Communications with mental health provider

[Aralia]

Good afternoon.  I have just found this website and message board and I am completely overwhelmed with emotion reading the posts here.  My dd is 20 and she does not have a formal diagnosis but she checks almost all the boxes in terms of impulsivity, hypersensitivity, narcissism, abrasiveness, lack of fulfilling social relationships, as well as a history of adhd, anxiety, learning disorders, suicide attempts and eating disorders.  She started CBT therapy when she was in third grade, and basically since then has also taken some kind of prescription medication supervised by a psychiatrist.  In the past three or four years, however, things really amped up in terms of the severity of her symptoms and the impact they were having on her life and the rest of our family.

My question for this board is:  how much communication should I expect to have with the psychiatrist of my young adult daughter?    The doctor she has now we found because of her experience treating eating disorders--there were frankly not a lot of choices available during pandemic and this dr was recommended by the in-patient clinic when discharging my daughter.  In the past, my daughter's therapists and doctors were warmer and provided a little more support to us. However, the current dr has made it very clear that my daughter is the patient and she does not communicate with family although we are welcome to leave her a voicemail or send an email if we have concerns, although she will not reply.

I am wondering if this is reasonable with a patient with bpd since they depend so much on their family for care and support.  For example, she is currently in another state with a summer job but called early this week with a whole drama complete with suicidal ideation and asking us to immediately come get her.    We were really unsure what to do and in the past we would have called her dr or therapist to discuss.  (We ultimately did not go get her because of logistics and kept postponing and she seems to have moved on and stabilized.)  She has not even had this dr for a year and we are worried what we will do when my daughter, who had to take time off, is planning to return to college out of state in the fall.

When writing this post, I had to keep editing my sentences because I naturally was writing "we have not had this dr for a year" to "she has not had."  So that is the crux of my question:  is it wrong to think that her dr should be the dr for the family if she has bpd?  How do we get advice on what is the best course of action when she is asking us to do something?  How should we handle the different kinds of anxiety-laden phone calls and texts, which often arrive several times a day?  Should we get our own doctor, assuming it is possible to find somebody (and it's really hard)?

Thank you so much for listening.

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

[Sancho]

Hi Aralia
Your post highlights one of the really difficult issues associated with dealing with bpd and the intense symptoms. We all rely on professional help but in my experience, not all practitioners have a good understanding of bpd and its effect on all those around them.

From reading the posts here I think you will see that parents have different experiences. Some people report that it ends up that the therapist seems to believe everything the child tells them - including things that are clearly untrue.

The bottom line I think is that the therapist has the right to set the conditions when the client is adult. It can be difficult to transition from a scenario when you are all able to be involved, to the current one you have. At least you can leave a message!

This situation can have its positive side. It is a step in a separation process and allows you to perhaps link up with your own counsellor.

I think also it gives you the opportunity to develop skills in dealing with the symptoms of bpd yourself - to have confidence in your ability to know your child and to deal with things as they arise.

For example, you handled the crisis very well. For someone with bpd the intensity of the pain has to be resolved immediately - by stalling you allowed time for the intense emotion to pass. I wish I had learnt this skill many years ago.

I suppose time will tell if this therapist is helpful for your dd. In the long term however, you will be your child's main support and setting yourself up to develop skills to do that is the most important thing.

[Aralia]

Sancho, thank you so much for your thoughtful reply.  It is true, there are positives and negatives to the situation.  I know that my dd feels that if we get involved we will take control.  But also the benefit to us of her keeping us out is that when she gets two completely independent opinions (ours and the doctor's) that also happen to be the same, she can't turn around and accuse us of conspiring with or controlling the doctor.

DD was in two separate residential facilities (not for bpd but other issues) and we participated in DBT training aspart of her therapy, both in patient and the extended DBT when she was discharged.  I think maybe my husband and I will try it again.  I believe there is a course for family members of pwBDP.  Maybe it takes a couple of times to get it to sink in.  The first time we were under incredible stress, we felt accused, it was all new.  The second time was a little more helpful.  Maybe now that we are not in an acute crisis we can relax a little and be more receptive and it will be more helpful.

[Sancho]

That sounds like an excellent idea. I agree - we are faced with crisis after crises and we manage as best we can. When an opportunity comes up to reflect/develop our skills and even just think about ourselves for a period of time, it is good to make the most of it!