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[DrJen]

Hi. 

Our teenage daughter has symptoms of BPD and has been diagnosed as bipolar with psychotic episodes.  I am hoping that this might be a forum to find others who understand.  I also have a sister with pretty much the same diagnosis, although the two are not biologically related.

While many sources indicate that this is the fault of the parents/guardians, I believe that biology plays the most important role in their cases - both responded "differently" as babies and young children.  Our daughter is currently on medication to control her bipolar symptoms and has started DBT.  Everyone in the family is on the same page in supporting the prescribed course of treatment. 

Whether our daughter has BPD or another closely related PD has yet to be determined by a psychiatrist.  However, the professionals working with her agree that living at home and DBT is "her only chance". 

The emotional pain that our family has experienced is great. 

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

[madmom]

Welcome, I think you will find many here who have experienced many of the same things as you.  My own daughter who is now 27, started therapy etc. at 16, but wasn't diagnosed with BPD until about five or six years later. I wish I would have known about BPD sooner, because I found out I could have been a better person and parent to her if I knew about the disease and had learned and used the tools you will see on the right hand side of the page much sooner with her.  Like you, my daughter was never abused, lived with an intact, loving family and so there is definitely some biology involved in her problems.  Today she is doing very well, and I hope telling you that will bring you hope.  Best wishes, please keep coming back and sharing your story.

[lbjnltx]

Hello DrJen

and welcome to the Parenting Board.

I'm glad to hear that your daughter is participating in DBT and that the family is all on the same page regarding her treatment.

Are you and Dad participating in the DBT skills program as well?  Is that provided?

My daughter was dx w/emerging BPD at age 12.  Addressing the problem early and having the supporting (not enabling) family involvement are the greatest predictors for healing and a more positive outcome of therapy.

I look forward to working with you and supporting you on this journey.

lbj

[DrJen]

Are you and Dad participating in the DBT skills program as well?  Is that provided?

There is no "CBT skills program" per se here. We travel about an hour to get to the closest DBT therapist available that works with teens.  Since we have other kids, one of us stays home.   Dad takes her to her appointments.  Family sessions happen, but it takes planning to coordinate schedules.  Our daughter's therapist is writing the teen DBT program for the institution that is involved.

After a triage therapist suggested DBT, I worked on learning about the therapy while we searched for a DBT therapist for our daughter.  We sit down for what might be termed a debriefing after her appointments to go over whatever she is currently learning. We have been keen to not "enable" for some time.  Our greatest additional challenge is undoing emotional damage to family members caused by others who did enable.

Madmom, I very much appreciate hearing about the positive outcome that your daughter has experienced.  It helps.  Thank you!   


 

[lbjnltx]

There is no "CBT skills program" per se here. We travel about an hour to get to the closest DBT therapist available that works with teens.  Since we have other kids, one of us stays home.   Dad takes her to her appointments.  Family sessions happen, but it takes planning to coordinate schedules.  Our daughter's therapist is writing the teen DBT program for the institution that is involved.

After a triage therapist suggested DBT, I worked on learning about the therapy while we searched for a DBT therapist for our daughter.  We sit down for what might be termed a debriefing after her appointments to go over whatever she is currently learning.

It's great that you have invested in learning about DBT DrJen.  Might it also be beneficial to practice the skills along side your daughter?  There are online DBT skills lessons as well as workbooks that can be purchased.  I found that speaking the same therapeutic language with my daughter helps her use/reinforce the skills she learned.  I become a model to follow as I help myself, it is a win win.

Our greatest additional challenge is undoing emotional damage to family members caused by others who did enable.

Can you expound on this?

lbj

[satahal]

Dr. Jen,

My daughter who is 28 was just diagnosed a few months ago - she was in and out of therapy as a pre-teen and teen for anxiety/ocd, depression issues.

I was very troubled by things I'd read about neglect and abuse being triggers for BPD because I felt that was not the case for my daughter. The worst thing I did was I yelled, no name calling, character attacks or anything that would qualify as emotional abuse - it was more you're driving me crazy, pick your crap up kind of thing and it was occasional. She was never hit. She was doted on - every opportunity, every fancy summer camp she begged for, classes, lesson, horseback riding, you name it. She was adored, not just by her parents but extended family as well.

She told me recently that her therapist was perplexed as to what triggered her BPD. They can't figure out what the trauma was. (Her biological component was obvious as my father and sister both had BPD.)

I came across a video on you tube with Dr. Gunderson titled "Interpersonal Hypersensitivity: Origins and Implications" - sorry don't know how to insert a link here - it's on the NEA BPD channel. He talks about how the child informs parenting style. The gist is that we alter our inclinations to respond to a child's personality and preferences. For instance my daughter didn't like to be held a lot - which kind of broke my heart - she always wanted to be down on the ground or in her crib - she was just calmer and happier that way so I let her go (while staring wistfully at the mom's with their cuddly babies). She developed into a social, independent little spitfire - hitting milestones early - a veritable rockstar of a child.

Looking back now I see she had some really strong preferences that were a little outside of the norm, and outside of my expectations and instincts as a mom but since all else was going well it seemed of no consequence.

By the time she was a teen and a preteen it seemed clear she was uncomfortable with physical affection or general mushiness - again I toned myself down in keeping with my perception of her preferences. In hindsight I think there was a dance going on and I was doing all the wrong steps - she probably needed me to be more demonstrative and lovey-dovey and here I was doing it less and less. Now, I'm showering her with hugs (when we're in the same country as she lives far away) and declaration of love. Even though she seems pained by the attention I'm not stopping - that's just her affect I'm learning.

I'm sure I made a million other missteps along the way but if she had not had the biological component for BPD, nothing I did would have been of major consequence. Dr. Gunderson says much more. I felt enormous relief after watching the talk.


Edit* Here is the link:  https://www.youtube.com/watch?v=E_kFNWXVF1Y&feature=youtu.be

[DrJen]

It's great that you have invested in learning about DBT DrJen.  Might it also be beneficial to practice the skills along side your daughter?  There are online DBT skills lessons as well as workbooks that can be purchased.  I found that speaking the same therapeutic language with my daughter helps her use/reinforce the skills she learned.  I become a model to follow as I help myself, it is a win win.

I'm not at all sure what you mean by practicing this stuff.  We purchased (and read) a DBT couple of skills books a couple of months ago.  I found that a number of what they are calling DBT skills turned out to be things I had picked up along the way in my own life as helpful.  At this point her therapist is telling her to practice things that had been suggested in the past.  She recognizes that some of this is the 'silly common sense' she disregarded.  Of course, now it is being presented with a formal structure and neat terminology rather than suggestions from Mom and Dad who are definitely not psychologists or therapists.  I'm up now to review stuff so that we can go over her weekly writing when she wakes before a morning therapy appointment.  She also is enrolled in a generic (non BDT) daily program until she turns 15 (when she "ages out".  This summer she is studying in her private cyber school so that she can enter a standard school year via the cyber school (public schools do not work for her). 

[I am avoiding answering your second question publicly for now.  If you really need to know more now, please send a private message.]

[DrJen]

Dr. Jen,

I was very troubled by things I'd read about neglect and abuse being triggers for BPD because I felt that was not the case for my daughter. ... .

She told me recently that her therapist was perplexed as to what triggered her BPD. They can't figure out what the trauma was. (Her biological component was obvious as my father and sister both had BPD.)

Thank you for the link.  I will watch the film. 

We have been 'gone over with a fine tooth comb' by the experts.  Those that know us best are our daughter's psychiatrists and therapists.  They find nothing wrong with us, our parenting skills, or our home.  In fact, we have been told that they wished some of their other patients had homes like ours (which made me feel better). 

Our daughter was unique, aka different, from other children that I've encountered from the start. When she cried, her brother of the same age would cry creating a stereo effect that got lots of soothing attention.  She did not cry when her brother cried.  Her hearing checked out fine and she happily engaged in her own activities.  We used to say that for whatever reason, his crying did not bother her.  (She is not autistic.) If she displayed empathy for others, that would no doubt have been forgotten as an insignificant variation in the development of little ones.  This small difference led to other minor differences in behavior and temperament, which eventually led us to where we are now.

[lbjnltx]

It's great that you have invested in learning about DBT DrJen.  Might it also be beneficial to practice the skills along side your daughter?  There are online DBT skills lessons as well as workbooks that can be purchased.  I found that speaking the same therapeutic language with my daughter helps her use/reinforce the skills she learned.  I become a model to follow as I help myself, it is a win win.

I'm not at all sure what you mean by practicing this stuff.  We purchased (and read) a DBT couple of skills books a couple of months ago.  I found that a number of what they are calling DBT skills turned out to be things I had picked up along the way in my own life as helpful.

Naming the skill while practicing it helps reinforce concepts.  For example the skill of wisemind:

As a situation begins to heat up and emotional temperatures (hers/yours) rise Dr.Jen might say "I really need to take a time out and get into my wisemind.  We will pick this discussion up at lunch."

At this point her therapist is telling her to practice things that had been suggested in the past.  She recognizes that some of this is the 'silly common sense' she disregarded.  Of course, now it is being presented with a formal structure and neat terminology rather than suggestions from Mom and Dad who are definitely not psychologists or therapists.

BPD sufferers are consistently in emotional mind.  Common sense loses out over intense emotional thinking.  Using the terminology in our conversations benefits our kids outside of therapy and helps them to practice, see the benefits in action (our actions) and we become part of their healing.  This is what I mean by speaking the same therapeutic language and being a source of support.  Modeling the skills we want our kids to learn and use is the highest level of support.

 

[I am avoiding answering your second question publicly for now.  If you really need to know more now, please send a private message.]

When you are ready we are here.  

lbj

[satahal]

When she cried, her brother of the same age would cry creating a stereo effect that got lots of soothing attention.  She did not cry when her brother cried.

This struck me - my daughter never showed empathy - and is not autistic. This didn't go unnoticed but what can you do? I wonder if this is an early indicator of a personality disorder?

My son is the opposite - totally empathetic and in tune with the emotions of those around him. My daughter just seems not to care.