Daughter hospitalized for self harm

[I Am Redeemed]

 
It's been a while since I have been on the boards here. I originally came here some years back because of my relationship with my kids' dad.

Unfortunately, I am back because of my D16 and her BPD-ish behaviors. I'm not necessarily convinced she has BPD but she ticks a few of the boxes and she does have complex trauma.

For those who don't know my story, I have six kids. I lost custody of them in 2013 because of domestic violence due to ubpdxh. It took me ten years to get them back. During that time they lived with my older sister, who has many BPD and NPD traits and who also raised me. My kids suffered lots of verbal, mental, emotional, and physical abuse under her care. So ... complex trauma.

D16 is the second oldest and is currently the one struggling the most from the trauma. Last January she spent two weeks in acute care after overdosing on some of my medications that she stole from the bathroom. She had just completed an In-home counseling program where she was seen once a week. We got her entered in a 3x a week program. She completed that. Around two months later, she started self harming again. We kept all medications and sharp objects locked up.

Early Oct she broke up with her boyfriend, had a falling out with her best friend, and then broke into the lock box and overdosed again. Called crisis, went to the ER, and she did six days in acute inpatient care

On my birthday in November, she and I got in an argument about her being allowed to be alone at the house with her new boyfriend. She admitted to having sex with the previous boyfriend, and I had said that no boys were allowed without an adult present. That night she cut her arm so deeply that it required medical attention. Crisis line, ER, seven stitches, two weeks in a different inpatient facility and I made the decision to get her into long term treatment. She's currently hospitalized in another treatment facility and could be there for around three months.

Anyway, I just wanted to tell a little bit about what I am dealing with and connect with some other parents who might know what it's like to have a child that really struggles with suicidal ideation and self harm. Thanks for reading.

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

[PearlsBefore]

I remember you pretty well, "Welcome back, glad you're here, sorry it's necessary!". The issue of Complex PTSD is such a tricky bit of dealing with BPD and BPD-adjacent behaviors because it does have one very common overlapping causation with BPD but does present differently (although similarly) I guess.

It can be very frustrating watching the Courts place children out of the home; I am very familiar with a young child who at age 9 made partial disclosure of incest to a professional after having alluded to it among other relatives as well. Police said it was a matter for Child Services, Child Services said it was a matter for Court, Court said it was a matter for an appointed Assessor...Assessor reported to the Court that the incestuous adult molesting him had not agreed to participate in the Assessment unless that issue and any evidence they disliked were off the table and not to be considered...Court ruled that meant there was no evidence to substantiate the child and ordered the child to continue living with the abuser.  No happy ending.

It's not a solution but a stop-gap, consider removing "dangerous" medications from the cabinet but not entirely...fill the empty bottles with placebos. She may reach for what's labeled vicodine or Tylenol 3 but is actually Gingko Balboa Calcium Vitamin C tablets inside, etc.

[Notwendy]

I am sorry you are dealing with this challenge. I think it is good that your D will be at the facility for several months. She is safe there and this will give them time to be thorough in their evaluation/treatment plan. I hope all goes well for her and your family.

[I Am Redeemed]

Thank you for your replies.

We don't have narcotics in the house at all (I am a recovering opioid addict) so the pills she overdosed on were my antidepressants. Thankfully, she didn't take enough to cause serious harm either time. I'm considering getting a metal lock box or keeping my medications in my locked car or something.

She has been placed on an antidepressant and an antipsychotic and will be participating in trauma focused CBT therapy. Her therapist said he believes she is currently trying to present as more stable than she is in an effort to get discharged. Seems like he's astute enough to see through her manipulation and he is paying attention to her behaviors, especially when interacting with other people. We have family sessions once a week where he coaches her in her interactions with me.

I'm hoping that the medications will help her to actually use the tools she learns in therapy. We're going to continue with outpatient therapy after she is released.

[kells76]

Welcome back IAR 

Was D16 compliant with going to the 3 month program (i.e. not trying to get out of the car/off the plane/etc)? If so, at some level (though she might never say it), she may be feeling relief. I would never have said that out loud about going to the hospital for an eating disorder at 16, but I did feel it.

She has been placed on an antidepressant and an antipsychotic and will be participating in trauma focused CBT therapy. Her therapist said he believes she is currently trying to present as more stable than she is in an effort to get discharged. Seems like he's astute enough to see through her manipulation and he is paying attention to her behaviors, especially when interacting with other people. We have family sessions once a week where he coaches her in her interactions with me.

I think that's common in general and not necessarily a BPD thing.

My 2nd round of eating disorder treatment was an IOP when I was ~18-19. It was a 12 week program with the option to be discharged at 10 weeks if the team thought you were doing well. Of course I believed, going in, that I was doing awesome, had it totally together, and would graduate early *eyeroll*

I did have to quit the job I loved to do the IOP, and I was upset about that. Earlier, during my hospitalization at 16, I was more upset at missing out on peer/friend stuff and my extracurriculars.

So, it could be age appropriate (not necessarily disordered) that she wants out of treatment and is pulling whatever levers she can. Could be friends, boyfriend, social life, etc, that she wants to get back to.

It's good that her team is on to her approach. Maybe they can work with her to understand what's currently motivating her to be done, and help her find ways to excel in treatment -- with the goal of finishing ASAP (even though that may just be "on time") -- that don't require her to "pretend" to be doing well.

I remember one visit with the ED doctor where a couple days before, I'd accidentally triggered my gag reflex when brushing my teeth, and threw up -- not on purpose. I disclosed that to the doctor, and I remember being kind of surprised at how I felt like they respected me telling the truth. It opened my eyes to a new approach; instead of always trying to be sneaky to make weight or hide what I'd done, they were much more "cool" when I just told them what actually happened. It made me realize that they might think I was doing better when I told the truth.

Hoping your D16 has some similar insights in her program. I think there is a lot of potential for it to be a good place for her.

...

Do you have any 1x1 sessions with just you and the team, or is family therapy the only place you really interact with them? And is there a parent support group attached to the program?

[I Am Redeemed]

Welcome back IAR  

Was D16 compliant with going to the 3 month program (i.e. not trying to get out of the car/off the plane/etc)? If so, at some level (though she might never say it), she may be feeling relief. I would never have said that out loud about going to the hospital for an eating disorder at 16, but I did feel it.

She was taken to an acute care psychiatric hospital directly from the ER by ambulance. From there, I broke the news to her that we were seeking inpatient treatment. Her social worker made lots of referrals and we found a place willing to take her about an hour away from home (acute care facility was around 2 hours away in the opposite direction). I was relieved she would not be discharged and have to come home to await admittance to the inpatient facility. The week she cut herself, she locked herself in her room one day and refused to go to school, so I could only imagine how she would have reacted if she were released in between treatment facilities.

She was livid. She hated me, she hated her stepdad, she hated her therapist, she hated life, she told her DCS caseworker she did not want to live with me anymore. And so on and so forth.

After a couple of days into the new facility (around week two of the total time she had been in treatment) the antidepressants must have started working because she suddenly was okay, she loved me, she told her caseworker I was a good mom and she wanted to live with me, she was going to be fine in treatment, she asked how the family was doing.

They have added an antipsychotic to her antidepressant and anxiety medication, so I think that is helping to stabilize her.

I'm sure she did not want to go to treatment. Full disclosure: I went to treatment for a month back in June to get help to stop taking a medication I was prescribed for opioid use disorder. I did not want to go. I hated it there. I wanted out. But I adjusted and went through it and came out better for it.

I have spoken one on one with her therapist over the phone. Usually, he calls during the week and then we have a family session by zoom 1X week.

[SinisterComplex]

Just nice to see you around IAR. Truly my thoughts and prayers go out to you. 

Cheers and Best Wishes!

-SC-