How to progress through therapy when it's hard to stop ruminating about the past

[HelloHowAreYou]

Hello! I'm happy to find this group. My 27 year old daughter was diagnosed with Bipolar 1 after a breakdown in college which was centered on a delusional relationship with a young man who was an acquaintance. My husband and I had no exposure to mental health providers until that time, so we learned as we went and trusted them. I often questioned why her "mania" was only ever experienced as agitation and anger - never the typically described energy and high productivity. Every time I was told that's a form of mania too.
Over the past 7 years she has tried dozens of medications, had 3 hospitalizations, 12 ECT treatments (at her insistence), many angry outbursts, and frequent manipulative announcements (we refer to this privately as "dropping bombs"). She only got worse over time. Every provider took the diagnosis she had, and never questioned it. I decided to do my own research, and took her to a private hospital we cannot afford for an assessment. That's when I learned about Borderline. She checks 7 boxes for that. She's now in DBT therapy 3 times per week (2 individual, 1 group).
And I have a question:
She has never progressed much in therapy before - even with a previous DBT therapist - because she doesn't do the work in between sessions as required. She brings all her emotions to the sessions, and they dig into that, but never build the skills. She has a hard time getting past the inner voice that replays every upsetting thing that ever happened in her subjective experience. She literally wallows in it - it consumes her and tortures her all day long. There is never any mention of abuse, but she is highly sensitive, and one of 3 children, and she feels her needs weren't met either at home or with friends. How can I help make this time different? I want to understand her pain, but also to challenge her to move on. I feel like her previous therapy was wasted, and we all need her to progress this time. She desperately wants to progress, and is committed to therapy, but needs to figure out how to benefit from it instead of just using it as an opportunity to vent. If you can provide me with things to say to express this in a beneficial way, I'd be grateful.
Thank you!

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

[Swimmy55]

Welcome! 
The positive is that she is in therapy and accepts her BPD.   The BPD adult child ruminations are extremely challenging , we know.  It is essential for parents to know that they also have a right to help as well.  As a matter of fact, one of the recommended books in the library here is " Walking on Eggshells" which states the best way to help the BPD person is to help yourself first especially as your daughter is an adult. 

Your first step in self help is writing here and we are so glad you did.  Please read around this site and others' posts as well.  In addition , some of us have our own therapists to help with navigating our BPD loved one.  I also go to a 12 step program like Codependents Anonymous or alanon, as they teach detachment and they are free fellowships.  Detachment is the practice of letting go ( with love) another's behaviors, thoughts, etc as we ultimately don't have control over these; we only have control over how we react ( or not). Please write back as you are able, we are here for you.

[zachira]

How does the therapist respond when your daughter is venting?

[FaithHopeLove]

Hi Hello
I join Swimmy and Zachira in welcoming you to the group. As Swimmy said, it is great your daughter accepts her diagnosis and is in therapy. Of course you want her to do her homework as well and hopefully that will come. But I think it will have to be in her own time. That said there is a lot you can do to improve the communication between you. I see you are already working on empathy which is great. Here is another skill you may be ready for called SET (support, empathy, truth) SET Is this helpful?
Hugs
Faith

[HelloHowAreYou]

Thank you all for responding! I definitely have empathy for my daughter; I think my issue is watching her fail time and time again. I hope this time will be different. With us, she has alternated between the person with borderline who acts out, and the "quiet type" who is practically mute. I have some of her therapy records from different providers, and they state that she "cries and screams" through sessions. They have allowed it and, I think, remained calm. This went on for years with different providers, and I wonder if it became more enabling than helpful. I'm sure the medications didn't help either. But eventually, I would think this phase has to end so she can focus on recovery. I'm thinking of reaching out to her current therapist (we communicate openly) and letting her know we need her to challenge our daughter to take another step forward. Her belief in herself has dwindled so much - and it was never strong to begin with. I'd love to know your thoughts - how can I push her in a loving, but effective way? We start every day with positive talk, repeating "I won't listen to the negative self talk in my head," etc., but then she says "I can't" throughout the day. "I can't read," "I can't converse," "I can't work," etc.
I'm grateful to have found this group. I have met with a therapist, and I have 2 very strong support groups of friends - we all share our "stuff" openly, so I feel heard. It's so hard, though. One moment, we're being criticized and judged; the next, she's mute and her gloom permeates our home. I know it's worse for her than us, but I have to show myself and my husband some grace too. We've worked hard to provide a stable, loving family life for our kids, and still, we must not have met her needs. It's so difficult to come to terms with that.
Thanks again for reading and reaching out!

[FaithHopeLove]

Have you had a chance to read the article yet? Pushing or challenging a person with BPD can be tricky business. Their sense of self is very fragile. That is why I am recommending the SET method. Many of us, including myself, have found that it is an effective way of communicating with our loved ones.

[HelloHowAreYou]

FaithHopeLove,
Thank you! I read through the SET information and I'm trying it.

[wendydarling]

Welcome HelloHowAreYou I love your name!

As Faith says our children are fragile, a 'push' or 'challenge' would tip my quiet BPD in the wrong direction, cause conflict. Like you I had little experience of mental health services until my DD was hospitalised and then diagnosed a month short of 27 in 2015. DD's been through 19 months of weekly DBT 14 months 2016/17, 5 months group 2018. The challenge certainly is to implement through gentle practice, practice the skills, tools, lessons just like we do here so I'm pleased you are giving SET ago.

We start every day with positive talk, repeating "I won't listen to the negative self talk in my head," etc., but then she says "I can't" throughout the day. "I can't read," "I can't converse," "I can't work," etc.

Is your DD initiating the positive talk at the start of everyday and then flipping to 'I can't'...?

WDx

[HelloHowAreYou]

I initiate the positive talk, and she usually joins in with a smile. As the day progresses, especially when there are challenges, she may start saying "I can't," but she generally ends her day early and we try to start fresh the next day.
I'm sure you've heard of Dr. Daniel Fox? I just discovered him on Youtube, binge watching about a dozen short videos about BPD. Some people have Netflix...but I digress.  Later, I showed a couple videos to my daughter. They really struck a cord. Just about an hour ago, she started crying and complain about what she "can't" do, comparing herself to siblings and others who seem to have it "so easy," and she's "stuck with this personality." I wanted to comfort her, and after validating her feelings, I pulled up Dr. Fox's video, "BPD and Catastrophizing." She watched and the switch was flipped... she calmed down. I'm grateful she wants to recover, and grateful for providers (even online ones) who help.

[PeaceMom]

Thank you Hello-
For sharing the Dr. Daniel Fox information. Wow, he seems to be very passionate about giving hope to those w/BPD. I’ve watched several of his videos and see that his messages seem to align with the books on BPD  that I’ve read.  He may even be more optimistic than those authors which brings me hope. I’m going to figure out how I can effectively share one or two w/my UBPD 19 yr old Daughter who has ignored the suggestions that she may have BPD. She’s addicted to social media so this may be right up her alley.

[Rev]

If you can provide me with things to say to express this in a beneficial way, I'd be grateful.
Thank you!

In my estimation, your question is very large for the scope of what can be written here. It is too simple a thing to say that there is very little you can say - that it is really more about the non verbal communication in how you say what you say, and more importantly, the timing of it.

Even as I believe what I say here is true, I know that there are a myriad of nuances so necessary to grasp that are tied to your context (not to mention the general stress of the situation)  for you to excel at  being the supportive and loving father that you are

Generally speaking, we can say the right thing, say it badly, and if the timing is right, it lands.  Alternatively, when can say the right thing, say it beautifully and if the timing is wrong, in fails horribly.

So - I would strongly suggest you get yourself into counselling as well. Those nuances can be teased out there.


Good luck. Godspeed.
Rev.

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

[wendydarling]

Hello

Just about an hour ago, she started crying and complain about what she "can't" do, comparing herself to siblings and others who seem to have it "so easy," and she's "stuck with this personality." I wanted to comfort her, and after validating her feelings, I pulled up Dr. Fox's video, "BPD and Catastrophizing." She watched and the switch was flipped... she calmed down

That's brilliant! It all adds up Hello, every single breakthrough is building a new narrative, that she can and she's not alone, there are people who get it, we are all walking with her. One thing I learnt with my DD is to not assume they are not working hard despite their struggles (often we may not see how hard they are working, much is internal work), they are doing their best like we are.

I'm wondering how long your DD been with the present DBT team, 1 group, 2 one to one? What happened with the previous DBT team you refer to? How come she left, was it her choice, did they ask her to leave?

I can see where your DD get's her determination and commitment from.   I relate, my modus operandi once DD was in DBT was to butt out, stand back lovingly, wait patiently, give her space to do the work, for her take responsibility, dig in. It worked. My DD was alcohol dependent (likely drug meddling, or more) suicidal, hospitalised...in the pit. She's since helped many people like your DD stay with. DBT.

We have a saying in our home, fill the hole with DBT, I hear you are too.  

Is your DD reading any life affirming BPD books?

WDx