Lessons Learned

[BPDAdoption]

It's been about nine months since I last posted. Life got a little crazy for a while and I had to focus on family.

An update and some lessons learned over the last 9 months.

Our DD13 completed residential treatment for PTSD in April. During her therapy it came out that her biomom, a prostitute, had prostituted our DD13 between the ages of 4-6. We just couldn't believe it. But an investigation actually led to a confirmation of our DD13's account. Child Protective Services wanted to prosecute biomom for sex abuse but could not get the district attorney to go along. The abuse happened 8-9 years ago so it would be too difficult to get a conviction.

Lesson Learned: BPD kids can be almost pathological in their lying. But sometimes they really are telling the truth.

We worked at a children's home where our DD13 was placed. We were her house parents. In January we were fired by our supervisor for "slandering" him to the organization's president. We had reported him for covering up child abuse. In July a state investigation into reports of covering up child abuse in the organization led to that supervisor being fired for doing exactly what we said he was doing. We are still waiting for the apology from the organization's president. We have been told that for legal liability reasons it will not be coming.

What amazed us was the support we got in the community. A few months before us another couple had been fired for reporting the same supervisor for child abuse. The community rallied around us like they had rallied around them. An acquaintance hired my wife full-time and gave me temporary work. A man we never met before wrote a $22,000 check to rent us a nice house in a great neighborhood for a year. People donated all the furniture and appliances we needed to fill the house. We had no idea that people in the community knew who we were, let alone were appreciative and supportive of the work we had been doing. At the end of the day, we turned out to be the big winners.

However, this termination did greatly affect our DD13. The first thing our former supervisor did was call the residential treatment center where our DD13 was staying and told the therapists there to cut off all contact between us and our DD13. We had been faithfully participating in family therapy and visiting her on our own time because the children's home had said that they were not going to let her return after she completed treatment. She was too much for them to handle. We had decided we'd become her family and we'd make sure she didn't fall through the cracks into "the system".

One of the therapists called us to tell us about the "no contact" order. Our DD13 went into a steep downward spiral and the therapists couldn't understand why an organization that didn't want her was interfering in such a negative way with her treatment. The therapists got in touch with the children's home's social services director in the main office. She issued an order that our DD13 should have contact with us again.

One of the therapists called us to inform us that we were permitted contact with our DD13 again. We made plans to see our DD13 the very next day. An hour after that call we received a call from our former supervisor's assistant. He told us that the meeting with our DD13 was cancelled and we ordered not to have contact with her without our former supervisor's permission. We called the therapist back. The therapist said she had received no such direction from the social services director so we had the meeting and re-established contact with our DD13.

Over the next several weeks staff from the campus where our former supervisor was director came to visit our DD13 at the treatment center. They tried to talk her in to turning her back on us. It got so bad that the therapists had a meeting with some executives from the children's home. The supervisor and his staff were then prohibited from having contact with our DD13. This enraged the former supervisor and he did his best to make our life miserable until the organization let him go in July.

When our DD13 was released from residential treatment back in April she was released into our care. In July the court appointed us her temporary legal guardians until a dependency and neglect hearing is held in which we will be named her permanent legal guardians. Child protective services fully supports us in becoming our DD13's permanent legal guardians. They are hoping a termination of parental rights will come sometime down the road so that we can adopt her.

Since release from treatment our DD13 has had a roller coaster of a ride. Her biomom, a prostitute, drug addict, and career criminal had abandoned our DD13 to her paternal grandmother just before her 6th birthday. Our DD13's biodad is a drug addict with multiple convictions for theft and assault. He dropped out of her life soon after biomom did. For more than 7 years biomom was off doing her own thing. But suddenly biomom wants to get custody of her daughter back. At the July court hearing, based on the evidence presented, the judge prohibited the biomom from having any contact with our DD13. Biomom's father just happens to be one of those multi-millionaire "motivational speakers" you see on television. He bankrolls the attorneys for biomom. She is fighting a losing battle but has plenty of money to do so. We struggle to understand why, after 7 years, she is suddenly interested in her daughter. She is in no condition to care for her and we are gathering evidence of ongoing criminal activity.

Our DD13 has begged us to get her biomom's parental rights terminated. She wants nothing to do with her. The main emotion she describes when thinking about having contact with her biomom is "terror".

Lesson Learned: The emotional upheaval and stress the biomom caused for our DD13 deeply affected her. The rise in stress and emotional discomfort started clouding our DD13's judgment and she started making some very bad choices. We learned that high levels of stress and intense emotional upheaval are triggers for our DD13. We've learned that she thrives in a low stress, emotionally stable environment.

Lesson Learned: There are three things we continually drive home to our DD13. You are loved, you are safe, you are wanted. The moments she grasps those three things are the moments when she is thriving. When she doesn't "feel" those three things she is stealing, lying, being promiscuous, and getting suspended from school. We are finally learning that when she is making bad choices it is not a personal attack on us, it is just the BPD getting the better of her. Instead of getting angry we try to channel the emotion into genuine pity. She doesn't need a constant barrage from angry parents. She needs discipline fueled by love and compassion.

Lesson Learned: We are sad that she experiences PTSD and has emerging BPD. But we did not abuse her. It is not healthy in our relationship with her to let our empathy turn to guilt. She is going to lie, manipulate, undermine relationships, be promiscuous, steal and sometimes engage in self-harm. Those are her behaviors and it is perfectly reasonable for us to enforce consequences for those bad choices. We have come to expect her to struggle at times. We've come to expect the house to be full of drama at times. It's just part of the territory. We've learned to just give ourselves timeouts and walk away when our stress level gets too high. Her emotional crisis is not our emotional crisis. Of course its not always easy practicing what we know we should do.

Her therapist helped us come up with 5 household rules for her: 1.) Follow parental direction; 2.) Accept parental decisions; 3.) Take responsibility for your actions; 4.) Show respect to all members of the household; 5.) Fully participate in family life. Right now she is hating these rules. She gets one or more checks on her behavior chart if she violates them. This results in a loss of privileges for her. Positive behavior also results in check marks being taken off her chart, thus gaining privileges back. She also gets positive rewards for positive reports from teachers, coaches, etc.

The main theme we are working on with her is "positive choices lead to positive consequences and negative choices lead to negative consequences." Her therapist tells us that BPD kids have poor linkage in their brain between cause and effect. They don't evaluate choices based on likely effects. They base their choices exclusively on their feelings. Because our DD13 is highly impulsive she often acts on the feelings she has in the moment without thinking about the consequences of those choices. This gets her into heartbreaking trouble.

Well I guess I've just written a mini-book. Will be happy to answer any questions... .at least hopefully I'll have some answers. The more I learn about caring for someone with BPD the more I realize that there just aren't any hard and fast answers to the issues that come up.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[lbjnltx]

So good to see you again BPDAdoption,


What a journey you and your family have been on.  Holding fast to your values and desires to help and protect children brought you into this situation and brought you through.  I'm always amazed at how God works through even the worst circumstances and broken people to achieve His will.  Your d13 is blessed to have you working on her behalf to give her love, stability, and a family.  It takes a great deal of self awareness and skills to stay compassionate in the  midst of our children's self destruction, rage and chaos.


Since leaving the RTC she continues in therapy.  Is the t (therapist) the same one she had in the RTC?  What kind of therapy is she participating in?  Does your family also participate?  Is it the same therapy model she had in RTC?

How are your other children coping with these life transitions?

Looking forward to learning more.

lbjnltx

[Rapt Reader]

Hi, BPDAdoption... .It's good to read your story, but really a sad read, too. I think your daughter is so very lucky to have you, although at 13 there are times she probably would be hard-pressed to admit it! It sounds like you guys have all been through the wringer with all of these circumstances (I can't believe how horrible that program Supervisor is!), but I'm so happy to hear that you came out the other side intact.

I, like lbjnltx, am curious as to the ongoing therapy that your daughter is doing, and if you and your wife are in therapy, also. I have an adult (36) son who was just diagnosed with BPD this past April while at a Dual Diagnosis Program that lasted a very intensive 21 days. Since then, he sees an Outpatient Therapist once/week, a Psych once/month, his M.D. once/month, and a Neurofeedback Therapist twice/week.

A lot of very intensive therapy, but since he's been diagnosed with many mental health issues, right now it is necessary. For the first time since he's been in his mid-teens, he is not using any alcohol or illegal drugs (he's been clean and sober since March 1st, 2013!), isn't suicidal or doing self-harming behaviors (yaaaaay!), and isn't depressed any more (whew!). The major factor in this turn-around is that when he entered the DD Center, he was very ready for a positive change, and once they dxed him with the BPD and taught him the DBT skills on a very intensive basis, the light bulb moment for him went on, and we've just kept it going since, with the above-mentioned therapies.

I truly hope that your daughter gets to that light bulb moment, and sees treatment as the positive force it can be, and grows to be a happy, healthy woman. I'm sorry it took so long for my own son to get to that point, but so very happy that it has happened... .there really is light at the end of the tunnel if the pwBPD knows they need help, wants to get better, and has therapies and treatments available to them. It's a struggle, isn't it? Godspeed... .

[Skip]

Thanks for sharing your story.  I just wanted to say thank you for what you are doing.

Skippy

[BPDAdoption]

Since leaving the RTC she continues in therapy.  Is the t (therapist) the same one she had in the RTC?  What kind of therapy is she participating in?  Does your family also participate?  Is it the same therapy model she had in RTC?

Her regular therapist is the same one assigned to her in January 2012 when she was first diagnosed emerging BPD at the outpatient psychiatric treatment center where she still receives her therapy. This place uses DBT as the treatment modality. She no longer attends the group therapy because she is not attending school there anymore and group occurs during the school day.

She had two therapists at the residential treatment center. One did the trauma therapy and the other did group and family therapy. Trauma therapy was trauma-focused CBT which specifically dealt with her PTSD.

At the RTC we participated in family therapy every other week

The family therapy sessions were focused on helping us come to grips with her past as well as helping us learn supportive skills to help her manage her PTSD.

She goes for therapy once a week. My wife and/or I meet with her therapist the first 20 minutes to get encouragement/coaching. She meets with the therapist the last 40 minutes.

The five household rules were developed under the guidance of her therapist. There is a behavior chart that accompanies it. The behavior chart has 10 boxes, arranged from mild to severe consequences. Each time she engages in a negative behavior she gets a check in a box. Whatever consequence in the box she receives (goes from losing $2 of allowance to no social time with friends outside of school).

We are focusing on 2 specific behaviors that receive an extra check in her box should she engage in those behaviors. One is lying and the other is disruptive behavior in the classroom at school. Both of these behaviors involve multiple violations of family rules.

If she engages in 2 specific positive behaviors she can get a checked box and the privileges associated with it back. The first positive behavior is honesty. If she tells us truthfully and accurately about a negative behavior first, before we hear about it from someone else like a teacher or coach, then she gets a checked box removed. The second is a positive report from someone about positive behavior she has engaged in. That will get her privileges back.

If, on Saturday when her grandmother comes to visit, she has no checks on her chart then she gets to go out shopping. Going to a store is a privilege for her because of her shoplifting we rarely take her in to a store.

What we are trying to get her to experience is the consequences of choices she makes. The more she "feels" the positive and negative consequences of her choices the more likely she will begin to value positive choices on an emotional level.

Also, a refusal to cooperate with parenting is an unsafe behavior.  For example, if she is being aggressive with a family member and refuses to back off she will be hospitalized. The same is true for any self-harming behavior. Periodically my wife has her strip down and she is checked for any new cuts and/or other signs of self-harm leads to immediate hospitalization. So far she hasn't been hospitalized since leaving RTC.

We did come close to sending her back to RTC. But they have a program where in-home therapy is provided 3 times per week. We are going to participate in that program with that therapist coordinating care with her regular therapist.

The hardest part for the siblings is dealing with the fact that she is an emotional 4 year old in a 13 year old body.

[Being Mindful]

Hello BPDAdoption,

Thank you for updating us. I am so thankful that you are there for your daughter. We all have a lot to learn from your experience. When you can, I sure hope you can continue to let us know how you all are doing.

Being Mindful

[Reality]

BPDAdoption,

Your story is so encouraging.  Your love for your dd... .

I am interested in the behavior chart you use.  Where is it kept?  Are the household rules listed on it? 

There is lots of tracking in DBT and it makes sense that tracking helps a person who has difficulty forseeing consequences of actions. 

Thank you for sharing with us.

Reality

[BPDAdoption]

BPDAdoption,

Your story is so encouraging.  Your love for your dd... .

I am interested in the behavior chart you use.  Where is it kept?  Are the household rules listed on it? 

The behavior chart is kept in the kitchen where she has access to it. When she receives a check (negative consequence) we make a note of what the check was for. On of her favorite things to do is totally cover up in dark ink the check and the reason for it when she gets a positive report (positive consequence).

The behavior chart is in a landscape format. The top has a spot to note the week the chart is for. Then all the rules are listed. Then there are ten boxes. In each box is the listing of the negative consequence for getting a check in that box.

Also in the binder are contracts she has signed acknowledging certain consequences for certain behaviors. This stops the "you never told me" fights that were so frequently occurring.

The chart has proven to be very useful to us. But it only works because there are positive rewards as well as negative consequences. Going shopping with her grandmother when she has no checks for the week is a huge motivator.

The reason why we are doing this is to give her a concrete picture of what responsibility is like. "Positive choices lead to positive consequences and negative choices lead to negative consequences."

Another important thing that goes with the chart is really changing our expectations of her. Right now we are focusing on honesty and positive behavior at school. We try to let lesser things slide. We could be on her every minute of every day for something if we chose to be.

I think we sometimes get so focused on helping her get better that we add a level of stress to her life that only serves to undermine her success. BPD kids do not to well in high stress environments. We have learned to let her room be a toxic waste area. We have learned not to react based on our feelings of shame when she is a public embarrassment to the family. Its hard to keep quiet, but those are battles for another day. She needs to have some joy in her life and not be feeling under constant attack by us.

Also, her loyalties are based on how she feels at the moment. We do not cave to her demands and we stick to the behavior chart. But by letting things go it allows moments of emotional attachment to us occur. They are fleeting but powerful.

Therein lies the most important key we've learned. Caring for BPD kids requires a delicate balance between love and discipline. We think of discipline as instruction. By negative consequences we are restraining certain behaviors and by positive rewards we are encouraging other behaviors.

She also needs to be held and told that everything is going to be okay. She needs to be reassured that our love for her is deep and strong enough to withstand her behaviors. She needs to know that we will stand by her even when it hurts. We call it "hugging the porcupine." Sometimes loving acts toward her are a sheer act of our wills. We certainly don't feel it at times.

Still it is all very messy and so much easier said than done. I don't want anyone reading this to think we have found some magical formula for parenting a BPD child. We haven't. But we have found ourselves to be more effective in the midst of the hardships of parenting by continually working on the things I've described above. That and a lot of prayer and support from others (particularly our church community).

[pessim-optimist]

Thank you so much for sharing this powerful story with us.

I have seen talk about charts and consequences before, and usually the story went that it did not work for the child w/BPD.

Including my step-daughter when she was little. Her mother had a chart (only demerits for any offense and 1 negative consequence: a spanking for each 5 demerits)... .I believe she meant well, however, I am told that her application of the rules was rather rigid and strict, not much nurture and love, and it created a lot of marital discord between her and my husband. The rules were the same for both the girls and while the younger thrived and easily avoided trouble, the older one (very sensitive and 'just a bit different' then, now 32 undiagnosed BPD) would rack up up to 5 spankings/day, which constituted a total 25 'demerits'   . My step-daughter told me, that looking back, she remembered just being angry with her mother and wanting to see how many demerits she could get... .Clearly a method gone wrong... .

Your story seems different in that you nurture with love:

1. You are applying both positive AND negative consequences

2. You are carefully choosing your battles, allowing your dd to have successes and be motivated to try.

Also, her loyalties are based on how she feels at the moment. We do not cave to her demands and we stick to the behavior chart. But by letting things go it allows moments of emotional attachment to us occur. They are fleeting but powerful.

Can you give us some practical examples of 'letting things go'? Is it the things you choose not to battle about like her room, or is it a type of 'forgiveness' for things you would normally enforce and she knows it?

Therein lies the most important key we've learned. Caring for BPD kids requires a delicate balance between love and discipline. We think of discipline as instruction. By negative consequences we are restraining certain behaviors and by positive rewards we are encouraging other behaviors.

She also needs to be held and told that everything is going to be okay. She needs to be reassured that our love for her is deep and strong enough to withstand her behaviors. She needs to know that we will stand by her even when it hurts. We call it "hugging the porcupine." Sometimes loving acts toward her are a sheer act of our wills. We certainly don't feel it at times.

Thank you again! That is such an important point!

I believe that that is a healthy approach to raising all children, but even more so the ones prone to BPD. They do seem to need that extra validation/reassurance/positive bump!

[qcarolr]

Therein lies the most important key we've learned. Caring for BPD kids requires a delicate balance between love and discipline. We think of discipline as instruction. By negative consequences we are restraining certain behaviors and by positive rewards we are encouraging other behaviors.

She also needs to be held and told that everything is going to be okay. She needs to be reassured that our love for her is deep and strong enough to withstand her behaviors. She needs to know that we will stand by her even when it hurts. We call it "hugging the porcupine." Sometimes loving acts toward her are a sheer act of our wills. We certainly don't feel it at times.

Still it is all very messy and so much easier said than done. I don't want anyone reading this to think we have found some magical formula for parenting a BPD child. We haven't. But we have found ourselves to be more effective in the midst of the hardships of parenting by continually working on the things I've described above. That and a lot of prayer and support from others (particularly our church community).

BPDAdoption - your story adds so much value for all our struggles with BPDkids, our intense love for them, and searching for ways to make things better. I wholeheartedly agree with the priority of the LOVE piece. Without that reasurance that she is safe and loved no matter what the behavior expectations would most likely be too overwheming. I have found this works for my gd8, who also suffers from trauma from the chaos in her young life. Some of it I have to take responsibility for in not adequately shielding her from her mom's wrath over the past 4 years especially. I did not get the safety needs that had to be met before the love could be taken in and the behaviors/expectations/consequences could be successfully addressed.

The second part - to give you as the parents courage strength and perseverance is your faith and the support network you have built. This keeps you all safe to be able to give the love.

You are doing such an awesome service out of your love for kids.

Giving me a model in my journey to be a better influence on my girls. My DD27 is often like a 15 year old in so many ways - have to modify my love and discipline(teaching) approach with her as she learns to meet her own needs as an adult. Stepping back is so hard to do. Yet only way for her to learn to reach out to the community resources surrounding her.

qcr