what next?

[momontherun]

I am at my wits end trying to keep some sort of sanity over dd15's choices.  I keep asking myself is this constant fear, frustration and worry worth the energy? I don't want to give up on her however, there is only so much I can do and wonder if she will start making better choices if I go nc for awhile until I can build myself back up to continue trying to support her or if her behavior will get worse... . worse being the next step - a successful suicide attempt.

See on Tuesday, she expressed how sad she is being homesick and missing all of us. I responded with I hear how sad you are perhaps laced with a bit of frustration. I feel the same way wanting to be with you and create special memories. Which I anticipate in doing when you get stable enough to come home. She said she does too so I asked how can we make that a reality? She said she needs to make better choices but its so hard when she is so lonely with a deep desire to make it all stop. I reminded her that her emotions are fluid - they are ever changing and last time she felt this way, the moment passed bringing in a new strength and courage. She agreed then came back with how weird it is all the adults in her life are no longer making a big deal about her si. I reminded her about our talks of acceptance and choices - perhaps all the adults have accepted this is how you cope - We have a choice to keep focusing on the how's, why's and triggers or we can move on and focus on the other things we need to work on just as you have a choice to continue does that make sense? She said yea but its bad I si I asked who says? she said society so we discussed how society is made up of clusters of families and how each family is different with view points and beliefs which changes over time with each generation and asked her how societies view points have changed? She said she didn't know so I asked if we still have slaves? she said no then caught on and gave many examples.  So I asked do all families celebrate Christmas? she said no then pointed out how sometimes with differing opinions even society accepts certain things with time. She said she felt better and our time was up so we said our talk to you later's which would be Thursday.

Thursday, I called her T several times as they usually call at 10 am and had a feeling something was wrong especially as noon approached then 2 pm then 4pm. At 4:30 they finally called and apologized for being so late as they just got back from the hospital then left it up to dd15 to explain what happened with a warning we only had 5 minutes to talk instead of our usual hour. She said she is tired of trying and fighting as she isn't getting any better so decided to break a light bulb and cut her wrist but that wouldn't be fast enough before she got caught so then tried to slit her throat. She received 9 stitches (6 on her wrist and 3 on her neck). I blew up telling her how dare she do this when there is so much in life she hasn't experienced yet and there are people in this world actually fighting for their lives specifically her uncle. Then told her how on Monday he was in a rollover atv accident racing with a few of his buddies when he made a jump and lost control - we don't know the extent of the damage yet and won't until time has passed if he even has that long. His brain got injured really badly and needs to have the pressure relieved from the swelling as there is so much blood is trickling from his ears however, in order to do that he needs to stay conscious long enough to have it done which he has only been able to for a minute or two before he passes out again. She said she is worried about him now and I came back with you should be. The whole family is scared he isn't going to make it but there isn't anything we can do for him that's not being done just as the family is worried about you and there is nothing we can do that's not being done. It's all up to you and the choices you make. Its obvious we can't stop you from trying to kill yourself though we can make it harder for you and the only reason I told you about uncle is to give you some food for thought until we talk again next week. Then our time was over.

I am at a loss on what to do or even say - her T doesn't know either but one thing is certain something needs to be done to make her stop. My mom says, I can't keep doing this as its destroying us living like this which the hard reality is she is right. My T is at a loss as well, validating that this is a very difficult situation and asked how the boys are doing with all this - they don't know just see me trying to hold it together trying to focus on positive things and know it has something to do with their sister. She suggested I start thinking about self preservation and what that looks like as well as, means for my family and we'll discuss it next week - I don't like where this is going then again I don't like dd15's escalating behaviors - where does one draw the line?

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

[pessim-optimist]

hi motr,

I can't imagine how worried and drained of energy you must feel... .    

We never had to deal with my sd32 trying to commit suicide (although she often talked about how she wanted to die) so I don't have practical experience or advice.

I wanted to send you warm thoughts anyway, and wanted to let you know that we here who read your post are with you, feeling for you and wishing a happy ending for your relative who's in a critical state and also for your dd to turn around.

One thought occurred to me during reading your post. I'm going to mention it, with a warning, that it's not backed up by experience, just observing and thinking about what you wrote: Is it possible that your dd escalated her behavior because -as she said - nobody was making a big deal about her si anymore? (of course that would still just be an explanation why, not how to battle it)

Let's pray the professionals figure out how to help her... .

Thinking of you,     

[pessim-optimist]

An afterthought:

Here's a video about BPD in adolescense by Blaise Aguirre.

www.youtube.com/watch?v=q4KjxxPp3Ls&feature=player_detailpage

He briefly describes how they deal with suicide attempts in their facility. The bottom line - they do not want the family members to give the pwBPD extra attention so it would not reinforce the behavior... .

I think that may be why you got 5 minutes instead of the hour... .    

[momontherun]

Thank you pessim-optimist for your kind words. Every time I come to this board, I feel so much caring and support which is really badly needed going through these difficult situations that are beyond our control.

The dr's were finally able to relieve pressure from my step brothers brain so he is doing better - being quite a jerk to all around him however, that's understandable as he is in protection mode. Seeing how there isn't anything more they can do for him at the hospital now he is stable, they let him go home to stay with his mom with many follow up appointments and a checklist of things to look out for as well as, do.

Yes, its possible and almost a certainty dd15 stepped up her escalation to get more of the response she is used to. I suspected last week, she is going through an extinction burst resorting to attacking another girl, getting restrained then si-ing as she felt bad for doing it. Seeing how she didn't get the response she was seeking talking about how she is looking for ways to get restrained again - it makes sense she would continue to escalate though I didn't think she would ever take it this far being so desperate to get out. Then I started thinking perhaps there is a girl there she is getting enmeshed with and doing this for approval and/or mirroring her as its so out of character for dd15 so I asked her T and she said she would ask the other staff to see if they have seen anything like that which they have not as it appears she has distanced herself from her peers only speaking to them as needed. So to help clear my head, I detached myself to look at all this as objectively as I can and do some deep soul searching... .

She has split the rtc (all bad with no way out) and me (all good- the only one that can help her) so its very possible I am hurting her treatment by being involved directly with her. So it could very well be that I have to stop the communication with her so she can get better as Marsha Linehan points out in the video 'back from the edge' www.youtube.com/watch?v=967Ckat7f98 there can be no interpersonal relationship while a person is emotionally unstable... . its just not possible. Being so involved could be adding to her instability though I keep redirecting her back to the rtc's boundaries and guidelines as well as, the subject at hand though in her perception it doesn't really matter and could even be equated to being a tease keeping her stuck in this dangerous loop.

So going back over some highlighted portions in The essential family guide to BPD I was reminded about boundaries (I can't control her and need to protect myself) and the 5 C's: 

*Clarify: whats important? safety, stability and health

*Calculate Cost: Pro's/Con's - Pro's: clear focus, level headed - more in control, stable, consistent Con's:abandonment, blame/anger

*Consequence: Self list of what can do - contribute to dd15's instability by being unstable, take care of and work on myself, show the boys how to deal with these things in either healthy or harmful ways

*Consider outcomes: relationship with dd15 ruined showing lack of trust, support yet alive. DD15 stays in this dangerous escalation bringing her family down with her an the real possibility of her demise.

*Consensus: Get on the same page with dd15's T with this boundary of nc until dd15 improves enough to continue with family t working on our relationship as its obvious its doing more harm then good at this point.

I just don't want to make that boundary as I am afraid she will view it as abandonment and really be alone so whats the use of continuing however, I am now afraid if I don't she'll keep escalating anyhow... . either way something needs to happen and going over everything so far this is the logical next step.

[qcarolr]

Momomrun

Your process of the "C's" has helped me stop and get a new focus on my dd27 going to jail soon. I am doing harm by my inconsistency. My doubts and fears get in the way. She has to do this for herself. How do I let bher know this or do I just stop showing up?

Qcr

[crazedncrazymom]

I'm so sorry you're going through this yet again.  I think the thing that makes me so afraid is that you have your daughter in a place where she shouldn't be able to do these things at all.  I mean a little si, sure, how can anyone stop that?  But to be able to get hold of a lightbulb just shouldn't happen. 

I think you're on the right track by not giving her any positive reinforcement for these actions, though (without watching Lineman's video) I wonder if NC is the best way to go with a 15 year old.

I'm so thankful she made it through this attempt ok

[momontherun]

QCarolr - We all need focus from time to time especially when its our children... . I am glad going over the 5 C's has helped I don't think not showing up is the answer as then it wouldn't be a limit and could make things worse in the long run. I plan on discussing this with dd15's T before dd15 joins us so I can speak plainly with her about it. If she agree's this is what is needed then when dd15 gets on the phone then I am thinking of using SET, make the boundary and use puvas if she isn't raging... .

Support/Sympathy - I am really worried I won't see you again as your si escalates.

Empathy - I understand how frustrated and overwhelmed you are struggling with your intense emotions.

Truth - I am living in constant fear, frustration and worry each time you choose to si and not use healthier coping skills rendering me useless to support you as well as, your brothers.

Value: Safety, stability and health are very important values to me.

Boundary: I cannot help others to keep them safe from themselves

Action: I am not going to continue with family t or our personal calls until there is more stability.   

Pay attention - listen to what she is saying

Understand fully... . ask questions to see what her perception is at the moment

Validate emotion - I hear sadness/anger/worry which is very understandable, I bet many of the girls there feel the same way - most people would if they were in your shoes however... .

Assert self - I cannot continue while your safety and stability are compromised the way they are as in order to be there for you, I need to take care of myself. We can both use this time to take care of ourselves so we can learn how to deal with this in healthier ways.

Shift responsibility where it belongs -if needed and she hasn't shut down.

Sound alright?

crazedncrazymom - The only thing I can say is where there is a will, there is a way. That's the problem with routines and consistency... . they know what to expect/when so if dd15 gets it set in her head this is what she wants to do, she will act knowing just when to do it. Sometimes its a planned thing like at the state hospital with 10 minute bed checks, her room on the opposite end as the boys and security camera's with a nurse's station in the middle yet she still managed to have sex on multiple occasions. Other times its discovering a staff member got complacent and didn't remove staples from a magazine (no longer there) or another girl broke something in a rage and she squirrels it away for later or get enough trust to earn hair barrettes then break them... . the possibilities are endless. Its very scary to look around and note all the things one can si with in any sitting. Then of course, there is the realization that si doesn't even have to involve objects for it to happen... . No one can sit by her side 24/7 watching every move she makes to keep her safe from herself - this is my reality.

I wonder too especially the way dd15 interprets things ie honey, money is getting tight so I am only coming (2 hrs away) to see you 2 times this week instead of 4 which I really hate to do however, I think its better this way than not seeing you at all. She came back with your wasting money on gas to come see me, I knew you didn't care - this of course was before I learned about validation and haven't noted any misinterpretations since I have been using it though I am sure they are there.

I do know boundaries work as she used to rage at me while I took it all in until I put my foot down and told her I love her with all my heart however, I cannot allow her to do this to me anymore and if I think its getting to that point, I must end contact in that moment as its not doing either one of us any good. I only had to hang up on her twice then she mimicked it by leaving the room during a family t session a couple of times ... . this was before she left state and we did our sessions in person and had nightly calls to check in with each other - she hasn't done it to me since though she has with others. So I am hoping this limited boundary will get her to stop or at least slow down the intensity of her si and start focusing on other things.

[pessim-optimist]

Hi motr,

the things that you describe sound pretty good, I have to admit that as it is regarding suicide I am out of my depth.

However as crazedmom suggested, nc seems a bit extreme to me too as it would likely be interpreted as abandonment and may push her further into despair. But it looks like you are not seriously considering that option any more... .

I would try to think of something that would be an incentive - more of something she wants/likes for demonstrated effort/cooperation with the RTC program?

How are you doing today, wishing you a peaceful day... .  

[crazedncrazymom]

I wonder if there is a middle ground that you can find between driving up twice a week, phone calls etc and NC.  I do think as parents we have to pull back to let our kids get themselves better.  How long has your dd been in rtc? 

When dd16 was in an rtc 40 minutes from the house I was always up there.  I think if I spent anymore time there they would have had to put me on the payroll.  I was trying so hard to let her know how much I loved her and wanted her to get better and come home.  DD acted out all the time.  She actually scratched what looked like a spikey type bracelet in her arm.  She was wrapping shoelaces around her neck, drinking cleaning fluid, attacking staff.  She was constantly on a level.  She didn't get even a teeny bit better after being there for 5 months.

I moved her to an rtc about 2 1/2 - 3 hours away.  When we were deciding on the place I told her I would only come up to see her or bring her home every other week.  DH is out of work right now but we have a deal that after he gets a job I will come visit every week and bring her home every other week, but only if she is fully participating If with her treatment. She is doing so much better having to "earn" time with her family.

After one of our phone calls a staff member called and told me how impressed she was.  DD started screaming about something going on there and I stayed calm and kept saying... . I want to hear about what's going on but I can't understand you when you scream.  She ended up saying... . OMG you deaf B**th I hate you.  I just said, I'm sorry you're going through a rough time but I'm not allowing you to talk that way.  Call me tomorrow if you want.  Bye Bye sweety.  Before I learned better I would have tried talking her down.  OMG why are you talking to me that way?  I know you're hurting but please don't take it out on me ... . etc etc.

I think sometimes we try so hard with our kids that we end up validating the invalid.  We try so hard to get through to them and to calm them down that it becomes more about us than about them.

[momontherun]

I suppose nc was the wrong word for it however that's what it will essentially feel like being further stripped down to just letters when she gets on a level where she can write and receive letters that is. Then slowly add back in family T then our personal calls again putting off our in person visit (supposed to be this month) until she progresses enough to handle it.

We started all this with a 3 week stay at the discovery unit at our hospital back in August - she was totally enmeshed with a 12 yr old boy that she was secretly seeing sneaking out at night, using her friends to see him even more, cutting, smoking pot, stealing from stores and it was everyone's fault. She was started on lexapro but that increased her anxiety so was switched to effexor. I visited her 4 days a week and called round the clock speaking with her once a day mainly calling to see how she was doing. She escalated her si and having sex with the boys given 24/7 sight/sound then earned enough trust to shower alone for 5 minutes in which she tried to hang herself so she was committed to the state hospital under a 72 hour court order. When I came to visit, I signed the voluntary committal paperwork seeing how she needed all the help she could get. I continued to call everyday and visit her 4 times a week until money got tight which lasted a week. During the 7 weeks she was there, we had 5 family t sessions, child services investigated (for the 3rd time in 2 yrs due to her accusations), b12 and trazadone was added and we found a long term rtc being advised she will need to be there for at least a year undergoing cbt and dbt with warning of repeat committals unless she somehow learns to regulate herself. It was during this time, I had to make the boundary with her to quit raging at me or I will end communication for that moment. She was given the incentive that if she stopped si for a week then she can leave reminding her throughout the day if that's what she wanted. She quickly turned around an helped going over the rtc options, discussing what she felt she needed to get better and we both agreed on the one she is now in going over the restrictions of seeing and talking together - that was back in November.

The day I transported her down, I signed her out in the morning and we spent the day shopping an packing going over the rtc's checklist, got her hair cut, saw a movie, went to dinner then took the flight. We both got a tour meeting the key members in her treatment (the P doc noted how high she was dysregulated - added on lamictal and removed the b12) then said our good bye's. A week later, we started out family t calls on Tuesdays with extra time to talk after her T had to go and personal calls on Thursdays... . her case notes didn't match what they were seeing and started wondering what she was even doing there then she started si-ing again as well as, having sex with some of the girls being gay (expecting rejection I am sure) then she cycled one week plummeting then the next improving. Each time getting us off topic discussing what was going on trying to find the trigger that plummeted her as well as, snapped her out of it. This was going no where so we started to discuss emotions and their functions as well as, given different opportunities to learn how to regulate herself a bit better. This lasted for 2 months (Dec/Jan) - the trazadone was removed, abilify was added then the frequency changed to plummeting one week then improving for 3 weeks (Jan/Feb) in which we started discussing acceptance, choices and personal responsibility getting side tracked with discussing her si again then it changed again back to one week on and the other off right after our very emotional visit in March when she demanded to be put into a different rtc so she could start over claiming how they aren't helping at all in which led to a discussion on how running away will be more harmful between discussions of her si - lamictal was increased.

In April, I discussed with her T how we keep getting side tracked each time she si's and need to be more consistent moving on while showing her acceptance as well as, working with her perception getting her to go over the choices she has and what each consequence looks like positive or negative. She improved for 5 weeks and we started discussing family identity going over her perception of traditions and roles trying to lead up to boundaries which she thought was stupid not seeing the point however, went along with it anyway with a brief discussion of what we can look forward to ... . our visit in June with the reality of having an overnight or 2 at the hotel, as well as, clothes shopping again and possibly renting a car to take in the sights as long as she stays on track - if that all goes well then she would get to come home for a trial visit in July helping me get her room set up (she wants a custom loft bed with couch, a built in the wall jewelry center behind a long mirror etc), go camping etc. and be home in August and continue with driving lessons, go to the state fair (end August/beg. Sept) etc. which led up to these recent events right after a couple off campus activities (went overnight camping and a visit to the humanitarian center with a lunch in the park) starting this plummet. 

Her pattern seems to coincide with the medication changes though going to more extremes of happy/sad for longer periods each time so I was looking more into that though after more thorough reading of the different medications, she is on the best ones to help combat her dysregulation. She seems to be stuck claiming that she needs to be home now as I am the only one that is helping her one moment then the next saying how if she is home and were to do this she would surely die so she needs to be there then again in another turn saying how she wants to transition to her Aunt's house coming from a step down program instead of coming home then how she doesn't want me to come and visit until she can get a pass to go off grounds so we aren't stuck in a room with brief periods of walking the grounds like last time then the next saying how she needs me and we can do all this at home then how she is tired of trying, not getting any better and is going to do whatever it takes to get out seeing how she can't be with her family she would rather be dead then back looping back to the start of needing to be home.  At the same time she makes small improvements in the program earning a bit more trust each day getting 1-2 more privileges each week which is encouraging showing she is really trying leading to more boosts in confidence as we root her on with continued emotional validation and incentives to look forward too. She then gets to a certain point and goes out of her way to have it all taken away like this time it'll be different making it seem to most she is just willful and attention seeking.

She says, her self talk is always negative not knowing how to think positively so I started sending her affirmations a couple times a week on little index cards to reflect on - she says this helps but gets tired of using them and now can't use them as all of her belongings are locked up. She started doing yoga which says helps however, she doesn't want to do it. She started an exercise program but hates exercising. She says doing her cd books help but can't work on them while on observations yet is promoted by staff to do them. Drawing and reading helps but she gets bored. She says she is using her DBT skills but they don't help (she only went to a couple classes between rounds of si). She says discussing her emotions with staff helps a bit but they tell her to 'get over it'. She says distractions help but she can't do the ones she wants to do (camping, hiking, window shopping etc). She says she participates in groups while the group leaders say she sits sulking. She says she is doing really well in school while the teachers say she is using the time to sleep and only doing the work at the last minute. She says she is sleeping really well just doesn't want to wake up. She says she is cautious of the other girls and staying away from them being lonely but is caught making out or being given objects or passing notes or making run plans. She says she is eating well but is on half portions for meals and full portions for snacks... . So many issues and we just don't know what to do at this point especially considering all the other factors at play (soon to be switched from child to adult guidelines, payment from medicaid and state funding, approvals from the state psychiatric board etc)

What would you do from here to help your child ?

[qcarolr]

I think sometimes we try so hard with our kids that we end up validating the invalid.  We try so hard to get through to them and to calm them down that it becomes more about us than about them.

My dh and I were talking about this yesterday. When I can be centered and hang up or walk away, with promise to be there when things calm down, it works so much better. So many years of being inside DD27's drama with nothing getting better. The key for me is to BE CENTERED, not trying to be centered. When I have to try too hard, then I need to be taking a timt out.

qcr  

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

[vivekananda]

Hi motr   

What a horrible time you have been through. Your capacity to look for the pathway through it, impresses me.  I feel that you will make the right decisions, because everything you say is tried and tested truths that we have learned.

I would like you to check out the National Clinical Guidelines for the Management of BPD (Aust) which was published last month, It has pulled together all the relevant/appropriate research on BPD. I could be wrong, you would know better, but what it seems to me is that your dd would be considered a chronic low risk. There are different approaches depending on the risk assessment. The report says in part, "In chronically suicidal people, active attempts to prevent suicide, such as hospital admission and close observation, may be unhelpful or even escalate risk... . Chronically suicidal people recover when their quality of life improves." There is much more written in the report, it doesn't refer to rtc's (we don't really have them in Aust), it is not a parent's handbook, it is written for clinicians. But it may help you understand better, see pp 124 - 132. It can be downloaded free from:

National Clinical Guidelines for the Management of BPD (Aust)

there is also info available on pharmaceuticals on page 62.

Value: Safety, stability and health are very important values to me.

Boundary: I cannot help others to keep them safe from themselves

Action: I am not going to continue with family t or our personal calls until there is more stability.   

I'm not sure if this is the best way... . isn't a boundary best expressed as what you need to do to protect yourselves and your values? (I hope this isn't a hornet's nest). If I were writing this I would say: Boundary: if my dd threatens si, I will break contact. That would reinforce my value and protect me from the worry etc caused by the threat of si. Another boundary could be: If dd si's I will not initiate contact until I have a commitment that dd will use other coping mechanisms.

Pay attention - listen to what she is saying

Understand fully... . ask questions to see what her perception is at the moment

Validate emotion - I hear sadness/anger/worry which is very understandable, I bet many of the girls there feel the same way - most people would if they were in your shoes however... .

Assert self - I cannot continue watch while your safety and stability are compromised the way they are. as in order to be there for you, I need to take care of myself. We can both use this time apart to take care of ourselves so we can learn how to deal with this in healthier ways.

Shift responsibility where it belongs -if needed and she hasn't shut down.

I would avoid the qualifier 'however' also 'but' - because it's like a signal, ok here comes the nasty bit... . Inside the box I made a few simple changes see cross outs and italics.

It seems to me that this latest set back came after a bit of improvement, in which case this is the old one two dance we are so used to. Two steps forward, one step back. Is that right?

sending you and yours Cheers,

Vivek      


   

[momontherun]

It has been horrible with small chances of hope dd15 is getting more stable then once I start trusting it she ups the ante so to speak. Sometimes it feels like the si's are deliberate distraction to stay away from a topic, sometimes its boredom or an ego boost or attention seeking and others its a genuine escape - hard to determine the difference and getting harder to be empathetic, trusting and hopeful as well as, staying focused.

After some more deep soul searching about all this then reflecting back what I can/cannot do  as well as your advice, I was ready to discuss this all with dd15's T and set the boundary. Here's how it went:

T: Dd15 got restrained over the weekend and sent to observations as she tried to take a staff members keys planning on running. They did discuss how its really not possible having to find the right key for each of the 6 doors to just get out of the building. She said she knew just thought it would be fun to try. I told her I am glad she isn't focused on hurting herself in this moment though I am concerned of this new pattern and requested a new risk assessment done as the only consistency is there isn't any it seems which is a major concern as it may be a new emerging risk. Which reminds me have you gys gotten any further on ruling out bi-polar yet or is it still ongoing? She said she would ask the p doc about it. It also seems that with our family T and personal calls that I may be inadvertently enabling her so not much has changed keeping her stuck and not doing the work to help herself especially seeing how she has split the rtc and family. T said dd15 told her she admits she has been just giving minimal effort and needs to try harder. I asked if she felt dd15 was being genuine or reflecting back what she thinks you want to hear? She said she wasn't sure and she is getting frustrated as well. I told her its understandable as we should be past this with all the tools, evaluations and discussions showing tid bits of progress here an there however this is my daughter and she is taking it to more and more dangerous levels and that it seems she has found a way to stay a martyr just showing minimum progress while continuing her unhealthy patterns and somehow forming the Karpman Triangle (persecutor, rescuer, victim) in most of her relationships including ours despite best efforts to stay on track. She agreed and laughed then said that about sums it up just didn't know how you felt about it. I told her I am willing to do anything to help her and if that means being the bad guy so she can be receptive for help in the program then so be it... . somethings gotta give her a wake up call. I just hope it works and she doesn't use it for fuel to continue her escalation. T said she allowed so much leeway for our personal calls as it really seemed to be helping but see's how we may be keeping her stuck and agree's something needs to happen.

DD15: I asked So hows it goin? she responded much better now, I no longer feel like suicide or ever si'ing again though she did make run plans and tried to run then got restrained and in observation started getting focused on trying again to make it to walmart (closest shopping center) and take as many pills as she can. I asked I thought you said you didn't feel like harming yourself anymore? She said now she didn't but yesterday she did. I asked so how about in the next moment? she said she didn't know its just she lost motivation and now has it back ready to continue T. I told her I really wish I could believe you its just I have been so worried I won't see you again taking your si to more dangerous levels and I get how you get to these places of being super overwhelmed getting dysregulated - I don't get you then choose to focus on staying in that place making excuses why you can't use your healthier coping skills. I understand you have an extremely tough time battling tour emotions. What you  need to understand is I am living in constant fear being really worried each time you choose not to use healthier coping skills which takes away the support I am able to give you and your brothers. Her T reminded her how others choices have a ripple effect on others. DD15 said she understands and will try her best to make better choices. I told her trying is not good enough - its another excuse setting yourself up before you start. I cannot watch while your safety is compromised and it seems I am only enabling you to stay on this up/down cycle getting more dangerous each time. Remember when our old neighbor started borrowing things? She said yeah I explained it started off with tp then it was tp an tobacco, then it was tp, tobacco and misc. food - this went on for ~ 6 months until it hit me I was enabling her to not care for her self. I don't mind helping people when they need it though I take really great offense when I know they can provide for themselves yet choose not too then I get really mad especially when it starts taking away from others I care about which I am starting to see here so I think in order to continue to be here for you I need to back away until you make a commitment to use the healthier coping skills that I know works for you. Her T asked her to repeat what I just said - DD15 came back with mom refuses to speak with me until I stop hurting myself. Her T said now thats not what I heard - I heard her saying she needs to take a step back so she isn't enabling you is that right? I said absolutely!  She asked dd15 if she knows what enabling is? She said sort of like doing things for someone that can do it for themselves. I said thats my understanding of it as well. T told her mom is frustrated by your choices knowing you can make better ones. I said yes, I just don't know what to do so we got help and started teaching you new coping skills - some work and some don't what gets me is you choose not to use the ones that work for you and even say your going to use them then don't so I need to take some time away to allow you the freedom to make better choices. She asked like what? I said well like your yoga which you can do anywhere, dbt though you only went to a few classes - Dd15 started defensively saying its over now T interjected what mom means is your not using the skills your learning - you have them and we know you know how to use them as you said they worked before and now your making excuses to keep yourself stuck. She said oh yeah I reinforced and said until you start using your healthy coping skills we cannot have personal time -We can write letters once you get to the status you can - she said she can now I said good so lets do that for our social time and we can continue our T sessions seeing how it goes hows that sound? She said horrible but knows we care enough to keep her focused and motivated. It helps we can still write and have T sessions to stay connected. T said yes and we'll go from there checking in each week. I said absolutely! Gotta help yourself before helping anyone else. In the meantime perhaps you two could go over the cycles of ups/downs since dd15 has been there and examine whats been going on - I see some of it though the question is if dd15 does and thats what really matters as its really up to her. T said we must end the call so say your good bye's and tell your mom how much you love her. DD15 crying mechanically said she loved me - I told her I love you with all my heart and soul - nothing will ever take that away and look forward to our t session next week. T said til next week and I know how to get a hold of her in the meantime for questions or concerns which I quickly reminded her to look into those things we discussed and get back to me.

Now reflecting on the conversation, I can see how we ambushed dd15 not being very validating nor supportive in the process despite all intentions and probably should have quit while we were ahead as dd15 withdrew... . I couldn't see her but felt it just the same. At least she is on the upswing being determined as ever - Time will tell how it all goes now

[vivekananda]

phew motr, that's hard work. I so understand your focus on making yourself clear; as I was reading, I was holding my breathe for you all myself.

I would feel proud of myself though that I had made such a difficult decision to reinforce my dd's health and safety - so, I am proud for you.

I understand that you would be worried about the lack of validation during the conversation. I don't really know if what you did say wasn't in general validating though. What you said was that because you love her, you will be doing this thing that is so hard for you. And it was also important to protect yourself and the family from the pain and hurt of dd's si. The analogy of the neighbour was great. It clearly explained what enabling meant and why it was important to stop doing that.

You haven't broken contact, you have left the responsibility for herself in her hands. And she has support to get through this.

I am no expert, but it seems to me you did it right.

It would be good to hear what others think, let's hope they put in their two bobs worth too eh?

Tell us how it goes, ok?

thinking of you Cheers,

Viv     

[momontherun]

Thanks Vivek    It is hard trying not to get turned around while speaking with dd15 - her perception is so... . different. She hasn't self harmed since this conversation  She has tried to run again though... . This time she earned enough trust/status to go outside of the secured walls for recreation time in the play yard (mainly for the under 12 crowd but the older ones get time there every once in awhile). She said she was layin on the grass sun bathing when the same girl that asked her to run before approached her again... . they ran and made it 1/4 through the pasture before getting caught (going forward from where they were there is 2 miles of pasture before getting to the freeway - to the left is fenced in railroad tracks then to the right is a cow then horse pastures then an rv park). DD15 told me in her indignant voice she fought the whole way back and now her knee really hurts as it was scraped really deep ... . She said she knows they didn't mean to hurt her but the funny thing is that after they did she was calmed and came to her senses and chose to walk with them back. She knows this doesn't get her any closer to her goals but can't seem to say no to anyone (except me) in the moment. She knows we are due for a visit, she also knows its not going to happen until we get our personal calls back ... . its all up to her and she keeps throwing the ball at me which I throw right back then her T wants to know how long this should last being pressured by dd15 which I told her 3 weeks of no si and if she does then the 3 weeks starts over - a sort of time out. If she doesn't then we can schedule our week long visitation though this time I will only come in the evenings so its not enabling dd15 to get out of her schedule of school and groups like before. 

Yesterday, I got a phone call for approval to give her a broad spectrum antibiotic for the knee scrape as its now infected as wells, antibiotic ear drops for an ear infection she has. I gave approval for both reminding myself even a small scrape can invite a nasty staph infection (very opportunistic and everywhere) though the ear infection is weird as the second and last one she had was 4 yrs ago but it happens.

Now today, I get a certified letter from Dept of Health and Social Services (one of the boards overseeing dd15's care/funding) advising me of an investigation they are conducting as in April the state of Nevada received an allegation of an inappropriate restraint and they have pulled all the kids from there. Then it goes on to say they are working with all the different agencies as well as, the rtc 'school' to ensure dd15 is safe and they will have their review completed next week then another 3-4 weeks to complete the report then I will be given a summary of the results. If the state determines dd15 is at risk of harm and recommend she be removed or if I no longer want her to be there, they will assist in discharge planning or securing alternative treatment.

Now I am wondering how many kids from Nevada were pulled (I know there are 2 from my state there as dd15 knew her from being committed to the state hospital) and what the circumstances are. Its serious when a state bans an rtc which makes other states take a second look - I get that however, if dd15 gets pulled now I think it will do more harm especially with this 'time out' of sorts as she wants nothing better than to start over in a new place then goes back/forth of coming home... . Her words: one one hand if she were to si it would probably be her death so she needs to learn to cope better and on the other only her family can help her... . I would love nothing more than for her to come home then what? more si, stealing, arguments, sex, drugs, sneaking out, pointing fingers, accusations etc with her brothers being in the middle and court ordered commitments here and there when she becomes a risk to herself or others  :'( The whole point was to give her new coping skills while I patch things up at home and we all learn to live with this but she isn't interested except in mini doses saying one thing yet doing another while seeming highly intelligent yet so uncomprehending ... . a puppet on a string and more of a danger to herself than anyone else could be yet use it to her advantage to be the martyr to fill the endless void she feels   

[vivekananda]

It all gets so messy when there is an investigation... . it undermines confidence doesn't it? And yet, we should feel reassured that there are these safeguards in place. Keep us in touch with what happens.

Your dd is only 15, a young girl (yes with BPD) and girls at that age are bound to be difficult even without BPD. Remember the 'serenity prayer' and continue to work on what you can. When your dd does go home, let's hope you are all better equipped.

Earlier you mentioned the validation techniques here on the site that are so helpful. Is there anything else you are working on? Have you checked out any of the other workshops here? Anything worth telling us about?

Lots of best wishes,

Vivek    

[momontherun]

Sorry I haven't responded until now as I have been busy trying to keep cool during this heatwave we are having, biding time waiting for the investigation to be completed, spending time with my boys and of course, yard work cleaning this place up a bit more. 

Lets see - What's been helpful? Communication tools (validation, puvas, set), staying focused on the subject at hand, radical acceptance, the mood gym (both me and ds12) and dbt for families what have I been working on? my depression, ds12's anger, reinforcing only good behavior and not enabling the bad behavior (giving excuses), practicing and teaching the boys mindfulness, working with ds12's fleas while trying not to be so hyper vigilant seeing the same signs as dd15, re-evaluating my values, getting back in touch with myself, reconnect with family/friends and self care... . my biggest obstacle is getting more than 4 hrs of sleep a night the last couple weeks. It is a lot so I have been breaking it down into baby steps trying to balance it all.

Monday, I received a call from a cps worker from Utah and was informed he was investigating an incident where dd15 was restraint and got hurt. He said, its a routine thing and they didn't find anything that warrants the police get involved at this point and the rtc took drastic measures (firing the staff involved) to ensure continued safety. He had no idea about the other investigation going on and as far as he is concerned his involvement is over.

I called our case manager to give an update of these investigations and see what we could do to cover all bases. He had no idea about the investigations going on since it just started - he did give me a few options to look into though: Benchmark Behavioral Health Systems (rtc in Utah) and Family Centered Services for their Therapeutic Foster Homes in my home town. I called both: BHS is a boys facility and FCS is unwilling to do a review as it hasn't been long enough since her last self harming incident (20 days now  ).

The lead investigator for the Division of Behavioral Health got back to me now their investigation is over - It seems the rtc is taking measures to restructure to provide a safer environment for the girls and they will not be removing the kids there however, taking a closer look at dd15's case she does recommend a lateral transfer to a different facility as there is has been no progress. She also said the Pdoc at the rtc also agree's a new placement is warranted. She said we could try to resubmit her clinical info to the rtc's here however, they more than likely will deny her again especially seeing she has been taking on more intense behaviors than before. She did recommend Copper Hills (In Utah) and Devereux Cleo Wallace (in Colorado) to look into and am wondering why neither of these 2 places were recommended before as they seem to be so much better, more informed and all on the same page (Sparks program - a form of dbt, cbt, ppc, equine/pet therapies etc). After talking to the admissions directors and clinician coordinators for both places, I am going to start the procedure to have dd15 moved to Copper Hills as soon as dd15's T calls me back.

[qcarolr]

mom - so much in short time. hope you can get that sleep now that things seem to be moving. hope the transfer can be a smooth one.

qcr  

[jellibeans]

momontherun

I am just finding this post... . sorry I missed it. What the heck! I don't know where to begin... . first I am glad your dd is being transferred to another RTC... . I think this is a good move. Your dd has been in this place long enough and has only shown small improvements at times and seems to be struggling big time. This is a really god move and I do think I looked at Copper Hills and it looked good.

I think you have certainly learned a lot during this journey and that is a positive thou it must have been difficult and painful at times.

Don't give up... . the change will be good and your dd might be more open to trying new skills. Your dd is young like my dd and I keep in my mind that she is still young and has time to grow and learn good coping skills. A bad day doesn't mean a bad life... . your dd is going through a hard time but things will get better... . believe that heart and soul. Try to keep things in perspective... . there is always be set backs and this seems to be a pattern for your dd... . two steps forward and one step back... . get going forward... .  

[pessim-optimist]

momontherun,

That sounds like a plan. Maybe the new facility will be a sort of 'reset' for your dd and her motivation to try hard. 

[vivekananda]

... . her last self harming incident (20 days now   ). .

I am keeping my fingers crossed for you, let's hope this stretches out into a distant memory. I am looking forward to getting a boring update from you about how life is so normal 

You have been so busy learning all the stuff, but please do get some sleep. You do need to keep healthy. I believe the Dalai Lama was asked the key to happiness and he said 9 hours sleep!  A wise man.

But if you have some spare minutes, have you checked out the 'validation workshop' we have now?

sending you so much best wishes,

Vivek      

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

[momontherun]

I like that pessim-optimist... . a 'reset' for her motivation. I keep saying lately, somethings gotta happen to help her get more stable... . at least more consistency and hopefully a T that has more of an idea how to help her help herself. I realize I was viewing the whole rtc move as giving in to dd15's demands to be moved which would enable her to continue to hide and 'start over' with a different set of people keeping her gone longer though that is happening anyway as well as, increasing frustration, more dangerous behaviors etc. I had to remind myself not every program is suitable for every person and it may have been 'right' for her 7 months ago but that is no longer the case especially seeing how they are restructuring and with all the new hires, they are not all on the same page which is exacerbating her behaviors... . I see that now. 

Ain't that the absolute truth jellibeans? There will always be set backs... . for everyone. I am not giving up - I can't give up... . I just get so frustrated, stressed and tired - I want it all to go away ... . I want that magic wand to erase it however, that is not going to happen. Ok that just sounded like a spoiled brat having a tantrum    Perhaps the 'magic wand' is the tools we are learning and using... . not to make it go away but to learn to live with this so its not so difficult or painful. Your right things will get better its just hard to see it at times. So for a constant reminder I painted 'what will be will be' over the main window in my living room ... . the wall is a reddish pink depending on the light - the writing is in white so it really stands out and my eyes are drawn to it every time I walk in the room.

Oh Vivek , I look forward to that too. How refreshing some boringness would be  I do need more sleep... . I love my sleep and normally could do it anywhere no matter whats going on around me sleeping 8-12 hours a day - that is what I am used to but for some reason unable to lately. So to increase my chances, I have been trying to physically wear myself out doing lots of yard work like redoing the sloping rock erosion control area... . not really a wall just a bunch of big rocks dug up from around the property and stacked across an area of 1100 feet wide by 4 feet high, battling the wild roses trying to eradicate them in the area I want a 'secret' fairy garden in... . 1/4 of the area is dug up (the roots from the cottonwoods and alders makes it impossible to get a rototiller in there) and sprayed with Brush B gone, playing with the boys (swimming, volleyball, races through the sprinkler etc), maintaining my flower and vegetable gardens etc. I get so exhausted and block out all my thoughts to just drift off to sleep then when I am almost there, I get startled by a noise or my leg jerks up out of the blue then I lay there trying to get settled again turning in different directions to get back to that comfy spot. This goes on for 2-3 hrs before I get frustrated and take a bath to relax and read a book for a couple hours then when I get drowsy again, I head back to bed then find myself seeking that comfy spot until ~5-6 am before I drift off for the night but come 8-9 am I am wide awake again. Perhaps my body is in fight/flight mode and I am ignoring it? I do know I am getting one heck of a tan  Now to lose the weight that has been packing on - my normal winter weight is 185, my normal summer weight is 160... . I am at 211. The thing is I just don't care in fact now I have an excuse to go clothes shopping... . its been 7 yrs since I have bought anything other than a bra, socks or a pair of shoes for myself.

I have been keeping up with that workshop just haven't posted to it again ... . soaking up all the wonderful information and letting it all sink in as I re-evaluate and reflect while trying to tire myself out. In fact, I have been doing that with many of the posts I read gaining different perspectives - I do need to participate more and give back what you all have given me. Perhaps when things settle down a bit i'll be in the right frame of mind to do so     

[jellibeans]

monontherun

Be good to yourself... . and take a sleeping pill if you need it... . sleep is so important. I don't know how you function with so little. I have a great deal of trouble sleeping and falling asleep. My H is a really snorer and I am a light sleeper. I need something to help me get to sleep.

I like that you painted a slogan on the wall... . I have printed out different quotes from this site and keep it by my computer to read and look at. Some time ago I saw someone suggest making a happy bag and filling it with items that would cheer you up. A photo of your dd when she was a baby, a video that makes you laugh... . etc

I know how hard it is when things are bad... . I have spent days just crying and feeling very hopeless but I think it comes down to believing that things will get better. Keep the faith and never give up hope... . at times that is all we have during those dark days.  

[vivekananda]

I love fairy gardens... . I love gardening too! Be careful of your back, you don't want to injure yourself.

RE sleep, have you tried a 'meditation' cd beside the bed. There are guided meditations, or just meditative music. It can be wonderful to go to sleep to, and if you wake up, just press the play button again. I think we sometimes need to reprogram our sleep patterns which can go haywire so easily.

Cheers,

Vivek