Help for setting boundaries with younger teens

[Halcyon_days]

I posted here a bit over the summer and the advice I was given was so helpful, thank you all. Anyway, I'm back again - looking for some commiseration and possibly advice.

My DD is 15, almost 16. We have had an incredibly tumultuous past few years. I am also a single mom, her dad has his own mental health issues and is not involved at all, so I've been shouldering all of this on my own for quite some time.

My daughter was hospitalized twice last year for eating disorder exacerbations and she's very close to another IP admission. She refuses to follow her eating plan and I understand that the natural consequence of that is that she gets admitted until she's stabilized. She has to consent for treatment in our state and she's previously refused ED treatment OR has agreed to it but behaved so poorly that she gets kicked out of the program. She will not participate in 1 to 1 ED therapy. Fine, I cannot force her, all I can do is support and encourage.

However, when she is not eating properly it makes all of her BPD symptoms worse. For example, last year after her second hospitalization, she became increasingly violent and unstable. She put herself in DHS custody and was adjudicated as ungovernable. She spent a few months in group home and foster settings and has been back with me for about 6 months now.

Aside from a few incidences of escalation from her, things have been "ok" - ok as in as long as I do not "rock the boat" and do whatever she wants whenever she wants it, she's fine. When I ask to her to help around the house, try to set limits on when her boyfriend can be over, or let her know that in order to have C she must first do A and B it is always a HUGE drama. If I say her boyfriend can't come over until she cleans the litter box (which is now 5 days overdue btw), she sobs and tells me she can't wait to move out because I am so toxic and he is the only reason she doesn't kill herself. If I don't give her money because she didn't do the thing I told her she needed to do to receive the money, same thing.

I agree, the home is toxic but the toxicity is coming from her. I'm not JADEing, but me enforcing a boundary or not giving in to her antics just seems to escalate her more. I don't expect a ton, but clean up after yourself, go to school, and respect that I make the rules regarding who can be in my home and when. I don't think these things are unreasonable, but maybe they are?

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

[CC43]

Hi there,

I really feel for you.  Eating disorders are so tricky.  Though my BPD stepdaughter doesn't have an eating disorder, she was just as stubborn.  I'm replying now because we had the exact same issue with the kitty litter box.  She was allowed to have her own cat, and yet she refused to look after it, including emptying the box on a regular basis.  Eventually my husband let her get her way, and he took care of the cat, maybe because he thought that the cat was the one thing that seemed to make his daughter happy.  But I thought that wasn't right at all, because he ended up doing all sorts of things that she should have been doing for herself.  Worse, like your daughter, she wanted to make the rules of the household:  coming and going as she pleased, not cleaning up after herself or her pet, having boys over (including overnight) whenever she wanted without asking, refusing to go to school/work/therapy, etc.  If she didn't get her way, she'd have a meltdown.  And so we found ourselves walking on eggshells, trying to avoid a meltdown.

All I can say is that being permissive and letting the kid make the rules of the household didn't get better.  In fact, it got worse.  What happened is that she went nuclear, as I call it.  As she got older, she thought she should have all sorts of adult privileges (but not the responsibilities), and if we didn't meet her demands, her tantrums got worse.  The first stage was to threaten suicide when she didn't get what she wanted.  And then she actually attempted suicide.  Moreover, her demands became more and more extreme:  she wanted unlimited tuition (even if she failed or dropped out of college courses repeatedly); she wanted a new car; she wanted her own apartments; she wanted unlimited spending money, she wanted to use marijuana in my home, etc.  What she didn't want to do was to get a job, go to therapy, help around the house or treat her family with respect.

I guess my advice is, try to enforce one boundary at a time, but be sure to enforce it.  Maybe the boundary is about pet care, or maybe the boundary is about not getting privileges if she doesn't go to therapy.  What do you think is the biggest issue right now?  I'd start there.

[kells76]

I guess my advice is, try to enforce one boundary at a time, but be sure to enforce it.  Maybe the boundary is about pet care, or maybe the boundary is about not getting privileges if she doesn't go to therapy.  What do you think is the biggest issue right now?  I'd start there.

CC43's idea makes a lot of sense; not to try to improve everything at once, but for your own well-being and energy, to focus on "low hanging fruit" -- an area where you're like "OK, yes, I have the energy to demonstrate follow-through here, and I'm OK with letting other areas go just for now".

...

When I ask to her to help around the house, try to set limits on when her boyfriend can be over, or let her know that in order to have C she must first do A and B it is always a HUGE drama. If I say her boyfriend can't come over until she cleans the litter box (which is now 5 days overdue btw), she sobs and tells me she can't wait to move out because I am so toxic and he is the only reason she doesn't kill herself.

Not sure if you've already tried this; maybe increasing frequency of reminders and having reminders on a schedule, even if it seems like overkill, could be an approach. I.e. for "generally normal" teens you might be able to just have one discussion and then they know the expectations forevermore from there and can function without reminders. With H's kids, it's a little different; we have done "expectation setting" conversations but both of them still seem to need reminders (i.e. expectation is that rooms get cleaned on Sundays, but they still need verbal reminders) but the difference in our case is that (a) the heads up reminder is usually minutes to hours ahead (your D may need much longer lead time) and (b) they will complete the task once reminded.

Would your D do better if expectation reminders happened every Monday night, or every 3 days, then 2 days, then one day, then 12 hours, etc, in advance, or something where it's both more frequent and gives her more time to process/execute on what needs to be done? Executive functioning can be impaired in BPD, so while a "generally normal" kid may be able to pivot 10 minutes before Boyfriend arrives and clean the litterbox really quickly, she may totally decompensate and have no skills to handle that quick timeline -- could be very overwhelmed.

Young kids often need a series of anticipatory reminders for transitions, in order to stay even keeled ("we're going in 30 minutes... we're going in 15 minutes... we're going in 10 minutes so it's time to get your shoes on..."). Maybe your D is emotionally in a young place too and needs that? You know her best, so I understand that this may be something you've either already tried, or would not suit her.

[Halcyon_days]

It's just so disheartening. We will be getting along ok for weeks but it falls apart so quickly and I'm needing to gray rock all the time. She's stressed about other things right now (possible hospital admission, currently failing all classes, pending criminal charges, moving a short distance) and there is a lot going on but being the punching bag is exhausting - I am the one helping her with all of it, but she's so incredibly ungrateful and hostile. I really do try to let it roll off me but it hurts.

I will work on enforcing one boundary/consequence at a time. That is something I can do.

[CC43]

Hi again,

I think you hit the nail on the head with realizing that your beloved daughter is stressed out about a lot of things.  My stepdaughter tended to self-destruct in the face of stress, because emotionally, she just wasn't equipped to handle it.  In the face of stress, your daughter is likely having a trauma-like response to ordinary events, such as being asked to clean the kitty litter.  That seemingly insignificant request could provoke a meltdown, because your daughter is basically living in fight-or-flight mode most of the time.  She could resent being asked to do something she doesn't want to do, and because her emotions are volatile, her response is likely over-the-top, totally out of proportion to the incident.  Does that sound about right?

Every kid is different, but with BPD, I think there's a definite lack of emotional maturity that adversely impacts routines, relationships, executive function and general coping in the face of stress.  In my stepdaughter's case, it helped me to think in terms of emotional age, which I estimated was about 70% of her chronological age.  So at 16, she'd basically be functioning at the emotional level of an 11-year-old.  That helped me adjust some expectations, for example concerning her ability to concentrate, tolerate distress, handle rejection, plan, solve problems and understand other people's points of view.  If your daughter seems overwhelmed all the time, it's probably because she is!  Moreover, since she's not very good with her choices, she tends to create even more stress for herself, which only adds to the feeling of chaos.  She's probably deeply ashamed that she breaks down in a rage or a puddle of tears in front of you--or worse, in front of her peers.  But she can't help herself, because inside, she's still operating like a little kid--yet societal and parental expectations are for her to act more an more like an adult, and be RESPONSIBLE.  She can't handle it all, and she doesn't want to handle it all.  It's just too much.  Worse, she feels like a failure, like she's inadequate.  She might even start to hate herself and get depressed.  Worse, to cope with her negative thoughts about herself, she might adopt a victim attitude and blame others for causing all her problems.  That way, she's not the failure--the fault rests with her family for demanding too much of her.  In fact, according to her distorted thinking, her family seems determined to abuse her.

Does your daughter tell you all the time that she can do whatever she wants, she's an adult, she's not a little girl anymore?  My BPD stepdaughter would say something like that all the time.  I think these statements reveal her own ruminations and preoccupations with feeling immature.  The reality is, she's scared; she doesn't really know who she is, or who she wants to become, because the world is too demanding and confusing for her.  She's probably frustrated that she can't seem to get what she wants, while working for what she wants is just too HARD and COMPLICATED.  "Everyone else" seems to have a perfect life, especially on social media, while she feels intensely jealous, alienated, left out.  Moreover, she gives up very easily (like an 11-year-old).  In short, she feels like a failure.  And that's why she feels compelled to remind you, she's a big girl and should be able to do whatever she wants, or she'll be furious.  Does that sound about right to you?

I agree with you that the eating disorder only makes things worse.  My stepdaughter doesn't have an eating disorder, but her poor daily routines (along with daily marijuana consumption) made her behaviors worse in my opinion.  She was eating crap, so she felt like crap.  She'd spend around 23 hours per day on her back in bed or on the couch, and surely she felt very sluggish and groggy because of that.  As she rarely left the house, I bet she was deficient in Vitamin D, which can make people feel depressed.  If people do nothing for weeks on end, they will eventually feel like nothing.  So maybe one thing you could try to focus on is healthy routines, such as healthy/regular eating, consistent sleeping hours and exercise.  I'm fairly certain that doctors will recommend adopting healthy routines as part of a treatment plan.  I'm a huge believer in healthy routines.  I think that food is medicine.  I think that without a regular sleeping routine, people are basically giving themselves jet lag all the time.  And I think that regular exercise such as walking is about the closest you can get to a magic pill.  I'm not saying that therapy isn't important--DBT is the gold standard for BPD.  I'm just saying that maybe you could focus on enforcing healthy routines in your household.  One thing you might consider is to ensure cell phones are off for everyone at nighttime (11PM to 6AM, or whatever time works best for you).

[Halcyon_days]

CC43, thank you for such a thoughtful response - everything you said sounds just like her. I need to make my peace, but it feels like giving up too.

We've really been butting heads about her boyfriend spending so much time at the house. I have been trying to place some limits because *I* need the alone time in the house without a guest here and I also want to spend time with my daughter. She keeps promising to do so but she still needs to spend every day with him. He's a nice kid and I don't mind him being here, just not all the time. I don't think I'm unreasonable?

She is viewing this as me taking him away from her and she just unleashes on me - I become pure evil in her mind, an abusive monster. I try very hard not to JADE! And I am sure it feels terrible to be away from him, she has says she feels empty, so depressed and he's the only thing that makes her feel happy. That sounds awful. I really do have empathy. I matter too though. If my need triggers her, I'm not really sure what to do here.

[CC43]

Hi,

If your daughter were in a good place, then you would probably be in a good place too, and the boyfriend probably wouldn’t bother you so much. But it sounds like right now your daughter is prioritizing the boyfriend rather than prioritizing getting her health and life back on track. My stepdaughter would do this too—she wouldn’t attend recommended therapy sessions because she wanted to do something else, like a fun trip. Well my opinion is that there is a time for fun things, but if her life is derailed because of untreated illness, then she needs to focus on getting better until she gets back on track.  Her life might be at stake.

What getting on track looks like might vary from person to person. I had to adjust my expectations for my stepdaughter, to align better with her emotional age. I think the direction of movement is more important than speed—moving forward towards a healthy, balanced life rather than self-sabotaging and “waiting and hating” all the time, ruminating negatively about a past that can’t be changed.

Just my two cents.