Mother of minor child w/strong BPD symptoms--too young for official diagnosis

[MomOtwo]

 I own the "Walking on Eggshells" book, but it seems to focus on adults with these symptoms. What do you do when it's your 14 year old daughter? I can't just choose to walk away--she's a dependent child. We've been actively treating her for anxiety (counseling on/off) since she was in 1st grade when she complained of chronic stomach aches w/no physical explanation (included an ultrasound diagnostic to help rule out physical issues). She's been on medication for anxiety (Lexapro) 4 years and attention deficit (initially concerta, later adderall XR) almost 3 years now and sees her psychiatrist every 3 months for a consultation. This last summer, I had a licensed psychologist conduct some personality testing to see if that would give us any insight. The results showed strong BPD behaviors. Residential Treatment has been suggested, but I feel that would just confirm her fear of being abandoned. She doesn't respect our rules and we're struggling to find ways to enforce effective consequences when she breaks those rules. Anybody else out there struggling with how to parent an "unofficial" BPD minor child? I'm  married but feel like the majority of care giving for my daughter falls on me. It's exhausting and emotionally draining. I need creative parenting ideas and to hear I'm not alone. Thanks!

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

[incadove]

I don't know if I did things right because I'm not that close to my child now who I felt had BPD traits but she is very responsible and caring (she's 18 now).  My worst mistake was taking things personally and reacting in anger to what I perceived as disrespectful behaviour.

The books I felt were most helpful were Reaching the Unreachable Child by Sheila Zaretsky and Transforming the Difficult Child, Nurtured Heart Approach; also Explosive Child, and Happy Kids by Cathy Glass (about repeating and reinforcing)

We did a lot of talking on a sort of meta level about things, and it worked best with my teen when I didn't try any direct control, but explained why things were a problem to me; I did use staged consequences but in her case appealing to her principles was more effective.  Every case is different and I don't know that she actually had BPD traits, but she definitely had fear of abandonment (she wasn't my biological child, and had experienced abandonment) and I think had some of the BPD emotions described.  Letting her know when I was truly proud of her and happy with her was also a powerful thing. 

Reading books about others experience was the most helpful to me when I felt overwhelmed or distressed.  I'm still often sad that I'm not as connected to her as I could be but she is successful in her life and has stable relationships.

[MomOtwo]

Golda--Thank you for the response and for the book recommendations. I'm glad to hear that she has a successful and stable life as an adult. That's encouraging. Hopefully as she ages (and gets more appreciative of all you did for her), your relationship with her will become closer.

[Bright Day Mom]

Hi MomoTwo. My D16 was dx last summer w/BPD; generally drs hold-off on dx until 18+, but her case was determined.

You are right, you cannot just walk away from your 14yr old. What you can do is change the way you and those around her communicate. The tools and lessons to the right will help you begin. 

Have you shared the psychologist's findings w/her psychiatrist?  If they can team up and begin DBT treatment and perhaps re-visiting her current meds could give her and you some much needed relief. 

Our family had been recommended residential placement many times and it was not even a consideration in our minds. Until life got too bad and we felt it was dire to get the expertise of the structured environment or potentially lose our child to suicide. I am happy to tell you after an 8 month stay and lot of hard work w/indiv and family therapy, we are all doing well. She is now home 3 months and still going strong with lots of support to reintegrate her back into "normal" family / school life.

Whatever path you choose, I hope it brings you the peace your family deserves.  It can get better, you are not alone.

[473harman]

Hi MomoTwo - sadly, you are not alone

I agree with everything BrightDayMom says as we have similar situations. We turned to residential when we had no other choice - and that came at us fast and hard. Even if you don't want to consider it right now, I would take a look at different places as there are many, and some have waiting lists. I wish I could have thought about this more before we were left with no other option. Does your daughter have an IEP? Placing her in a therapeutic day school might be an option where they can incorporate therapy into the day.

Also - I can tell you that "emotionally sensitive" and "emotionally reactive" behaviors can be there early in childhood - I see it in my 7 year old.

See if you can find a DBT specialist in your area. When we first tried DBT with my 16 year old, who is in residential, it didn't work as her behaviors were too far gone. It did work in an intensive residential setting, and DBT skills (validation, validation, validation!) has worked wonders with my 7 year old.

Wishing you peace

[Kat816]

Hi there,

It's good your daughter is in counselling. Since she is still a minor you should look into the DBT or CBT programs.  I have a 16 year old daughter and she is now getting back to DBT.  All the doctors, counselors have told me this is the best fit for BPD.  If they are willing it makes it so much easier.   Don't give up.  Keep her busy and interested in things, explore what she likes to do.  Maybe find youth groups that she could attend as well.

From what I have read ,researched and applied with my daughter it is best to be consistent. Whether that be for the rules of the house, respect etc. Don't make the consequences to drastic but realistic and manageable for them. They do need boundaries and giving too much when they can't handle it and it goes wrong just makes it harder for all to deal with.  We want to be there for them but at the same time they need to know they need to be responsible for some of the choices they make.

In DBT they learn and you learn as well to validate.  This is a big part of it and empathy.  It takes time and practice but we started using it and it does help.  It keeps things from getting too out of control when my daughter reacts.  When they are not responding and getting mad and not listening. This is where you end the conversation and let them know that you understand they are upset and when she is calmer we can talk about this later.  Let them cool down as it could take minutes, hours or even another day. As parents we need to know how to work on our skills as well as they do. We all want to problem solve and fix things, we need to step back from this approach and use other approaches that will communicate better with people who have BPD. 

I wish you and your family the best for the future for your daughter.  Take it day by day. We can't control and worrying can overwhelm us and exhaust us.  Be there when they need us as they do need us no matter what they say in anger it is not their true thoughts but a way for them to control the pain through anger.