How t get adult stepdaughter to get therapy for BPD

[Sailor1423]

Our 30-year old step daughter  has violent ,  uncontrolled outbursts of anger and she has disrupted significant family events such as aa recent wedding. It has been escalating for the last 10 years.  We have cut off  contact with her by saying we love her and want to include her in future family activities, but will not unless she gets into therapy. 
Many have told us she will not go.  This is our bottom line.  We can not have her around other family members or friends and subject them or us to these unpredictable , abusive incidents.
She realy loves her Dad.  You would think she would do anything he asks in order to keep tht relationship.  Are we foolish to think this No Contact will work?

[kells76]

Hi Sailor1423, welcome to the group. Stepparenting is hard even during the good times -- I imagine even more so when your SD30 is dealing with outbursts, violence, anger, and unpredictability.

Here's an article we have on the site about your very question -- is it possible to make a loved one get much-needed therapy:

https://bpdfamily.com/content/how-to-get-borderline-into-therapy

There's a video at the end, too, plus a mention of this book:

"I am Not Sick, I Don't Need Help: A Practical Guide for Families and Therapists", (2000 by Vida Press.) (authors are Amador & Johanson).

Let us know your thoughts on these ideas...

kells76

[Sailor1423]

Excellent article and video on why BPD won't recognize that they are mentally ill and won't go into therapy.  But immediately, I started finding counter-arguments in my head--
What if we just say , we don't think you are mentally ill, but
 we want you to go to talking therapy to just help with interpersonal communication skills.  Skills to  particularly to not blow up in anger when distressed.
Point out that everyone can use improvement in their interpersonal communication skills. But we will not see her again or have her around unless she participates in therapy.

[kells76]

What if we just say , we don't think you are mentally ill, but
 we want you to go to talking therapy to just help with interpersonal communication skills.  Skills to  particularly to not blow up in anger when distressed.
Point out that everyone can use improvement in their interpersonal communication skills.

It's a great question, and it's good that you're thinking of alternate ways to communicate or phrase things. It sounds like you want to be effective.

One way that BPD is described is a shame-based disorder. This can mean that "pretty normal" ways of having a debate or discussion or conversation, where we might use explanations, or try to make a case/argument, or justify why it's important... can blow up in our faces, because pwBPD have such a sensitive radar for feeling blamed/shamed. That doesn't make it "wrong" for us to want to explain why something is important. It just gives us information, that "broadly normal" ways of sharing with people don't always work with pwBPD.

One acronym you might run across here is don't "J-A-D-E". You can check out this link and see if any of it resonates with you, or is stuff you've experienced or tried with your SD30:

https://bpdfamily.com/message_board/index.php?topic=139972.0

Gotta run, but so glad you're posting again!

[Confusion8]

From my own personal experience, therapy doesn’t offer much. Most of the time you are scared and alone and you don’t want someone to tell you have something wrong with you. We feel, experience and interact with the world a bit differently so just a simple comment like, I don’t understand what you are going through but I want to help so tell me what I can do to support you goes a long way. Talking to someone who is like you also really helps, you understand what is happening to know and in turn that rationalises it.

Just some thoughts from a random sufferer. Wishing you all the best

[livednlearned]

What if we just say , we don't think you are mentally ill, but
 we want you to go to talking therapy to just help with interpersonal communication skills. 

Another possibility is to let her know you are taking a time out to learn how to keep yourself safe from these emotional outbursts.

She may not have the capacity to fully reflect on her actions because her pain is so intense and her behaviors are so desperate. Pointing out yet another defect in her, and the need for her to get help, will likely feel like adding insult to injury, even though her behaviors are the ones that are interpersonally unacceptable.

It's really about being effective. Giving people ultimatums usually doesn't work, especially for people who struggle to control their emotions and feel such profound confusion about what's happening, and why.

My SD was an intense walking ball of need unlike nothing I had experienced before. She was more covertly aggressive than overt, probably more of quiet BPD type than externalizing. Trying to reason with her backfired, and trying to get my husband to control her backfired even more.

The only thing that worked was focusing on me and letting go the illusion that I had control over what she did.

Once you feel ready to be around her, once you've learned some of the skills that can help in these difficult relationships, start small. Maybe just you and your H with her. See how that goes. Sort of a love and logic approach. Short visits in public if that helps. Give yourself an exit plan so you can up and leave to protect yourself in case things don't go well.

With my SD, she goes to therapy but we don't think she's honest with her therapist. I'm sure if we did family counseling and shared our experiences and observations she would get a BPD diagnosis, but that isn't ever going to happen.

When I realized she isn't going to get a diagnosis and won't get the kind of therapy she would benefit from, I tried to learn what I could about DBT and will mention things as applicable. I'm not sure how helpful it is for her but when she is in crisis mode, I find it helpful for me to say, "Have you tried boxed breathing?" instead of getting pulled into solving a self-created crisis she is fully capable of solving herself.