Introducing Myself

[gingermayme]

Hello,
I am the parent of a 17 year old with BPD and Bipolar disorder. He has been in and out of mental health facilities for the last three years, and is in an acute facility right now. He will be 18 towards the end of March. He has not been able to live in our home since May, and two weeks ago he disrupted his placement (which led to his current hospitalization).
I am struggling with emotional boundaries, knowing what's the right thing to do to support him as well as my other children. I often feel like I have to choose between my children to balance the need to protect everyone's physical and emotional safety.
I am very well versed on DBT, current research regarding BPD, boundaries, and self compassion. I have participated in extensive therapy myself as the daughter of a parent with BPD. I am currently in an intensive outpatient program myself to help alleviate the anxiety and depression due to consistently increasing intensity from our ongoing situation.
I am looking for a place for support, encouragement, advice, and understanding about the complexity of loving and supporting a nearly adult child with BPD.
Thank you in advance for welcoming me.
GM

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

[kells76]

Hello and a warm

Wow... three years of intense treatment for you son, and he's only 17 -- my heart goes out to you all. You must have been dealing with some intense behaviors since he was young.

So he has an out-of-home placement and is now in an acute care facility.

When he was just in the OOH placement, before the facility, what kind of schedule or structure did you have for interacting with him (if any)? I'm curious if you had a set day of the week to spend a set amount of time with him, or if there was some other kind of setup?

Maybe that could give you some ideas for how to support him while balancing that with caring for your other children. That is -- if the plan had been "parent spends time with S17 for 2 hours every Friday", then maybe you can keep that going -- set aside two hours every Friday (or two hours total per week) for supporting him, and mentally release the rest to his care team. I might be off base -- just some ideas.

How many other kids do you have? What are their ages? And do they all still live at home?

That transition point from "legal child" to "legal adult" does sound incredibly intense when BPD is involved.

Has your S17 had any areas of success in his life -- a subject in school, a hobby, caring for a pet, an area of knowledge about an interest (even if it's "just" knowing a lot about a TV show), cooking, volunteering (even if briefly), sports, artistic endeavors...? Getting a feel for how pervasive/impactful his diagnoses are.

Glad you are also getting IOP support right now. Other members here have also done inpatient and outpatient treatment to take care of themselves, so you're not alone.

This is really a group that gets it about the beyond-intense challenges of having a pwBPD in the family system, and how it's not "one size fits all" for how to cope, especially when it's your own child.

Fill us in some more, whenever you feel up for it;

kells76

[gingermayme]

Thank you so much for your thoughtful response.

He was discharged from the acute facility last week. He was placed in the custody of the department of family and children's services today due to his extensive needs and concerns for the mental and emotional safety of our younger daughter who still lives at home (15). The older daughter is 18 and is at college.

We are going to start therapeutic visitation virtually either tomorrow or next week, depending on if he is amenable to it.

Custodial placement outside of our care was the absolute last thing we wanted, but at this point we just cannot meet his needs and don't have the available resources to support his successful transition to adulthood. I am heartbroken.

Our son gets very attached to whomever is his romantic interest at the moment... his current girlfriend is expecting in December, but it is a high risk pregnancy (yes, another significant layer to everything).

He loves our dogs dearly and has a pet chameleon that he absolutely adores and has taken care of. He has always been extremely gentle and loving towards animals and those less fortunate.

He quickly loses interest in most things but is cognitively brilliant, artistically talented, and can master just about anything he puts effort into in a very short amount of time. For a while he was very focused on skateboarding, then on art, then on becoming a doctor, then guitar, now it is auto mechanics. He has struggled in school his whole life but academically, he is able to perform well when he wants to. His impulsivity and emotionality have upended every school experience he has had since 5th grade. He puts his hobbies (guitar, art) aside when he becomes romantically involved with anyone. He's never had a solid persona... he mirrors whomever he socially surrounds himself by. For example, he was very into the "skater" crowd for a while and got a whole new wardrobe. Then he was into being more preppy; again, everything including his accent, dress, demeanor, etc. changed. Before his most recent hospitalization, he was on a "country" kick all the way down to the cowboy boots.

Thanks for taking the time to read this.
GM

[CC43]

Hi there Ginger,

Boy it sounds like you've had it rough.  It's heartbreaking witnessing a child with BPD self-destruct, while making your homelife practically unbearable.  I think you're right to prioritize your other children's well-being, because they could come to resent you and their brother if it seems you channel most of your time and resources to your son, and if you allow him to be a bully or terrorist in your home.

Though it must be painful to place your son outside the home, it sounds like it might be the best option for the time being.  Do you have a sense whether your son is taking therapy seriously?  Has he come to the realization that he has a problem?  Unfortunately, I think that therapy doesn't really work well unless the patient is ready for a change.  My stepdaughter, who was diagnosed with BPD in her early 20s, had to hit bottom--twice--before she decided that she had to take therapy seriously, in order to have a chance of feeling any better.  If your son is anything like my stepdaughter, he'll nevertheless lash out at you because he thinks YOU put him in his situation, not his behavior.  He'll blame you for everything.  You probably know by now that this is not your fault.  His thinking is disordered by BPD.  His hatred and ill words are just him projecting his mixed-up, super-sized feelings onto you. 

I can identify with your description of your son's fragile sense of self, which goes deeper than merely trying different experiences and pursuits in adolescence.  My stepdaughter also seems to have a very hazy sense of self.  One manifestation of that, in my opinion, was experimenting with hairstyles and clothes.  Of course, changing up a hairstyle is completely normal, but when it came to my stepdaughter, a change would typically coincide with some sort of manufactured crisis in her life.  Anyway, I think she continues to struggle with who she is and wants to become.  Another manifestation of this confusion involved changing majors in college.  One day she decided she wanted to pursue one course of study, but she quickly saw that it was challenging, and she impulsively gave up.  This knocked her self-esteem strongly and led to a suicide attempt.  I think she was initially so invested in pursuing a certain major, that when she gave it up, she felt totally untethered and disappointed.  Her self-talk was probably very negative ("I'm a failure, I'll never amount to anything, I don't know what I want to do with my life, my dreams are shattered, I don't like anything, I hate this, my life is over . . . my parents really messed me up, no wonder I'm such a failure, it's all their fault, I never even had a chance, I hate them for putting me through all this").  For most students, changing majors and finding something to focus on is a normal part of the college experience.  But for someone with BPD, it seems exceedingly tied up with their identity, and possibly linked to pleasing others.  And then when that doesn't work out, they're completely lost and don't know who they are or what they want to do.  Then it seems they pivot to something else, in response to external cues rather than internal ones.  Again, changing majors is not unusual, but the pivot with someone with BPD seems like it has more to do with external factors and relationships ("I want to be an artist because then I can hang out with my cool friend" or "If I study to be a doctor, my parents will be proud of me"), rather than genuine interests, or anything internally-driven.  Does that ring true to you?  To take this idea further, one time I did a skills-finder test with my stepdaughter.  Our home state has a cool website that helps young people explore possible careers.  Anyway, there's a questionnaire which asks all sorts of questions about likes and dislikes, and then it analyses answers and suggests possible careers that best align with those likes and dislikes.  Well, when I tried to walk my stepdaughter through the questionnaire, I was astounded at how hesitant she appeared.  It's as if she had NO IDEA about her likes and dislikes.  I emphasized, there are no right or wrong answers in this questionnaire, just respond using your gut instincts.  She seemed totally lost.  I ended up having to answer half the questions for her (Well, I think you're really creative, you like sketching, right?  So let's say, just for fun, that you like to create things.  This question asks whether you like to read.  Well, I haven't seen you read many books lately, so let's say that reading isn't really your thing.  OK?).

I'm not sure how to handle the notion of a fragile identity, except to say that as parents, you have a lot of influence on your child.  When the lines of communication are open with your son, you might think about helping to guide, or nudge, him in directions that seem to fit his personality, understanding that he might feel completely lost on his own.  This might look like building up his confidence:  "You're really artistic.  You excel at taking care of animals.  You are extremely intelligent when you're engaged."  All of these are marvelous gifts, but he might not even be aware that he's blessed with them, possibly because his self-talk is overly negative because of BPD thinking patterns.

I'll add that one dangerous pivot my stepdaughter made was to start using marijuana.  The way she talked about it, she made it sound like "everyone" uses marijuana, as if she started using primarily to impress others, or to fit in.  Well, using marijuana made her BPD symptoms and self-sabotaging behaviors much, much worse in my opinion.  The only times she was highly paranoid and had bouts of psychosis were when she was using.  My advice would be, if your son is using illicit drugs, you should make every effort to prevent that.  If you're giving him spending money, you might reconsider and give him things in kind instead.  (If he wants his own spending money, then at the very least he needs to find a job and work for it.)  And the messaging needs to be clear--marijuana and illicit drugs are harmful for people suffering from BPD.  My stepdaughter had to hear that from doctors before she finally quit.  I thought her dad was too liberal concerning the question of drug use in my opinion, and he would say things to her like, "Just be careful with drugs," because when he was young, he and his friends smoked pot casually, with no serious or permanent ill effects.  Well, pwBPD are not known for showing judicious restraint, and I think that today's drugs can be much more potent and harmful than they were decades ago.

My other advice would be that, for as long as you are financing your son's life, you do not allow him to be what I call NEETT--Not in Education, Employment, Training or Therapy.  My stepdaughter was NEETT for an extended period, essentially on vacation, with no responsibilities and no daily structure.  She had fewer responsibilities than a kindergartener, who by the way can manage to get up, get dressed, tidy their room, eat meals with family, attend school, take a daily bath and say please and thank you.  She, however, couldn't manage any of those things while untreated.  You'd think someone would be happy to be NEETT, but the opposite is true.  She was miserable.  She was doing nothing, so she felt like nothing.  You might think, we can't force our son to get therapy, or go to school, or to get a job.  You are right about that.  But if you're supporting him financially, you do retain some control.  If he's living under your roof, you should have a high degree of control.  I'd say, to live under your roof, everyone has to follow some basic rules, like:  Everyone is respectful.  No violence allowed.  No illicit drugs allowed.  Quiet hours from 12 AM to 7 AM when no gaming or phone use is allowed (turn off screens / disconnect Internet).  Everyone contributes (chores, bills, keeping the home clean/tidy).  Every adult pays for their own personal luxuries (personal phone, gas).  Everyone has a job to do (school, work, training and/or therapy).  I would also caution about making retreating to a bedroom too comfortable.  In my opinion, having access to screentime and videogames 24/7 makes holing up in a bedroom tolerable, maybe even enjoyable, while avoiding real life.  If it were my kid, I'd completely cut off phone and screen use during hours when they should be working, studying or sleeping.  I think that maintaining healthy schedules and living habits helps, ESPECIALLY someone dealing with BPD.  If you make your son pay for his own phone device, his own data plan and his own internet connection, then at the very least, he has to work a little to earn it.  If not, he can go without a phone, data or internet.  It's his choice entirely, and adults make those sorts of choices every day.

Finally, I found it helped me to think of BPD in terms of emotional age.  I thought that my stepdaughter's emotional age was stunted, about 70% of her chronological age.  So when she was 18, her emotional age was the equivalent of a 13-year-old.  At 21, she acted like a 15-year-old.  When she turns 30, she'll be about 21, emotionally speaking.  Maybe that's why, experts say that BPD behaviors might diminish during the 30s--I presume that's because the emotional age finally reaches a basic level of maturity.  Thinking this way allows me to adjust my expectations for my stepdaughter's behavior, and it also gives me a little hope that she might someday "grow up" and handle things more like the adult she is physically.

Just my two cents.  You're not alone in this.  I wish you strength and peace.