Adult stepdaughter with possible BPD (trigger warning: suicide and abortion)

[SummerZinnias]

My stepdaughter is in her late 20s, and I'm beginning to believe she has BPD. Her mom killed herself when my SD was a teen, after years of substance abuse, infidelity, and abusive behavior towards SD's dad. My husband divorced her mom, and her mom died a couple of years later after many suicide threats.

My SD was resistant to therapy after her mom died, and her dad didn't push it because SD seemed ok. She was still top of her class, star athlete, and a favorite employee at her part-time job. Very high-functioning.

Looking back, she's always had relationship issues. Her high school boyfriend was nice enough, but boring so she'd pick fights with him.   She ended up cheating on him with another guy right before she went to college, and it's been a series of very tumultuous relationships ever since. Fighting, cheating, occasional physical abuse (sometimes by her).

She is very successful in her career, but her personal life is a different story. She luckily still has a couple close friends but has alienated many more (it's always their fault, but that's become a pattern).

She parties non-stop when she's not working, to the point where she'll wake up in random apartments or sometimes her own, not knowing how she got there. And with that goes risky sexual behavior. She's had multiple STDs because she won't insist on protection and even went off birth control last year.

Our relationship with her is pretty stable, but I feel like we all have different roles. Her older brother gets angry at her and compares her to their mom, so they fight. I'm more of her confidante about all of her drama. She's close with her dad but doesn't share much about her personal life because she feels judged. We've both brought up therapy, but she'll go a couple times and that's it. There's always an excuse why she can't go back.

There's so much more, but I'm going to get to the latest incident. She called me last week and told me she's pregnant. And she's going to have an abortion. (I really don't want to debate the morality of this - I'd just like to discuss my concern about her.) She is in a fairly new relationship but cheated on him last month. She's not sure who the father is. She also lives in a state that has outlawed abortion, so now she's also put herself at legal risk.

I am honestly terrified for her. The actions that led to her pregnancy were so careless - going off BC when she's having unprotected sex, cheating, drinking to the point of cheating. I'm so afraid she's going to wreck her her career or we're going to lose her, either through one of these actions or by her own hand.

She lives across the country so we only know what's going on by visiting her or through what she shares with us. And it is so hard to talk to her - she's very good at twisting things to justify things to herself or she'll promise to try therapy again or she'll get defensive.

We're in therapy, and our counselor has tried to guide us in how to approach this with her, but I really feel like she doesn't grasp the depth of SD's issues. I think SD needs to see a psychiatrist, and I don't know how or if we can help her see that.

We're looking at flights to go see her ASAP after she recovers, but I don't know how to talk to her when we get there so that she'll hear us. Do we approach it like an intervention? Do we go in with a checklist of her actions that concern us? Do we suggest a psychiatrist? We always handle her with kid gloves - do we show her the full scope of our worry/anger/anxiety?

Thank you if you read all of this, and for any guidance or words of wisdom you have.

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

[SummerZinnias]

I should also say that although I didn't get into it all in my post, I think she meets at least 7 of the 9 traits in the BPD description. I'm not sure about suicide ideation/self-harm or dissociation/paranoia.

[Sancho]

Hi SummerZinnias
I can well understand your concern and anxiety. It sounds like sd meets many criteria for BPD - but being able to hold a position in the workplace and maintain independence are high functioning for sure.

My dd also has a self destructive life style - but is low functioning.

The issue is always that WE see consequences or possible consequences, but they don't or they are so impulsive or emotionally needy that the short term relief from their intense symptoms over rides any thought of consequences at any given moment in time.
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It is natural to want to 'fix it' - usually this means by trying to get them to understand and then to change - to commit to therapy in such a way that change will happen, or to try some medication etc etc.

I think it's good to look to the past to guide you in the future. SD hasn't committed to therapy. How does she react if you bring up anything that is a bit challenging?

As things stand, you are a confidant for sd and she has a good relationship with her dad. I think that it is important to protect these roles and in order to do that it's important to look at each option you can think of at this point in time and identify the possible consequences of each option.

One of the things talked about here is 'learning by natural consequences'. It can be so hard to be watching a slow train wreck but I am not sure we can prevent it. Being there for a bpd child is so difficult - yet it perhaps is the best gift we can give them.

I hope this makes sense! I feel I have been a bit wandering!

[SummerZinnias]

Not wandering at all! Thank you for your perspective.

I have alcoholic parents, so I understand the futility in hoping that people who are struggling will have a lightbulb moment and seek help. We just want to convey to her that while we love and support her, we have grave concerns, without walking on eggshells like we usually do.

You've given me some things to think about. Thank you!

[CC43]

Hi Summer,

Your concern and desperation are justified. It’s so hard witnessing a loved one suffer trauma and make a series of self-destructive decisions. If your stepdaughter has BPD, she’s likely making those decisions because of intense internal pain. When she’s suffering she probably can’t think straight or doesn’t care about consequences, even is they are dire. In a way she might think she doesn’t deserve to treat herself in a healthy way, because she basically hates herself. Low self esteem and negative attitudes might be plaguing her.

One question that comes to mind is whether she’s truly pregnant. I’m wondering because BPD is often associated with fact distortion, subconsciously designed to hurt an enemy or to deflect blame. It might even be a cry for help. My adult stepdaughter has been diagnosed with BPD, and she will often distort the truth such that she’s perceived as a victim of abuse (in line with how she feels, and to get attention or seek help). Just something to consider.

Even so, I think your stepdaughter has achieved amazing professional success considering her traumatic past and BPD behaviors. It makes sense that she would have trouble getting past the past. That’s something that therapy may be able to help.

A huge asset though is the support of her dad and you. I think keeping the lines of communication open with her will be important. It didn’t sound like she was abusing you, so that’s a huge plus too.

For therapy to work, your stepdaughter would have to want to change to get better. I don’t think you can force her into therapy. But maybe this latest incident could be her « bottom » that makes her realize that she can’t continue on like this. If you’re lucky and she talks with you, maybe she’ll open up. But if she’s adamant that others are to blame for all her problems, and she’s the victim, that’s a defensive tactic. When she’s thinking that way, she can’t take responsibility for her choices and she’s not ready to change in my opinion. That line of thinking indicates that she expects others to change, not her. If she’s talking this way, if I were her confidant I probably wouldn’t try to mention therapy. But if she’s saying things like she doesn’t know what to do and she’s desperate, I might see that as an opening to try to talk about therapy. Maybe she has PTSD, or BBD, or depression or a mix. It might be a relief to know what’s ailing her and get customized treatment, whether medications, DBT or something else. Doesn’t she deserve to feel better, even just a little? 

[js friend]

Hi Summer zinnias,

My udd has always told people that I have never there for her (of course not true) so I would make sure to your remind your dd that you are concerned for her. I would frame it in a way that you are concerned for her safety and being taken advantage of rather than to make it about her behaviour. In my experience bringing up their behaviour just brings  more shame and will push you further away. Pwbdp already know what they are doing or have done and dont want to be reminded of it. As others have pointed out your dd must want to make that change, but it wont be until she is truly ready and maybe it may be too stressful at this time to bring up therapy and psychiatrists. I dont think you should go there with any agenda other than to just support her. This is a time that you just really need to play this by ear.