just in a tiny way each day. 

mama-wolf,

I will be following... my Partner's D19 has been diagnosed with PTSD and is also demonstrating issues around food.  I'm not very involved with what is going on it's more between my partner, D19 and sometimes sister D23. 

There seems to be more going on than straight anorexia it seems to be sometimes combined with binging too but not full on bulemia...she's not sweeping through the kitchen and wiping us out of food for example.

D19 actually just did her intake this morning for an outpatient eating disorder program, she went for blood work earlier in the week and she is to have a physical.

There is also a 5 day Trauma Program that we are looking at too (short I know but that doesn't mean it can't be helpful).  To me (the total unprofessional) the trauma is at the root of all that is going on with her.

Lnl - my partner and I will also be reading your attached article.

History of D19's issues...

     -Was molested by another child as a child. (Initial Trauma)
     -uBPD mother (Ongoing Truama)
     -Parents Separation at 10 (divorce was high conflict for 2 years)
     -uBPDmother has primary custody for 2 years of separation/custody
     -In Therapy with her sister - with an ineffective therapist - mom actually crashed
      sessons
     -Parental Alienation (by mother towards father)
     -3 Evictions of mother (2 when she had primary custody of daughters)
     -Divorce Final dad gains primary custody - mom has 3 weekends a month
     -Suicidal Talk at School/Inpt Psych at 13
     -Through the inpatient visit gains a good Therapist who she worked with until just a
       few months ago (she is leaving her practice to become a mom)
     -Psychiatrist added to the team/medication prescribed
     -at 15 voted with her feet to live with dad full-time and is low contact with mom
     -Another Suicide threat/another inpatient stay at 17
     -Medications adjusted
     -at 18 we move in together and blend families (doing therapy visits virtually)
     -at 19 goes to college
     -at 19 loses therapist - dad gave her some names of new people asked to set up
      appointments - she never did
     -at 19 date raped (more trauma)
     -at 19 covid-19/school closes/virtual school from home
     -at 19 suicidal thoughts dad took to the ER no inpatient available but did give
      resource information thus the programs mentioned above.

She has a history of cutting and issues with food - not sure how long either have been going on - she suffers from depression too and has sleep issues - up all night/sleeps most of the day.

It is incredibly sad for me to look at this list.  She is so much more...vivacious, funny, smart, creative, social, loving, caring...

Dad is struggling, finding all of this overwhelming and I don't blame him I do too.  She is very emotionally needy and draining...lots of anxiety and drama.  Her overwhelming emotions and impulsive behaviors have led her into some not good situations.

My role in all of this? Not much even though I live here I am on the outside looking in. I support dad, try to just have a "normal" relationship with D19.  (hard to do when she mostly only comes out of her room when I'm sleeping)

I'll continue to share what is going on here and keep in touch with your story.

Panda39

Really good to hear back from you -- I know you're busy.



Tricky stuff. Couple of thoughts. I think I'm with WSM
I'd guess that the IOP facility has some kind of "intake coordinator" or other "juggler" type position. Basically someone to coordinate a bunch of other people, given that multiple providers for D11 will be involved, at minimum within the facility. I wonder if you can leverage that in order to "meet the requirements" of communicating to xW... maybe not right at first (and that's where I see you just having to suck it up for a bit), but as soon as D11 is a client, maybe talk to that person, say something like "we have a complicated family situation and already have a lot of providers involved. Whom can I deputize here to coordinate communication?" This could be a win for you not having to be The One to update xW; plus, it's one less thing you have to do. Someone else can be "incident commander" so you can focus on being Mom.

Plus, it'd put xW in a double bind -- is what she REALLY wants information? Then, hearing it "straight from the coordinator" should be good enough... right? Or... is it the engagement with YOU that she wants?

Another thought -- so, somehow it is going to happen that xW will be conferenced in on the calls (or something), right? Any reason not to also get either the PC, or the T's, or both, on the line too? Again, lots of providers, everyone needs to be on the same page... why not have more eyes/ears on the call? The plus could be that if xW knows they're there, she might behave better. That could also be a minus, depending on the goal.

Either way, I'd encourage you to reach out to the IOP facility as soon as it's possible and get their help in coordinating communication. I would suspect they have lots of experience working with families where there are already some "communication rules" like OFW/no text/etc.

Plus, maybe if the PC hears from the facility "our coordinator will manage communication to the parents", that'll take some stress off of you.

...


Might be a weird sort of "extinction burst" where now that she sees how serious things are getting, she's making one last effort to keep her freedom. Whatever's going on
Both true. She needs inpatient, and getting any nutrition in her, for any reason, is always a plus.


Good call on framing it more as "earn a reward" for eating vs "consequence" for not eating.


D11 might feel relieved, too -- though she probably won't tell you that.


Fingers crossed. Really proud of you for doing this for her. I can't imagine how scary it is from a parent's perspective.


Understandable -- especially because post-discharge, compliance with the treatment plan is so essential and the parent/adult in charge typically takes full responsibility for all food stuff when the patient is underage.

...

I'm envisioning a couple or a few weeks, maybe less, of you lifting a LOT of heavy weight in terms of coordinating communication between providers. My hope for you is that you can lean heavily on the IOP facility staff and deputize a provider there as the "communication coordinator". Or, as the pieces shuffle around, perhaps an existing provider can step up and be deputized as the "comm coordinator". I don't see it as an unreasonable position that you're Mom and it's your job to care for D11 and work on your relationship with her... not to spend your time and energy helping professionals call each other.

I'm also envisioning a couple of weeks where xW is pretty involved as a voice on the phone in these conversations -- perhaps in person, if things go that direction. It might be a few weeks where it is hell to have to interact with her. I hope that it will be an enlightening experience for the IOP team so that they can understand the family structure (I suspect family T of some kind will happen at the IOP, though I could be wrong) and make recommendations and guidelines based on what's best for D11 in her recovery -- hopefully aligning with the current PP of severely limited time for D11 with xW.

This won't be their first rodeo, so if they get any kind of sense that one parent will enforce the treatment plan and one can't or won't or "D11 is old enough to manage it herself" or whatever, they'll know.

...

Still here for you! And like WSM said, self-care. Can you watch a movie with the kids this week? Have a nice beer sometime?

kells76

Well, it didn't take a few days.  The medical director had their intake coordinator call because they want to admit D11 tomorrow morning at 8:30am.  I conferenced uBPDxw in on the conversation so that she could confirm agreement.  So we are headed into at least a few days of inpatient care, which will then transition to residential care (which is essentially the same, just without daily monitoring by a doctor).

They said this will be about a 3.5 hour process where we will meet the entire treatment team, and uBPDxw plans to be there (I'm not surprised).  It is really going to suck, but again I intend to be very clear about what I think is the foundation of the problem.  It's only the recent changes (pandemic and my mom's illness) that have pushed D11 over the edge, but the struggle has been there for a long time before that.


I will definitely request that they take it on themselves to manage coordinating communication with both of us parents.  I don't want to be the go-between any more than I have to be.


Yes, one more thing I plan to make very clear is my experience with uBPDxw not being able to follow though on commitments, maintain a structure, do effective planning, etc.  She simply cannot handle this in a consistent way to meet what D11 is going to need--not to mention that it would take a fundamental change in her personality to address the foundational problems.


I am really, really hoping they will be able to see through uBPDxw's attempts to mask, dismiss, and otherwise reshape facts to suit her.  I want to collect so much information, notes, etc. but really don't think there's enough time for me to do that without missing out on a lot of sleep tonight.  And I figure being rested is going to be an important part of keeping myself calm and able to handle her crap.


S7 is with uBPDxw's parents until after the admissions process tomorrow, but we'll try to do something fun together.  I will definitely be having a beer.

mw

They understand the urgency and the level at which D11 is struggling. If they don't even want to wait 24 hours, then I think they see the seriousness.


It could be more, just so you're prepared.


Right. For me as well, there was definitely one very large-scale stressful "trigger" event (that had nothing to do with food), but that was only "blowing the lid off" of a bunch of stuff that was already there.


Good job! Makes tons of sense.


Also makes sense. Remember that "how" you do the intake interview (or any other "meet the professionals" sort of thing) is just as important as "what you tell them". So, be the focused, calm, detail-oriented MW that you are in the intake. I'm sure xW can "take care of herself" and show them who she is in 3.5 hours... you just be you when it's everyone together. That'll give you some time to get sleep tonight and then later, I'm sure there will be 1x1 meetings with just you and staff members. Might be a better time to share more of the gory details.


Good for you. Make it a nice microbrew. Let me know if you need anything.

Hey, how are you doing? No rush to reply - just thinking of you guys.

I didn't think it could get worse, but it did.

The admission process at the eating disorder facility actually went about as I expected.  uBPDxw pulled out all the stops, making sure she shared the same supposedly essential examples of how D11 has always clearly had something fundamentally wrong with her. 

uBPDxw especially likes to tell the story about how, when she took D11 for her two-year-old check-up and they pricked her finger, then-D2 became like an animal with rage, tearing the band-aid off her finger with her teeth (which got blood "everywhere"), crying and screaming, totally inconsolable for several minutes.  And each time, I have to speak up and remind her that we spoke with a therapist back then who explained that it was a normal reaction for some kids that age who just need a chance to get the emotion out and "reboot," at which point we should just be there as a calm presence waiting to comfort them.  uBPDxw doesn't exude calm and patience, so I have no doubt that then-D2 did not feel comforted.

And whenever I give specific, factual examples of uBPDxw's unacceptable behavior over the past few years (throwing things, yelling and cursing at the kids, shoving furniture, driving erratically and unsafely, etc.) her response is that D11 knows exactly what to say to me to get me to react, implying she has lied and manipulated the story.  And I have to speak up and point out that I either have specific proof of the behavior, and/or S7 has also shared the same information with me independently.

uBPDxw also has a diagnosis of adult ADHD, and her impulsivity is off the charts.  So she cannot shut up, stay concise, stick to the point, etc.  So the process they told us should be 3-3.5 hours ended up being 4 hours, but I got through it, was able to hug D11 goodbye, and start this part of the journey--or so I thought.

About two hours after we left the facility, they called and said that D11's resting heart rate was too low (down to 42bpm).  When they were checking her in, it was at about 60bpm, but they said that was probably the anxiety of being there, and now that she had started to settle in a bit it went back down to a dangerous level--and was certain to drop further overnight while she was sleeping.  They had to refer her to the children's hospital for monitoring and stabilization, because they didn't have the telemetry there to keep a constant eye on her heart rate or an onsite lab facility to monitor her blood levels on an essentially real-time basis.

So I went back to pick D11 up and take her straight to the children's hospital, where I have been camped out with her since Friday evening.  The good news is that her electrolytes and other levels, heart rate, and EKG have all been doing  well.  The bad news is that it was 3.5 days of absolute hell, battling through each meal--and between meals--watching her scream and wail and panic over so many things.  From the IV and frequent blood draws to the meals they brought...she has been all over the spectrum of anger, despair, fear, and desperation.  She has asked me to leave her room, and has begged me to come back, clinging to me when I did.  She repeats the same questions and makes the same arguments over and over, trying to get different answers so that she can go home and continue with the same eating behaviors as before.

The hospital has an eating disorder protocol that they started upon our arrival, and D11 has been in an absolute tailspin over them feeding her "too many calories," getting her "fat," etc.  It has been a major struggle, but she did get a little more compliant about actually eating...she just loses it in the hour or two afterwards as she realizes the food is in her to stay.  She usually starts retching at that point, hoping and convinced she needs to throw up, but knowing they won't let her in the bathroom to do so.  She came close to having to get a feeding tube put in, but we managed to avoid that so far.

We are discharging this morning in an hour or so, and I take her directly back to the residential program.  I think it's going to be extra hard on her this time since she was there for a couple hours already.  She definitely has a sense at this point that she will be there for a while until she can get better.  She really struggles being away from home.  At least here at the hospital, she had me with her...

I'll try to check in again later and let you know how it went.

mw

Ugh. "At least" it shows the facility staff who she is.


That's good.


That's also good.


That may be her "currency" at the moment -- have the privilege of NOT having an NGT by complying with the meal plan.


Poor kiddo. And you both are going through so much. I hope it could be helpful to get really specific info from the facility about communication and visits. Maybe having calls/skype/visits clearly scheduled could give her something to hang on to. And yeah, she is probably going to be there longer than she thinks. I do remember that about both my stints in treatment -- a "light" delusion that "I'd be done in a few days or a week".

...

All the "hell" sounds normal... not that that's helpful. I think that's all I can say -- this is all normal, you're not doing anything wrong, you're doing everything right, and it's hell. And, one day, your daughter will be grateful and will look back on this and be thankful for what she has learned.

This may be unrelated, but a few years before my son was born and before my marriage flamed out, we tried to help a single friend in the congregation.  We had to drive her to a local hospital one night, unknown to anybody she had been cutting herself periodically and this time she had cut her leg too deep.  The best she could explain was that she felt better cutting herself because she decided when to cut herself and when to stop her pain.  In her case it was that she could control when the pain or cutting ended.  I knew there were FOO issues but never had details.

There might be some similarity with ED?  Surely it's more than just being able to control her life through her eating, but reading your story reminded me of her mental distress.

FD, yes, I think there is some similarity in what you described.  Ultimately, an ED (and from what I understand even cutting behavior) is related to control.  For an ED, it's about controlling what goes into--and sometimes what comes out of--your body.

Transferring D11 to the residential program on Tuesday went OK.  She was very anxious about going, but compliant.  When we got there they had to prick her finger to check her blood sugar, and that really set her off...she was pretty inconsolable for several minutes and the intake team got a full dose of it.  Afterward, I had an opportunity to update them about the constant battle over meals from the weekend, my observations about how she did with being on Ativan at the hospital, etc.  At least this time uBPDxw wasn't able to be there, so it was less stressful on that front.

It was an odd week for me after that, no longer being directly and constantly engaged in D11's care.  Since they are not doing in-person visitation, she calls via Skype once a day, and by phone at another time during the day.  I have been making sure to catch her calls when she makes them, especially since she has absolutely no interest in calling uBPDxw.  Her mood has gradually improved during the week.  The first couple of calls were very tearful, but the rest were calm--even though she still talked about what she didn't like about being there.

They do have her on a different medication now.  I forget the name, but it's a low dose of something that's more effective at helping with the anxiety and especially the thought patterns associated with the ED...better than the Ativan for sure as far as I can tell.  They talked about needing this to help her brain chemistry while she's still so underweight, and that once she's closer to expected body weight her brain will be better able to do the psychological work necessary in therapy to really battle this.

I even got to have dinner with her on Saturday evening.  I knew they do family meals, but didn't realize they would do one so early with her.  She chose the meal (breakfast for dinner), and it was prepped for us to cook when I arrived.  She did really well before and during the meal...but 5-10 minutes after we finished eating she started fixating on the thoughts about how much they're feeding her, how "fat" she thinks she is, etc. and I couldn't get her mind redirected.

Otherwise this weekend I have done my best to exercise some self care per my T's instructions.  My son has been with uBPDxw, and with D11 where she is and my mom at the hospital for her next round in-patient chemo, I haven't had to take care of anyone but me.  I even boarded my dog for a couple days so that I didn't have to worry about what time I got up in the morning.  Now it's almost bedtime, and then we'll have to see what Monday brings...

mw

Really good to hear from you!  :hug:

Kids just got picked up and I have to go to bed early, so more tomorrow.

What's it like to have nobody to care for except you?

Warmly,

kells76

That seems expected. That's good that she's compliant. I think underneath all the fighting and digging in, she really does want help.


Like, "really" not able to be there? Or, she could have been there, chose not to, but describes it as "just not able to be there"? I mean... a relief for you, either way.


That'll mean a lot to her. I remember calling my mom and venting like crazy at the start of round 2 of treatment. That is one of the first times I remember her just listening, and not trying to tell me it'd be OK, or fix it, or whatever. Not that she would do that a lot, but it's more that it was meaningful to me and made an impression that she just listened to how I felt.


That's good. Does she talk about making friends there at all? That might come later, after the venting. Great opportunity for you to validate  *)


Yes, makes sense. As she stabilizes long term, she won't have to be on the meds forever. Crutches, not wheelchair. I've been med free for years and doing fine via skills/tools, so it makes sense that she'll get extra support now but different (self) support down the road.


Are you able to talk with the tx team about their strategies when she does this?


 |iiii good job on the self care.

Still here for y'all;

kells76

I'm so glad you are getting time for yourself.  You need to be able to recharge for later.

You are doing a good job taking care of your kids.

Weird and empty...and I keep waiting for "what's going to go wrong next?" which my T has been expecting and trying to help me with as well.  She says I've been going through an ongoing traumatic experience these last couple of months, between all the emergencies with my mom and D11 (and it's likely to continue for a while).  Really bugs me to be back in the throes of trauma since I feel like it's getting in the way of any progress we might have been making otherwise therapeutically.  Like I should just be able to handle this kind of stuff already, not be so affected, be able to keep progressing with my other work.  I know that's not how it works...but it's still frustrating.


Well, her excuse was that she had S7 with her, so I am guessing she did not feel willing or able to again ask her parents to keep him while she came out to the hospital for the second intake appointment.  Or just not up for sitting across the table from me again as I updated the team, knowing she couldn't have been there or helped with any of it even if there hadn't been the restrictions due to COVID-19.  She would have been so triggering for D11 at that point anyway, so I'm glad she wasn't there for D11's sake regardless of how stressful it would have been for me.


She doesn't really talk about friends much yet.  I have tried asking her a little about other kids there, but she doesn't say much.  I do think that's going to take a little time.  She bounces back and forth between her roommate being mean and bossy and being nice, but I think at the base of it she likes her well enough.  I can tell she's also learning more about how to be part of a community and interact with others on that level.  She's learning to speak up--in an appropriate way--when others upset her, and to also receive that same feedback.  She didn't much like it when another girl said D11 triggers her sometimes (probably because she's so new to the program and still openly talking about the food and calories sometimes).  So we have talked about that a little, too.


Yes, I will be discussing it with the therapist this afternoon.  And they have provided support materials to me, which I honestly haven't made it through yet, so I need to do more of my homework.  I also bought a couple of books that were highly recommended by the therapist, so I know I'll get there...


Thank you worriedStepmom...never feels like enough to me, so it helps to hear the encouragement.

mw

It's gonna be maintenance for a while and doing a lot of the stuff you've always done to hang in there, most likely  :(

For me, that's when I hold it together best.

The time when I really fell apart was during peace time when things got quiet. I didn't know how to *do* life when there wasn't something on fire. Intellectually, I could recognize that I was experiencing safety but my body responded as though the soldiers had left their posts.

Do you do body scans or anything like that? Dropping back into your body when stress is high, even for a minute or so, can help to reset some of that chronic alert fight/flight stuff that jacks up our nervous systems and creates deep exhaustion.

Yes, that has been my biggest struggle prior to all of the latest crises.  Things would be relatively quiet with uBPDxw, and while my T would encourage me to use the opportunity to catch my breath, I would be on high alert for whatever's coming next.  And something would always come--and has now come in a BIG way--which only reinforces that reaction. 


No, that's not something I'm familiar with, but in my latest session with my T she said she wants me to take frequent, brief breaks during the day to check in with myself on some level.  Get up, move around a little, get some coffee, etc.  And the family T has also suggested that I specifically take cognitive breaks.  Sounds a little crazy, but she said even if it's something as simple as staring at a binder clip and focus on it opening and closing for a few minutes, just to get my brain to stop constantly planning and organizing.

uBPDxw is now also pushing on decisions related to S7's childcare over the summer.  On 5/29 when we thought we were going through D11's initial intake at the ED hospital, she made a comment about S7 starting summer camp at the YMCA in mid-June.  I shouldn't have been, but was pretty surprised at her assumption that he would just start camp given the ongoing pandemic--especially with my mom living with me and going through some really aggressive chemotherapy.  I mentioned I felt we should discuss other options, and then the crisis of the next several days with D11 prevented much follow-up on the topic.

So uBPDxw sent me a message on Wednesday last week, the day after D11 got out of the children's hosptial and went into the ED program, after I had barely slept for days or thought about much of anything else.  She asked to know the plan for S7's daycare starting 6/25.  I'll copy the subsequent exchange below:

mw:

uBPDxw (response sent 3 minutes after my message...talk about impulsive behavior):

mw:

I figured at that point uBPDxw would take this to the PC, which it seems she did, because then I got an email from her with the following (and I am pretty sure she was coached by the PC, plus she is herself an attorney):

The family T weighed in at this point with:

And by this point, I was just done.  I know I am not being very BIFF, but I cannot stand for uBPDxw to keep misrepresenting our interactions, nor for the professions in the case to react without any acknowledgement of uBPDxw's very specific contributions to the problem.  So here is where it stands as of last night:

So again, I know it wasn't the best response, but it was the only one I am capable of right now.  I'm expecting that the PC will be involved, and the family T will have feedback in tomorrow's session.

mw

One thing I sense in the interactions you share with us is the frustration about uBPDxw getting a thousand free passes, whereas you are expected to make no false steps. It must feel crazy making to have professionals involved this deeply in your family and not have someone say, mama-wolf gets to scream for once!

Given what you are going through (even just the recommendation from your T to focus on a binder clip), it's no wonder this additional push from uBPDxw is pushing you close to the ledge.

Seems like the professionals recognize that uBPDxw is the instigator of conflict and because she cannot contain herself, they try (more or less diplomatically) to appeal to your ability to control yourself because you can. They are not taking sides which means they're trying to focus on what's best for S7 without calling out behaviors. That probably works ok for you when uBPDxw is the only stressor but now there are 4 serious life-changing stressors and that expectation on their part isn't working. Plus, I have to imagine that holding in your anger and being lumped together with someone whose behavior is chronically adversarial even in the best of times builds resentment until it can't be contained anymore.

Meanwhile, they seem to believe that you two can still work cooperatively to come up with solutions.

I have to say that wouldn't give me a whole lot of confidence in my team but then again, my ex locked horns with everyone involved in our case. That's when they got it. When he began to treat them the way he treated me.

Until then, they seemed to have a lot of expectations that I would magically make our relationship cooperative.

Do you feel that you can communicate to them directly what you need from them?

Thank you, LnL...I think that is one of the most validating statements ever directed my way and it is much appreciated.  uBPDxw has had so very many opportunities to fail and keep failing, and it still constantly feels like it all ends up on me to make up the difference--both as a co-parent and as a parent.


Exactly...I usually have more capacity for that, but now just isn't the time to expect it from me--and it generally isn't fair to do so anyway.  I'm not supposed to be the only functioning adult here.  I have yet to be given any space to breathe and actually heal from the whole ordeal, and lacking that space means my only option when we interact is to keep it as minimal and business-like as possible.  But uBPDxw constantly pushes against that.


I'm not sure it will do much good to say anything to the PC at this point.  He's doing his job and I accept that.  When my mom first went into the hospital and we learned her cancer is back, I did notify him and the family T.  The family T was kind enough to ask what support I need, and I basically just said I need her help to make sure uBPDxw stays in her lane.  I do believe the family T has been helping with that over the past few weeks, and was frankly surprised at her contribution to this topic yesterday. 

I get that she has to put on a show of encouraging our cooperation, but if any professional who has had any interaction with me and uBPDxw thinks there is a chance in Hell that we can "stay in lockstep" together as co-parents during D11's recovery from ther eating disorder then they do not deserve their professional credentials.  My active custody motion is going to end up going to court because at this point, we'd be risking her life to send her back to uBPDxw.  The big question becomes how best to handle S7 in the mix.  I support him going there some, but not 50% of the time for various reasons.  Chief among them, and in spite of specific instructions to the contrary from the family T, he still sleeps in uBPDxw's bed when he's over there because she can't get him to sleep in his room!

mw

Looking back on the two emails -- the one from ex and the follow-up one from family T, and the response it generated from you ... what seems to get kicked to the side by them is a revisit of your earlier statement that you need time. Then you got swept forward in the current or urgency and your needs were subverted again.

I think this might be the root of what's happening, at least here in this example. You are expressing what you need (time), which is kind of a place saver for the decompression you need in the midst of this sh!t storm you're going through.

I guess the question is whether the professionals can help you give yourself time when you need it? Maybe at least giving them a heads up that you will be doing this (taking additional time) going forward?

They seemed to get swept up in ex's urgency and were focusing on how to help ex write an email, followed by family T's comments that kind of seemed autopilot-ish. Maybe in part because s/he gauged that you were doing ok based on your earlier reply that you were handling things and just needed help with ex.

When you responded with options and plans and ideas for S7's care, it's almost like you were being pressured to ignore what you indicated you needed, at least to ex, which was a minute to catch your breath.

Her townhouse is closing down and she has to move? That probably seems urgent and dramatic to someone who can't regulate emotions. And there is some urgency in getting child care, always. But not compared to everything else you're coping with. Someone has to make sure this piece of self-care is not lost on others and I think it's gotta be you  *)

I'm wondering if it's worth writing an email to the family T and PC saying, essentially, "I'm under tremendous pressure to keep the balls in the air right now, and I hope you would agree that D11 being treated for an ED, mother receiving aggressive chemo, the stressors of the pandemic, meanwhile working and figuring out safe care for S7 adds up to a lot, and it would for anyone. Even so, taking a step back, given all that's going on, I'm handling things remarkably well and important positive things are happening. However,  I need _______ from you right now so that I can summon the patience necessary to make good decisions with ex. I'm not asking for _______, I'm asking for (time? empathy? permission? forgiveness?) when these matters come up with ex. If I do not respond to ex's requests immediately, please know that it's because not responding is better than caving to a demand that can actually wait, at least under the circumstances I'm dealing with right now."

I don't know if this last scuffle amounts to anything but I think there was a missed opportunity for them to recognize the tremendous strain you're experiencing right now. A lot of us here tend to have wide shoulders that can carry a lot of weight and people often don't realize how tired we get. So we have to tell them and make sure they hear it once, twice, three times.

You may not need to cash in your request for extra time but by telling them in advance, you pre-empt things with some important self-care.

One of my good friends had a nasty custody battle with an NPDex.  She often called me in tears because she'd get messages from the professionals involved similar to the one you got. She felt like she had to be perfect, that she was called out for tiny things, and he got away with all kinds of behaviors that hurt the kids and caused her extreme stress.

(They didn't have a parenting coordinator - those aren't common here - but did have therapists involved.) When it came to court, the testimony was solidly in my friend's favor.  They gave her a hard time to
a) prove they weren't biased, which was her ex's favorite accusation when things didn't go his way
b) show that she handled receiving feedback well and attempted to course correct, unlike her ex
c) help her be a near-perfect coparent, to limit the risk the judge might believe ex's accusations against her

The professionals were doing their best to help her win her custody case, but it was really, really hard for her in the lead up to all of that.  Really hard. 

I tell you this long story for encouragement.  It's okay for you to feel overwhelmed right now.  It's okay for you to rage a little at how unfair it is that you have to be perfect.

It's also okay to let them know, calmly, what you need, as LNL suggested.  It would have been okay to respond with something like, "My goal is successful coparenting.  As I said to ex on Y date/time, I'll have a plan ready by Friday.  At the moment, I'm still trying to deal with the aftermath of D11's inpatient admission, and I need a little time to think through our needs over the near future."

You don't have to jump immediately - it's okay to set boundaries, even with the professionals.

(It's also okay to call your best friend and just cry on the phone.  That's what they are there for.)

Solid advice...yes, thank you.  I need to pause and make sure I'm communicating specifically what I need (or was being denied in the first place).

It's kinda funny that when I spoke with the family T during our session this past Thursday, this whole exchange didn't even come up.  Admittedly, she was very highly focused on some terrible behavior she witnessed from S7 towards uBPDxw during their part of the session (her telehealth platform lets her connect with either of us separately, or conference us all in, but she has been keeping us separate for now).  The behavior she described from S7 was absolutely terrible, and uBPDxw just wasn't able to get him to listen, contain himself, respect her, etc.  I was kinda floored by this, because he simply does not act this way with me.  I have seen him almost react to me in a similar way, but it never escalates, and I have seen uBPDxw have some difficulty with him...but nothing on the order of what was described by the family T.  Really not sure what to do about that other than continue to document that she's struggling as a parent...for that inevitable day when we end up in court to settle my custody motion.  However, at the next custody exchange I did make a point to tell S7 in front of uBPDxw that I heard he was behaving very badly for her, said it was not OK, and asked him to apologize to her.  He did so halfheartedly, but he did it.

As far as the exchange with uBPDxw over childcare, when I had asked at the end of session whether the family T had any other feedback for me, she said she didn't.  She acknowledged everything I'm dealing with, and said I'm doing great.  Specifically used the word great, which felt odd, but OK.


Yes worriedStepmom, this sounds extremely familiar.


Thank you for this.  I do sense this goal from the professionals involved in my case...but as you said it doesn't make it any easier to go through.


That's definitely falling to my sister at this point, but also some other close friends.  I'm trying to lean on my support network as much as possible, as my T suggests, but it's just not something I'm very good at.  Practice, practice, practice...

mw

I wanted to share an update that D11 is definitely improving after being in the residential treatment program for just over two weeks. 

The T and dietitian had a serious talk with D11 late last week about her still only taking in about 75% of what she was supposed to be getting under her meal plan.  The T described it as "a pretty straight-shooting session," and by the time I talked to the T this past Tuesday she said D11 really turned it around after that!  D11 even called yesterday sounding very proud of herself that she had moved up a level on the meal plans (meaning she can now plate her own snacks).  They start out not being able to plate any of their own food, and gradually step up until they are plating all except dinner.  She is already looking ahead to getting to the next level where she can plate her breakfast.

Definitely a little relief for me.

My T has been out of the office for a few days caring for her daughter, but made the time on Monday to send me an update on having had a chance to catch up with the family T.  She shared that the family T told her there are no concerns about me "whatsoever," and that I am correct that uBPDxw is trying to spin things against me, but that the family T says she has "displayed a gross level of insensitivity toward mw during the last month that needs to be addressed" and it's hard to take info she sends at face value.

So even a little more relief.

However, the saga continued this week over arranging summer childcare for S7.  In spite of encouragement from the family T to use the opportunity to work together, uBPDxw left all efforts to identify candidates, interview them, etc. to me.  She barely responded to any of my messages about status or feedback, and finally got back to me this past Monday with agreement to hire the one I identified as the best fit.  She also completely ignored any of my prior statements about how I would reimburse her a daily amount to put towards care in her home, and I know it was because she was waiting until we had someone lined up so that she could send me this gem on Tuesday:


As far as I'm concerned--and the reason I agreed to this term in the consent order--track out care is a track out camp, which is what our kids have always been signed up for with the YMCA.  Track out care is not an option right now because of the pandemic, just as sending the kids to school hasn't been an option for months because of the pandemic.  The local Y is actually running their summer program, but I have already pointed out to uBPDxw that many programs aren't running because of the pandemic risk and I don't feel comfortable sending S7 to one.  It is entirely her option to escalate to the PC if she feels strongly about putting him in track out care--which I highly doubt he would agree to do.  Failing that, then we would each be responsible for childcare in our homes, again just as we have been through the end of the school year.

uBPDxw knows one-on-one in-home care is far more expensive than covering a track out camp would ever be.  I'm pretty sure she decided that since I'm the one expressing reservations about sending S7 to camp, and based on the language in the custody order, it means I'm entirely responsible for any other alternative form of care.  I can see her perspective--especially given the deep-rooted resentment over our financial situations that she has held onto since we separated--but I just don't agree.  I do think she was waiting for me to have things lined up (for which she is planning on more hours of coverage per day than I am) and then slap me with the full financial responsibility.

My biggest concern is actually how loosely she wants to interpret the language of the order.  If she sets a precedent now of me paying in full for any alternative form of care, then what stops her from having me pay for in-home care after school rather than an after-school camp?  Or from future in-home care whenever "track out" is in session.  I just see so many potential red flags, I feel like I need to be pretty firm on my stance...while also trying to be (somewhat) friendly.


I was pretty certain uBPDxw would not accept that answer, and I was correct.  I'm not surprised at her wording since she is generally a transactional attorney (trusts and estates) but has been working on some litigation lately, too.  I'm just so tired of her threats.  "Arrange childcare by Friday or I escalate to the PC"..."Pay in full or I file a motion at court"...


I really wanted to send her a long response, but managed to keep it to saying I'd think about it and respond the next day.  And then the next day I spoke with my L, who sent her L a letter breaking down what I typically pay for, the reasons why that's not an option, and how reasonable I'm being by offering to pay more than I usually would over the summer (especially since normally that would only be a 3-week duration, but since the school schedule changed due to the pandemic we're now talking 8 weeks). 

So now I'm waiting for what comes next...

mw

Wonderful news about D11! Thanks for sharing the update. I often find myself wondering about my internet-only friends and how families are doing, and I'm cheering for health and wellness in D11's battle, not to mention yours.

Yeesh to the email directive and squeezing you for money. It's always something, isn't it, especially with attorneys who have a PD. I'm convinced if I tried to give my ex a million dollars he would turn it into a fight somehow.

Maybe I missed something, but is it possible to offer your sister as extra care during BPDxw's custodial time if money is tight? So, still paying the $40/day but then offering to relieve some of the financial burden by having someone else involved? I suspect not, but I'm curious if even just a hint of a different solution might get her to stand down on the motion.

My ex would coat his aggressions in these reasonable-sounding very professionally laid out arguments and if I proposed a reasonable solution, it would both defang him and simultaneously infuriate him because (I suspect) he felt his bluff was exposed...? Reasonable solutions used to really anger him.  :( Especially if they appeared to be win-wins.

Thank you so much, LnL!  There has just been so much angst with D11's situation, I was glad I could share a positive update.

I realized how much the situation with S7 was taking over the thread, so I created a separate one for the issues I'm tackling on that end here:  https://bpdfamily.com/message_board/index.php?topic=345078.msg13114040#msg13114040

mw

That's good news -- really positive that she is taking pride in self care (though she may not see it that way) and, more importantly from my perspective, that she is taking ownership and responsibility. I recall that being an area of confusion for me during the ED -- "what should I eat" was based on "what do I notice other people eating or not eating". Taking responsibility for food prep at any level is an appropriate move to say "you know what, I'm the one who's responsible for me". Good job D11!


So both T's are in agreement that you're not the problem. This seems like a good foundation from which to work on the childcare issue.

Am I right in guessing that xW is still not taking steps through the "open door" she DEMANDED to have for participating in D11's ED recovery?

...

How's the timeline looking on D11's tx? I ask because you have so much to juggle. Maybe keeping D11 in that "oven" until she's "good and done" (pun not exactly intended) is a safer bet for everyone right now... i.e., while I don't think the tx team would be like "mw, are you good if D11 gets done early?", I just wonder if there's a way to... IDK, have D11 get really, really stablilized in treatment, while you lock down the other moving parts in your life a little more.

Thanks, kells76!  It did seem like D11 backslid a little bit over the weekend...she was a little fixated again on when she can leave, and under what conditions.  She pressed pretty hard, and I try to keep it general without talking a specific number of weeks.  When I said yesterday that it would have to do with getting her back to where her body needs to be in order to be healthy, and not feeling the way she has in the past about restricting, she basically ended phone time.

I remind myself that this is not going to be a linear journey, but it was a little disheartening to hear her sounding again a little like she did that first week.  I had dropped off some additional clothes for her that I picked up at the store (she wanted another sweatshirt and sweater and I tossed in a couple more t-shirts) and I worry that might have triggered her in some way.  Plus on Friday afternoon she asked some more specific questions about her grandmother's condition (fighting lymphoma) and I think that worried her a bit as far as being unable to see her for several more weeks.  I'll be talking with her therapist tomorrow and will be sure to bring these things up.


Yeah, pretty much.  I never see her in the online parent education/support group sessions they have been doing on Friday afternoons--except one a couple weeks ago for just a few minutes.  She was logged in with video, but dropped off, and there has occasionally been someone dialed in anonymously by phone, but I'm not sure if that's her or someone else.  She definitely isn't participating actively if it is her.  Otherwise, she seems to be exercising her "right" to take up 45 minutes out of the 90-minute family therapy session through the program's therapist, which is currently being split for us since the T sees this is not the time to be trying joint sessions.  And I know the T isn't having D11 participate in those parts with uBPDxw, so I'm not sure what the time is being used for other than for uBPDxw to satisfy her need to get a "complete update" on all that has been going on.


D11 was actually pushing me pretty hard on this question today, and I ended up getting a little short and frustrated with her.  I know she's coming from a place of anxiety and wanting to map out what's going to happen, but we were again back to earlier behavior where she kept pushing the same topic and questions to try to get an answer.  I really have been avoiding the details on this with her, and need guidance from the T on how best to handle it.

From the latest update on her weight, she has about 20 lbs. to gain.  Assuming she stays on track with completing her meals, they said she would gain 2-4 lbs./week, so I think a realistic estimate is that she could be there another 7-8 weeks.  From there, she would enter a partial hospitalization program (PHP) that runs approx 3 months.  Under normal circumstances, that would mean she is there during the daytime 6-7 days a week, and home with me at night, but under COVID they have been doing that program remotely for 6 days a week.  After PHP, they shift to IOP which I think is three days a week for a few weeks, and then I think she would transition to regular weekly sessions with her outpatient T.

I definitely want to push for her to be really stabilized before she moves to PHP, and my biggest concern after that is to push that she does not have the Sunday visitation with uBPDxw once she leaves residential.  I think that would end up being too triggering for her to maintain her recovery, but since that's in the temporary custody order right now I may have to push for an emergency order to put it on hold.  I have no faith that uBPDxw will accept a recommendation from the clinical professionals that she forego the visitation indefinitely.

mw

Quick thoughts:


Yeah, that fluctuation sounds normal (not that that makes it easier for you). Recovery definitely won't be linear, like you mentioned.


Is she allowed to talk to Grandma? Does the team know that's important to her? Good idea sharing with the T.


Certainly possible... it was for me, though each ED patient can be different. You can try cutting all tags out next time you send her some duds -- seeing size #'s or letters can be triggering. That being said, she's going to have to learn to deal with that at some point. But yes, you could smooth things out by doing no tags.


Not to be "trees not forest" with all the details, but I wonder if anyone on the team "takes attendance" -- it seems like the more documentation you have of the door being open for xW to participate in treatment, but she doesn't DO anything and might actually undermine specific guidelines, the better for D11... any way to get all this data to your L?


Do you feel effectively out of the role of "information distribution manager"? I remember chatting about that with you a few weeks ago.


OK, that's good. Another 2 months might buy some time towards a safe reopening of the PHP... fingers crossed.


Any way to give your L a heads up (if you haven't already) about what you see coming down the pipes? Maybe a way to have everything "ready to go" at a moment's notice, when inpatient wraps up.


Sounds, sadly, believable. Would the professionals disclose to you xW's non-compliant stance? Or could they disclose that to your L? Ugh and ugh, as awful as it sounds, it seems like getting xW to "say on paper" that she has no intention of following an ED clinic's recommendation seems... like the ultimate breakdown that was being discussed earlier in the thread.

Yes, my mom lives with me, so during the times that she is home from the hospital she is definitely accessible.  D11 only gets certain times to call/Skype, so it's harder to make sure they can connect when my mom is at the hospital.  I have tried asking D11 if she wants to talk to her, but before our recent conversation about how sick she is, D11 kind of shrugged it off.  I think she has been withdrawing a bit from that relationship when she knew my mom had gotten sick again, and I have already given a heads up to her T at the ED facility.  Even if D11 has been pulling back a bit (in spite of recent concern expressed), our family T suggested we encourage some contact, because we don't want to just leave it and then have D11 end up with some serious regrets later if my mom passes while she is away in treatment.


I did think about cutting the tags, but was reluctant to do it because I wanted to be able to return/exchange what she didn't want.  I completely get how the size info can be triggering, so I'll definitely be talking through that today with the T as well.


I think they do generally note who attends, but I don't think that documentation goes anywhere.  I haven't noted which sessions had a dial-in participant, but will certainly let my L know that I have only seen uBPDxw logged into the web platform once for a few minutes.  uBPDxw is very adept at playing the victim, so I have gotten used to keeping track of the times when she has had opportunity after opportunity to do something about it, but just doesn't.


Yeah, for the most part they seem to be handling the information flow so that I can stay out of the middle of it.  Very much a relief for me.


I have definitely been keeping my L up-to-date on developments.  She knows where I stand on custody for D11, and what I would prefer for S7, though that will be a harder argument in court since he's not experiencing quite the same trouble as she is (yet).  It's not actually proven yet that uBPDxw will resist keeping her distance, but I just see that coming, too.  I fully expect to be in court in a few months, and the family T will probably have to testify, which will mean we can no longer effectively work with her as a family T because uBPDxw would never trust her after she openly gives her professional assessment of the situation.

mw