I'm starting to think I am in denial

[Elbry]

My DD and I had a meeting today with a Nurse Case manager.  It was the first time meeting with her, she has come into the picture to try and minimize my daughters hospital visits, and to help us come up with a plan to do that.  My DD was her usual uncooperative self answering with "I don't know " to everything and becoming agitated and snarky when pushed.  After dealing with history, the conversation came around to what do we do now?  DD does not want to cooperate with HCT, or Individual therapy or groups.  She has never engaged or really talked in individual therapy, she just says "I don't know".  After months of HCT, she engaged a little bit but not much it was still mostly " I don't know" to everything.  And in DBT group she just sits there.  So the nurse said there are only 2 more options, one more type of therapy (I can't remember what it was) or residential.  And considering safety concerns, residential is probably what we are looking at.  Well, that's when the tears started, and the "you just want to send me away" and "you just want to get rid of me because you can't handle me" started.  Now I'm crying.  The nurse looks at me and says " she's manipulating you right now".  And my immediate thought was No, she's upset, she has a right to be upset about going to residential.

So then the nurse asks DD to fill out a couple questionares (sp)  and she flat out refuses and I told her if you keep refusing to cooperate with everything, and refuse to be safe, there is nothing left but to send you to residential. And she still refused to cooperate. She continues to berate me with how horrible I am to send her to residential, how I don't care about her, I just want to get rid of her etc etc.

As the nurse was leaving she said "I don't mean to come on too strong, but I have to be honest with you and you probably won't want me to come back, but I am going to tell you again, that is nothing but manipulation". 

I have been thinking about this all day.  I think I have denial about my DD.  I see her as sick, and I believe she is, but I am thinking maybe I excuse too much of her behavior by blaming it on her illness.  She does have choices.   How do you tease out what is in their control and what isn't?  I know she lies to me, she steals, she sneaks around... . I think I need to toughen up.  It's hard because every confrontation gets blown up and then I have to worry is she going to cut or is she going to try and kill herself.  I just started reading "How to Stop Walking on Eggshells".  That's exactly what I have to figure out.   

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

[MammaMia]

Elbry

Manipulation is a HUGE part of pwBPD getting what they want and they can be very creative about it. You do not even know it is happening until it is too late.  

I hate the "I don't know" reaction to everything they do not want to address. I get it from my adult BPDs and it becomes infuriating.  Another irritant is that they cannot answer a question... . hate questions.  Ask a question... . you get a question OR "I don't know".

This is classic.

You could try the case manager's suggestion for a few days and see what happens. 

[Rapt Reader]

I'm sorry you are having to go through all of this, Elbry... . It's not unusual, though, and the Nurse could be right--though as her Mom, you do know your daughter better than anyone else, so I don't want to discount your own interpretation of her behavior.

You say you are reading "Stop Walking on Eggshells" by Randi Kreger. That's really great, and it's a good book to start understanding your daughter. Another one (the one I read after "Eggshells" is "Overcoming Borderline Personality Disorder" by Valerie Porr. I highly recommend that one, too. It was the book that actually gave me the deep understanding of my BPD son's disorder; it takes a while to finish (it's very informative and you need to take breaks every couple of chapters or so, to let it all sink in), but it's become my BPD Bible and go-to book when I have concerns or questions. The Index is good for that, and my copy is dog-eared, bent up, and has cappuccino stains, but I love it 

My son also manipulated me and my emotions as a teenager and in his 20's (and I shouldn't lie... . even beyond that; he's 37 now, and only in the last year--since his BPD diagnosis and treatment & recovery--has he truly stopped manipulating me). I was totally justified in believing that he had a mental illness that caused his trauma-filled perception of his life, and his "reasons" for his behaviors. But, he was a master at tugging at my Mom heartstrings, knowing that my empathy for the reason for his troubles could be counted on to help him out of them.

Only when I was physically separated from him and unable to protect him from himself, did he end up self-destructing enough for him to end up being admitted to the Programs that found his diagnosis and treated him for it. Had I realized in the years and months and days before the spectacular flame-out of his that landed him in the Psych Ward of our local hospital, and then the Dual Diagnosis Program that diagnosed him and started him on the treatment that began his forward turn in the right direction of recovery, I would have been firmer with him and let him fail enough to get to that point many years earlier.

You are so very lucky that she is so young and can be admitted to the RTC now, in time to save her young years from the trauma and self-destruction that plagued my son until he was 36 years old. You are doing the right thing by having her treated and going to a RTC; don't ever forget for one tiny second that you are helping her at a time that she can't help herself. She may be manipulating you, or maybe is sincerely petrified that you "just want to get rid" of her. Or, maybe it is a combination of both. But, you do know best, you know your own heart and that you are doing the right thing no matter what she feels. Be strong... . make her go. Now. When you have the chance... . Validate her feelings, her fears of going. But then tell her the truth: that she has to go because she needs to.

When she is 36 years old (or 26 years old), and probably further from your control than she is right now, she might have to actually have her beloved car totalled, get arrested for possession (being addicted to something terrible for several years up to that point) and decide to kill herself, before finally being admitted to the Psych Ward and then the Dual Diagnosis Program that saves her life, to get her life in order. Please don't extend her torment and troubled years if you have the chance to get her the right help now... . You are lucky to have found this site, and the right reading materials and posting parents while your daughter is so young 

[RunningWithScissors]

Elbry - I just want to extend my support.  It can feel like you're in a 'no-win' situation trying to figure out what to do when your loved one doesn't seem to be helping themselves. 

I certainly don't know all the details of your experience, but I would give serious thought to the comments of the nurse.  In my own case, my husband and I learned early on that our son was capable of doing anything (supporting himself, participating in therapy, attending school) only if he wanted to.  If he didn't want to do those things, nothing would convince him to do it.  Our challenge as parents was to find ways to convince him that the pain of doing things was less that the pain of not doing them.  For example, his habit of skipping school quickly ended when I told him I had taken a leave from work and would be escorting him to school, and sitting beside his desk to ensure he stayed for every class.  He wasn't happy, but decided he was able to attend without parental supervision.  Since then, we've had to let him experience the consequence of other behaviors just to allow him to learn what works and what doesn't (i.e. not paying rent = eviction, eviction = living on the streets).

I don't presume to know what to suggest in your situation, but pointing out that vague answers and other evasions will result in placement in a residential program seems like an appropriate link of action to consequence.  It's a struggle watching our loved ones grapple with some of these easily avoided crises, but sometimes our wish to rescue is counter-productive.  The need for change usually starts with us.  I guess one question to ask yourself is 'Has my approach in the past given the desired result?'  If not, it's time to try something else - with all the love and validation you can muster.

[jellibeans]

I will second the book "Overcoming BPD by Valerie Porr" truly the best book out there!

I do think your dd is manipulating you... . they are very samrt and they know how to get things done... . your dd also sound like she is ODD as well... . that is what my dd16 struggles with the most and I am sure is what is holding your dd back from getting the help she needs.

I think being consistant is one of the most important things to do as a parent. Putting those boundaries in place and keeping with what you said. I don't think it is a matter of tough love but it is a matter of having consequences for their poor choices.