BPDFamily.com

I have a daughter who has gone 2 rounds in a psychiatric hospital in the last two months and is currently in a day treatment program.  She has massive explosions and then ends those episodes being so distraught she makes a suicide attempt.  Three attempts in the last two months.  Having her at home is difficult. She is disrespectful and verbally abusive to others in the family, especially her 13 year old sister who doesn't handle the constant criticism and mocking very well.  Now that she is 18 her constant theme is, "I'm an adult, you can't tell me what to do."  We have rules and boundaries and we are consistent with those.  Our only leverage is limiting her phone service when she won't comply and or when she is hurtful.  Those limits are often the beginning of her very explosive episodes.  I am ready to let her know that her behavior can no longer be tolerated and she needs to move to her own apartment.  She is finishing up high school and then I would like to transition her.  My question is, how can we do that safely.  She is so unstable that I fear the end result will be suicide.  I want to do all I can to help her function safely and reasonably on her own, but I fear it will not turn out well.  Any suggestions?

How does she feel about moving out? I mean, in general, does she talk about wanting to move out?

I wonder if the recent rounds of hospitalization are connected to the pressure she feels coming from her "adult" age to successfully become an adult. Ending up in a hospital due to extreme behavior seems more like she's (unconsciously) seeking somewhere to actively avoid responsibilities. Not that it's purely her fault, just that the emotional pressures to care for herself overwhelms her ability to manage the volatility she has going on with her emotions.

My SD23 was described by her psychiatrist and therapist as chronically suicidal and knowing that someone you love is wired that way can bring you to your knees.

Have you heard of Marsha Linehan's memoir about building a life experienced as worth living? Linehan is herself BPD and was institutionalized for two years based on her BPD symptoms. Then she went on to develop DBT to help those who were chronically suicidal.

For reasons I can't articulate, reading her book helped me get over my fear of SD23 committing suicide. Or helped me put it in perspective, if that makes sense. That wasn't necessarily the point of the book, I don't think, but reading Linehan's story and how she learned to interact with suicidal patients (acceptance plus change) made me realize what I can and cannot do when it comes to SD23. It's not just a complicated problem, it's one of the most complicated, most troubling mental illnesses that even experts have struggled to figure out.

Linehan describes suicide as a failure to assert one's self. Asserting one's self is explained in more detail in the book. The ultimate assertion of self is becoming an adult and all that it entails, which people who have BPD really struggle with.

Do you have a safety plan for D18? And how does she respond to having a BPD dx (assuming she has one)?

Where SD23 lives there is a DBT clinic that has different levels of care depending on how well someone is functioning. SD23 is not using those resources yet, but we know they are there just in case she experiences psychosis again. I believe it is level 2 that offers twice weekly group skills/ peer group, plus once weekly individual therapy and 24 hour coaching. It's the last part that SD23 really needs. She puts so much strain on family and friends that she wears people out. I think level 1 is inpatient. I can't remember level 3, but it might be the DBT skills group without the 24-hour coaching, I'm not sure.

I think there are a lot of solutions that can help and you're in the right place for support.  :hug: