18 year old daughter with BPD

[Tamara96]

I am new to this site!

I am hoping some of you can offer us some guidance

Our 18 year old daughter has shown signs of BPD for a very long time. Her life is simply slowly but surely spiraling downwards. She is not attending college, works sporadically, changes jobs frequently. (she was a high acheinving student, who did it effortlessly, and always had a desire to become a surgeon she has a passion for human anatomy). To us, her mental health is much more important than her studies, so that is our focus with her.


We are doing all we can to encourage her to get help but she refuses. She attended DBT a sessions only 3 times and  dropped out, because she  can not talk about feelings.

Her therapist of 4 years told us that it is becoming very evident she has BPD, and has told us that until she wants help, there is little that any of us can do.

We have approached her about receiving more treatment, she refuses.

We are exploring residential treatment options and wilderness camps and are open to offer any of these, but the issue comes back to: she doesn't want to get help, therefore she will not go.

Does anyone have any suggestions on how to convince a BPD Young adult that she/he needs treatment? We just want her to find inner peace.

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

[Rapt Reader]

Hello, Tamara96 &  

I'm really glad you found us--I have just the information you are looking for: Getting a "Borderline" into Therapy, and it is loaded with advice for the type of situation you are in right now. You are right that unless your daughter is willing to get the help, it is very difficult to force her to do it. According to the Article linked to above:



What can we do for a loved one with Borderline Personality Disorder traits?

If we want to help a loved one to get into therapy and, more importantly, to embrace the therapy, we need to "plug in" and understand both the perceptual filters that our loved one has, and their motivations.  This generally requires a great deal of listening.

Studies show that there are three areas that are most productive for family members to focus on.

Building trust. Not blaming or not finding fault, but rather respecting our loved one's point of view, listening without telling them that they are wrong - especially regarding their point of view that they are not ill if that is their thinking. Amador says that family members and clinicians should listen carefully to the loved one's fears.  "Empathy with the patient's frustrations and even the patient's delusional beliefs are also important", remarked Amador, who said that the phrase "I understand how you feel" can make a world of difference.

Reinforcing the developing awareness.  Reinforce the struggles that the loved one perceives as concerning. One of the most difficult things for family members to do is to limit discussions only to the problems that the loved one with the mental illness perceives as problems - not to try to convince them of others. Work with what you have. It is important to develop a partnership with the loved one around those things that can be agreed upon.

Our belief that the loved one will benefit from treatment.  Our loved one may be happy with where they are and moving them from this position is as much art as it is science - and it may take time.

What Not To Do

Professionals do not recommend that you tell a loved one that you suspect that they have Borderline Personality Disorder. We may think that our loved one will be grateful to have the disorder targeted and will rush into therapy to conquer their demons, but this usually doesn't happen.  Instead, this is difficult advice to receive and more likely to sound critical and shaming (e.g., you are defective) and incite defensiveness, and break down the relationship trust.  It's not like a broken leg where the affliction is tangible, the cure is tangible, and the stigma nonexistent.  While we are grateful to learn about the disorder and the pathways to recovery - for us the information is validating and represents a potential solution to our family problems- to the afflicted, it is shaming (you are defective),  stigmatizing (mental illness in general, Borderline Personality Disorder specifically), and puts all the responsibility for the family problems on the loved one's shoulders.



I do recommend you read the whole Article I linked to above; the whole thing is really very helpful and eye-opening. All of the members of this Board know exactly what you are going through--each one of us also wants our child with BPD to have inner peace and a happy, successful life just like you do, Tamara96... .Please let us know what you think of that Article, and if you have any questions. We really do care, and want to help  

[SlyQQ]

A sideways approach always seems to bear the most fruit if you are critical try not to place the blame squarely on her shoulders e.g. My BPD step d not getting enough sleep the weather is so hot / cold i have had trouble sleeping have you awnser ... .yes or no oh well you have been looking a bit tired I thought that may have been it reinforce this several times through the day one way or another wout confrontation an hope it takes the same can be done with encouraging therapy but a much longer ( months or even years ) time frame bringing it up indirectly when ever something goes wrong a friend of mine went to therapy when she got sad they ... .etc etc hopefully eventually they will think it is there idea to improve things get better 

[Eggdad]

My dd was 20 when I learned about BPD and was pretty convinced she fit the dx. I struggled about how to approach the subject with her and finally bought an autobiography of a recovering BPD. I showed her the book and said "The emotions the author describes in this book remind me somewhat of how you sometimes describe how you feel when you're feeling down. I thought it may interest you." She read the book and completely identified with the author's state of mind.

I don't think she would have accepted my telling her flat out I thought she had BPD or been interested in a clinical book on BPD. The autobiography format was the perfect approach.

[Tamara96]

Thank you for all this information.

I am reading up as much as i can and watching all the informative videos. It is all so helpful, but a lot to digest.

In reply to Eggdad - I know my daughter suspects she might have BPD as she mentioned it once in passing to me a long time ago. She is not a reader, so I am not sure she would read a book, but I am happy to give it a try. What is the name of the book.

[Eggdad]

The first autobiography we have read is unfortunately not available in English, but the second is:

1) L'ennemi en moi, by Etienne Gervais

2) Get me out of here: My recovery from borderline personality disorder, by Rachel Reiland

Dd has been an avid reader since she was 10 yo, being immersed in books was her main coping mechanism to escape social interaction and her inner pain since that age. I guess that's why reading a book worked so well for her.

I have also seen good comments about "The Buddah and the Borderline" by Kiera Van Gelder but haven't read it myself.

[Rapt Reader]

My adult (37) son who was diagnosed with BPD in 2013 has read both "Get Me Out of Here" by Rachel Reiland and "The Buddah and the Borderline" by Kiera Van Gelder, and he loved them both. He felt he got a lot out of them, and was thoughtful about them and recommends them to others with BPD (he told me to tell you that   ).

I've read both of those books, too, and have to say that not only did I love those books, but they really helped me in the early days of his diagnosis and Recovery to understand him better, and to have hope that he would recover from BPD just like the authors of those 2 books.

[Tamara96]

Wonderful! I will look up all 3 books (french works for me!), read them and then decide which one would be most suitable. Thank you so much.

The comment about hope from Rapt Reader, really resonated with me.

The roller coaster is so exhausting, I keep fastening my seat belt, but sometimes it's just not enough and i become worried that it will never end. So I look forward to some hopeful reading.

[golfball]

Tamara96,

I am in a similar situation as you, except my daughter is 17 and is not going to therapy.  We have been told by therapists and doctors they think she has BPD, but our daughter doesn't think anything is wrong with her.  Our daughter has been at a therapeutic boarding school for the past year and turns 18 in the Summer.  We are very afraid she is going to "leave" once she turns 18 and we are afraid for her safety.  What was your experience when your daughter turned 18?  Does she currently live at home with you now?  Thanks!

[rationalmind]

My DD17 will be 18 in two months. She's currently hospitalized and I'm looking into RTC because she just can't live at home, but I know when she turns 18 she will "check herself out" and go right back to drugs. She has been unable to finish school, maintain good relationships, or keep a job.  She seems so lost but fighting so hard to be an adult.  Maybe when they turn 18 reality will hit and they will realize a number doesn't change much except for responsibility. Wish I had a solution. I think the best we can do is to validate their feelings, support them in making good choices, and help them to find the help they need when they want it. Prayers for you. 

[Tamara96]

To Rationalmind & Golfball,

I should clarify - my daughter has been seeing a therapist for 4 years and a psychiatrist for 2 years but she is NOT doing therapy. She does not attend regularly, it's more like an occasional visit when she can unload how horrible the world treats her. We introduced her to DBT and she balked - of course - it was work - making her talk about her feelings.

To answer your question - what are we doing now that she is 18 - doing everything we can to keep her safe but know there is also only so much we can do!  (and that is the hardest part of them turning 18: accepting our limited ability to influence them.) :'(

We have set her up in a little apartment (are lucky we can do that) because we needed sanity at home, her siblings need peace and this way she can be a little independent.  She is working part-time, but has a hard time attending work regularly, so it's a matter of time before she is fired.

I check in on her daily. Make sure there is basic food in the her fridge, and I have put a GPS tracker on her car so I know where she is at all time (for her own protection - she is so impulsive and tends to bolt when under stress and used to go missing for days). This way I just know where she is and if she is in distress I can find her and help her. She moved out only 2 months ago, so this is all still new. (I really did not want this solution - couldn't bare spending hard earned savings on an apartment and utilities etc, but it's been really good.)

I make sure to have the cell numbers of her key friends or boyfriend of the moment. I have also spoken with some key parents. It's all about setting up a safety net around them, and doing so in a way that does not compromise their privacy. It requires a lot of tact. None of this is easy as the friendships are always changing and it means staying two steps ahead of them. So far this has worked and I get calls when it's needed.

I have some friends who set up their newly 18yrold with family or friends, who take them in for periods of times 6-12 months - it seems to work quite well as they are less likely to act out with strangers. These are all baby steps to independent living

Our family's hope is that one day she will accept to go into RTC!

We too had hoped she would turn 18 and hit a wall of maturity - or a light bulb would go on - but this did not happen. She turned 18 and remained as dependent and needy as ever and yet asserts she is an adult and therefor independent. We have been told it takes years often for the lightbulb to go on.

It's a very frightening transition period. But we must remain hopeful.

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

[rationalmind]

I hear your frustration about not participating in therapy.  After figuring out that insurance won't cover any RTC (and at 30K per month and her psychiatrist actually saying she is too functional for RTC) we are now likely having to bring her back home. She's made a lot of strides while an inpatient and we are working on getting her into an intensive dual diagnosis DBT program for kids just like her, but of course I am nervous as she is talking about going on all these trips when she is 18--somehow that number to her just means I can't stop her.  I think she will end up realizing that house rules don't change when you are 18 but that may mean the street which is such a scary prospect. We've thought about the studio apartment (we are moving cross country in just a few months) but I'm not sure she could manage either.  Please keep us posted!  It sounds like your daughter is making some progress, albeit TLC.

[Tamara96]

Ah yes, to any teen 18 is a magical number. And for a BPD teen, I think it means so much more.

In their minds they truly believe it means they do not need to abide by any rule regardless of living under our roof and us footing the bills.

To clarify: While my daughter has a studio apt, I would not say she is living independently - she has her place, but we come by to manage it.  And she comes home two days a week.

This arrangement gives her the semblance of independence and the family some downtime from the BPD roller coaster ride. We are close enough we can keep an eye on her safety.

I found turning 18 caused so much turmoil in my dd. Has anyone else found this?

They are child and adult, they are independent yet dependent. It is very confusing for them because cognitively they know what needs to happen to become independent, but emotionally just just aren't there.

How are any of you managing this?

And back to my original question... .how have any of you manage to convince your BPD newly adult child to accept treatment! I am at a loss on this point!