How do you handle the hard choices?

[hurtingdad147]

Our adult daughter has BPD. We recently made the decision that she needs to either complete a treatment plan created by a licensed psychiatrist or she will need to move out. She made the decision on her own (she even did all the research and made the calls) to a local behavioral health hospital to start an inpatient treatment for the BPD. We accompanied her to the hospital for support, and when she got there, all the forms she filled out and that we filled out indicated she needed help for her BPD. Once she was admitted, she decided she was only there for her nicotine addition (someone has been supplying her vapes, but we don't know who), and for an eating disorder. She asked for an against medical advice release today. We told her we don't support that and that we don't think it's best for her to be in our house unless she completes the stay and commits to the outpatient follow up.

She's been telling anyone who will listen that we are abusive and don't want her around. That couldn't be further from the truth. We love her and were happy to have her move back in with us (she moved out on her 18th birthday because we were "toxic and abusive"). It's crushing to hear. We just want our girl back to who she was. And telling her she can't come back without having anywhere else for her to go sucks.

Are we messing up? Are we doing the right thing? Somewhere in the middle? We've responded to all questions from friends that she's hurting and we're doing the best we can.

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

[SKYWonder]

Hello Hurtingdad,
     I hear you and understand how tough it feels to "put your foot down" and say you can't come back unless...  Please stick by what you really need for yourself and for her- you see that there is a problem - you know you can't take anymore - and you know that you want her to change.  Don't allow her accusations to sway you to change your mind.  pwBPD are great at manipulations.  They will accuse you of the most irrational things.  Just know that she is just trying to make you change your mind.  She is really asking you to help her when she gets mad and say mean things.  She signed up to go in to get help but is now not being rational.  She will be fine when she calms down and know that this is the best thing for her.

I am hoping and praying things turn out for good for your family.

[Pook075]

Hello and welcome to the family.  I'm so sorry you're going through this and there aren't many answers.

Personally, I do think you're doing the right thing since it's what we did with our BPD daughter around that age.  You're responsible for you.  She's responsible for her.  She doesn't like your rules so let her go see what the world is actually like.  It will be hard, it will be heartbreaking, but this is what she wants.  Give her what she wants and don't let her come home until there's respectful boundaries.

My kid was homeless for over a year, bouncing from couches to a halfway house to wherever she could find.  That entire time, our doors remained opened...if she would be respectful and contribute.  She felt those rules were too harsh, and it was her decision since she's responsible for herself.

Once she did finally come home, she left about a month later because it began to get ugly again.  No problem, she's responsible for herself....she could follow our rules or make her own rules elsewhere.  About a year after that, she had a complete meltdown and started taking her mental health seriously.  Everything changed from that day forward, and we have a great relationship today.  No toxic stuff, no drama, or passive aggressive behavior.

You're only at the beginning and it's terrifying, but as I look back from the opposite side, I would do what you're doing 100 times out of 100.  Welcome her home once she's thankful to be home with family, or let her make her own way in life.  It's all her decision and none of it is on you.

I hope that helps!

[Swimmy55]

I echo what was already stated. 
I, too, had to have my adult son removed from my home after he became violent.  Going to court, restraining order, emergency psych stay, the works.   
It hurts so much.  However, if the quality of your life is such that it is endangered/ diminished by the acts of another adult ( even though your adult child), you have to act on your own behalf. I agree wholeheartedly that if she stays with you , she needs to be on board with continuing getting  help. 

[SoVeryConfused]

I don't have the exact same situation, but I had another child with anorexia. She would also willingly go into treatment and then want to leave. We told her if she did, she could not come home. That was hard. Scary. Sad. Frustrating.

I even had to tell her grandpa that she might call but he could not offer her a bed. That was hard for him. I explained to him - and what I would say to you - this decision is for now. The goal is to get her to stay, and if she feels she has an out, she may not. Our job is to not give an easy out today. It's in her best interest to stay.

If she signs out anyway, then that's a second decision on whether to let her come home or help her with a hotel for a night etc.That decision comes later.

For now, make it known that leaving is on her, and since it's not recommended by the treatment teams you won't support it.

FYI... my child stayed and finished her program. She would tell you today that she understands and is grateful we held our ground because she wasn't able to do it for herself. Not the same as with BPD, but similar enough. I get it, though- all of this is so hard.

[CC43]

I was in a similar situation with my adult BPD stepdaughter. She decided to withdraw from treatment programs early and not complete the recommended follow up. Unfortunately she had to hit absolute bottom before being ready to accept help. And her dad had to give her an ultimatum:  either she follow doctors’ orders, or she’d be on her own (not living in our home or getting any more money from.us). Her doctors also gave an ultimatum:  she had to complete the program, because there was nothing else they could do for her, as she had already tried and/or rejected everything else.  The only other available option would be involuntary commitment.

Here’s the twist:  I think my stepdaughter warmed to the notion of getting help from “professionals.”  She simultaneously avoided the pain of judgment from her family while feeling validated in her victim narrative (that she was so messed up by abusive relationships that she needed professional help to cope). It also relieved her loving dad of coming up with solutions himself. Then his priority number one shifted to ensuring his daughter followed doctors’ orders. Getting treatment became his daughter’s exclusive focus for a time, and she had to do the work. Vacations and other things she wanted to do would have to be deferred until she stabilized. Not surprisingly, the doctors insisted she stop using pot. I’m happy to say that she turned her life around pretty quickly. Though she still struggles and needs lots of support, it doesn’t feel like life and death anymore, and she’s looking forwards now instead of constantly rehashing past grievances and lashing out, out of control.

[once removed]

a quick reality check: people with BPD traits often redefine the reason for treatment the second they feel judged or trapped. it isn’t manipulation in the cartoon-villain sense; it’s their nervous system screaming “danger, abandonment!” and reaching for a safer narrative.

BPD is wired around rejection sensitivity. making housing conditional on total treatment compliance can feel like the ultimate confirmation that “im unlovable unless I’m perfect,” which triggers more flight, not less. research shows motivation grows when people experience collaborative limits (“we’re willing to support you while you work some plan”) rather than either/or ultimatums. rock-bottom approaches often produce homelessness, risky relationships, or self-harm spirals before they produce insight.

a middle-path boundary you might consider:

safety: "you can stay if you’re not actively using illicit substances in the house and you agree to a safety plan about self-harm.”

incremental:  “pick any licensed outpatient or PHP program you’re willing to engage in — DBT, trauma-informed therapy, etc. show up consistently and we’ll keep revisiting how it’s going.”

transparency: “we won’t police every session, but we need you to sign a release so your therapist can confirm attendance.”

house norms: chores, respectful language, no vaping inside—whatever keeps the family environment stable.

framed this way, you are neither enabling nor abandoning. youre offering a stable base while she experiments with commitment. if she decides to bolt, the choice is hers, but it’s no longer because “my parents kicked me out".

for you:
consider a parents’ skills group (family Connections, NEA-BPD) so you’re not white-knuckling alone.
a therapist of your own who knows BPD family systems can help you hold boundaries without guilt.

nobody here is naive about how hard sustained treatment can be, but “loving limits plus a clear on-ramp back into care” generally gives a young adult with BPD the best shot. whatever you decide, keep posting; this stuff is too heavy to carry solo.

more info here: https://bpdfamily.com/content/support-child-therapy

[hurtingdad147]

Unfortunately, we've been down the path of the middle ground. She unfortunately did not improve, but actually got worse. She came by 2 days ago to get more of her stuff. She is couch surfing and seems to have found a safe place to stay for now, but she oddly seemed to be in a much better place. She's not great at putting on a show of safety or happiness for us, so I'm hopeful that she really is doing well. When she left the facility on Monday, she said she would show us she could get better and I told her I believed her and hoped she would. She's still pretty mad at me, but she'll still talk to my wife and her siblings. I'm hopeful.

[kells76]

She is couch surfing and seems to have found a safe place to stay for now, but she oddly seemed to be in a much better place. She's not great at putting on a show of safety or happiness for us, so I'm hopeful that she really is doing well. When she left the facility on Monday, she said she would show us she could get better and I told her I believed her and hoped she would. She's still pretty mad at me, but she'll still talk to my wife and her siblings. I'm hopeful.

Given the circumstances, that does sound like a lot of hopeful signs. She is with relatively safe people, is talking about proving that she is getting better, and is in contact with multiple family members.

It's great that you could validate her expression about getting better 

Not sure if you've mentioned -- how old is she?

[hurtingdad147]

She is 19. She moved out on her 18th birthday because she didn't like our boundaries (she never has - hallmark of BPD, I know.). She lived with her boyfriend and his parents for almost 6 months before they broke up and she moved back because she had nowhere else to go. She moved back in with in December. She has not really held a job very long. She just lost her most recent job because she was saying inappropriate things about upper leadership and creating drama. She has at most been working about 20 hours/week for $10/hr and claiming that it is too hard (she was a hostess at a restaurant that isn't super busy) so she doesn't have the energy to do anything else or find another job. It's hard. I was very much in freeze mode on Monday (I literally couldn't move from my desk or get my hands off the keyboard). The whole world felt tilted. I'm doing better now, but it still sucks.

[CC43]

Hi again Dad,

I feel for you and can relate.  I'm in a similar situation right now.  Alas, the middle ground doesn't always seem to work very well with my BPD stepdaughter, because she thinks, she's an adult, she can do anything she wants, and yet she expects her dad and me to continue to finance her life indefinitely.  The good news is that she managed to graduate from college, and she didn't give up after numerous failed attempts.  The bad news is that she seems allergic to working.  She was fired from her very part-time job a while back and didn't replace it.  Her college health plan is coming to a close, as is her apartment lease.  Her dad said that now that she's a college graduate, he expects her to get a full-time job with benefits and get on a path to supporting herself.  He offered to let her live with us so that she could save up some money, as long as she stayed on that path, and as long as she was respectful in the home.  He doesn't even expect her to do chores (she never has done chores anyway), or help pay any rent or living expenses.  But that's not what she wants.  She wants him to find her an apartment in one of the most expensive cities in the US, far away from us (her support system), and sign her lease without having a job lined up first.  She wants yet another summer vacation, and then to get cosmetic surgery, even though she won't have insurance, before she starts a job search in earnest.  She's being naive because she is underestimating the cost of living in the expensive city, as well as her job prospects, given her lack of work experience, and yet she's resistant to getting any sort of starter job, let alone a full-time one, that would bolster her skills, resume and wallet to put her on track for a job that she aspires to, in a city where she thinks she wants to live.  For now, she's declining the offer to live with us, because she doesn't want to, which I understand to a degree.  But her handicap of emotional lability is preventing her from getting on with what she should be doing (searching for a starter job and an apartment nearby that she can afford), and her priorities seem to be all mixed up.  She's focused on wants (cosmetic surgery, vacation, airplane travel, going to a city with a supposedly better dating scene, etc.) and not needs (leveraging her degree to get a job, any job, with health insurance benefits).  She has a list a mile long of all the reasons she doesn't want to consider this or that job, and it's both disturbing and tiring, because she can't express what type of jobs she WOULD consider.  Her entitlement and negative aura are so taxing, I don't even want her in the house at this point, and I really hate to say that.  The joy of celebrating her graduation, a wonderful milestone, only lasted a couple of days before the demandingness and petulance set in.  I understand she's anxious about the future, and we offered to help her ease into it by letting her stay with us, as well as assist her in her job search (I think I'm really good at that!), but she resents the help because it's not the help she wants, i.e. unlimited spending money and an expensive lease co-signer with no strings attached.

I know the situation I describe is a bit different, but there are some parallels.  My husband is saying "You are welcome here if you work towards getting a job with health benefits," and you are saying "You are welcome here if you focus on therapy right now."  Around three years ago my husband said the exact same thing you are saying right now.  Maybe that could give you a little hope?

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

[CC43]

Hi Dad,

I just read your last post, and my immediate reaction is, she's so young, meaning, she can turn things around before derailing her whole life!  You say she had a part-time job, and I'd say, that's fantastic, especially at her age.  My stepdaughter is much older, and she just went through the exact same thing:  working as a server for very part time, maybe 12-15 hours per week, at an easy/slow restaurant.  Though my stepdaughter has had some success with employment, by the same token, she creates drama and either quits or gets fired after a time.  I suspect that her general negativity and low energy play a role, too, and so when there's a poor customer interaction, her manager doesn't give her the benefit of the doubt.  At your daughter's age, I guess that is to be expected, but at my stepdaughter's age, it's even more painful, because the stakes are much higher, and the "price" of lagging behind her peers seems higher, too.  Plus it's a big hit to her self-confidence to get fired, even if she blames others for it and has a litany of excuses.  And the complaints that the job is too HARD, too TIRING, she can't DO THIS are exactly what I hear over and over.  And I'm thinking, when I was her age, I worked on average 80 hours per week (in a very demanding professional field), for two decades in fact, after which I downshifted to 60 hours per week.  But in my stepdaughter's mind, she thinks her fatigue is extreme, and she probably fails to realize that work is hard, but you choose to power through it, because you want the paycheck and to stay on track in your career.  Grab a coffee, put on a smile and get cracking like everyone else, and you can go to bed when you get home.  But I can't say this, because for her, it's all about emotions in the moment.  For me, it's all about actions.  She's a feeler, I'm a doer, and so there's that disconnect.  I don't know if that perspective is helpful at all.

My second reaction is, though your daughter probably thinks she can do whatever she wants, she really can't at her young age, and that's an advantage for you right now.  She needs you to be strong and help her decide to get help.  I know it's really painful and can be discouraging, but you are showing her you LOVE her by trying to get her help (by not enabling a self-destructive status quo), no matter what she says when she's in a mood.  Today, my stepdaughter (when she is stable) will say that her dad SAVED her life by getting her the professional help she needed.  She might pretend to forget that from time to time, but it is what she really needed.  And she is doing better, the stalled job search notwithstanding.

All my best to you.