Please help me.

[Trying306]

My 20 year old daughter has been struggling since she was 15. She has always had anger issues (big feelings disproportionate to the stressor) even when she was little. She showed social anxiety traits we noticed in high school and depression. We took her to counselling and she’s been in therapy since she was 17. She’s been diagnosed anxiety, depression, and ptsd (from a sa by her first boyfriend when she was 15- which she hid and we don’t find out until a self harm attempt and hospitalization when she was 17). She is convinced she has BPD- and says her therapist and psychiatrist confirmed it (but they have never mentioned it to us). But then again she is 20 so maybe they have and just don’t tell us? The past 7 months have been an extremel challenge. She is struggling so much, her meds have not worked, and her episodes of verbal aggression has escalated to physical violence- but only against me and my husband (her father). My younger daughter has witnessed these events, but she has never had any sort of episode in front of anyone else. No teacher, employer therapist doctor or friend has any idea she has these episodes. To them she is the smartest and sweetest person. At home though, she is so volatile. She never truly participates in any family day to day activities. Getting her own food or drinks (we have to hand deliver them to her room- exactly what she wants not what the family is eating) and she refuses to help out at all. Even asking her to unload the dishwasher or to bring down her dishes will trigger her anger. Unless of course we have company. If we can get her to participate she is the model of a human. Helpful, friendly, outgoing.
The last seven months her episodes are daily, If not multiple times a day. She is now even hitting me or pulling my hair as I am trying to drive her to university because she was running late (even after I packed her bag for her with her laptop and headphones, brought her her morning meds and breakfast, started the car to warm it up for her, and gave her gentle reminders of the time). Unfortunately I forgot to hand her her mittens so the verbal abuse began. I’m stupid I’m a bi&;$, I’m useless and it is now my fault she refuses to go to class (because I couldn’t find where she put her mittens). Without reacting in any way, keeping calm I got her into the car but she then was screaming at me (to get a reaction out of me-I suppose) she grabbed my hair as I was driving and tugged hard enough I almost lost control of the vehicle. Again. I didn’t react and kept driving her to class (as we were now 4 minutes away from her being late). I know I have to pick her up and get her home asap because she has an online midterm 15 minutes after her class ends. But I asked her as I was dropping her off what time and which doors does she need to be picked up, and she refused to answer: she just got out and went to class. I took the day off work just so I could get her to and from class in time for her online exam, and I know she doesn’t mean the things she says or does, but how do I set boundaries? Everything I read says to set boundaries but HOW? The one time I said “sweetie I am sorry you are feeing overwhelmed right now, but you can no longer put your hands on me or your dad. I am done with the violence.” Apparently all she heard was “I’m done”. This validating her belief I am abandoning her. It took weeks for her to call me her mom again. She still demanded I do all the things for her, but “I am no longer her mom”.
There is so much more, but I am struggling so much. We love her and just want so badly to make sure she feels loved, validated and safe, but every time we try to set a boundary the situation becomes so much worse. We are trying to get her into a private facility in a different province (as we don’t have one here) but she does not want to take a semester off university. Since she is 20 we can’t really force the issue. Chronically she is 20, but mentally and emotionally she could not move out or be in any way self-sufficient..
How do we set boundaries without triggering an episode? And is this the best time to do that when she seems to be in such crisis?

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

[BPDstinks]

hi!  I am so very sorry to hear this I guess I would say welcome to the club, but it is not the club to be in very quick version (i always say I sound "non-chalalant" but mine has been going on for so long...my almost 26 year old daughter was diagnosed with BPD nearly 4 years ago; at first, I was her favorite person (again, not the place you want to be); I have researched BPD, joined NAMI, I have a therapist, who specializes in assisting parents of children with BPD, I have read (I suggest...) Walking on Egg Shells (I Hate You Don't Leave Me....is very clinical); for awhile, I would stay over her apartment, she had me hide her knives, there were 3 inpatient psych stays, I had to force feed her once, like you, she could be nice or soooo sooo mean; fast forward, 3 years ago, she said I was "enabling her" and cut off ties with me, her dad, sister & beautiful nieces (we practically raised); so, I don't necessarily have advice, just stay strong and hang in there....BPD is a BEAST please reach out, if you like

[Sancho]

Hi Trying306
You are surely in a very difficult position – particularly as DD is now a legal adult (here she would be). In reading your post I am wondering a few things such as do you see DD take the prescribed meds or do you hand them to her and presume she is taking them?

The other side could be that the meds are not well targeted and affecting her in many ways such as quality of sleep.

Also what meds has DD been prescribed? This does give a clue as to what the doctor has identified. You describe the morning scene – and also that DD suffered from social anxiety from a young age. The morning you describe is one that I can really identify with. The tension at that time of day I found to be connected to poor sleep – unable to get to sleep, then tired in the morning – and huge anxiety at the anticipation of the day ahead.

There were two responses – one was all out blaming and abusing me, the other was avoidance ie refuse to get up. Do you have an idea of DD’s ability to get to sleep and her sleep quality?

I do think timing of boundaries is important. A lot of the time I think we put up one when we have reached the end of our tether and are trying to stop ourselves drowning under the weight of the chaos. It is the end of the academic year here – not sure where you are in the world and how that fits with her studies.

This might sound ridiculous, but I think the most important thing at the moment is to let go of your anxiety regarding DD. My DD picked up on mine and it sent her anxiety through the roof. I learnt to do what I had to do but put my mind in another place. It as especially the case driving her to school. Talking made her anxiety a lot worse. If I was anxiously driving her, it made it worse .

There is a great deal to sort and I think focusing on one thing is helpful. I am speaking only from my experience of course but I would:
-observe what is happening re meds and know what they are supposed to be doing
- step back in my mind so that I disengaged emotionally from DD. If you do this for a while, I found it helped enormously for DD to be able to express what was happening for her.

I am probably not making sense – so apologies. I understand the importance of getting her to class etc – and I would prioritize that too – it’s just that it doesn’t seem as though the professional support has got to the bottom of your DD’s issues. The focus on you as a target of anger etc sure looks like BPD, but are there sensory processing issues, ADHD – just thinking aloud!

[SoVeryConfused]

HI,
This sounds like a lot, and I'm really sorry. This sounds like a dangerous situation for your family. And not one that is going to get better without some changes. In my opinion,  physical abuse shouldn't be tolerated, so maybe it is time to get the police involved.

From a boundaries perspective, boundaries are what YOU will do if X happens. Because we have no true control over another person's actions, we control what we will do in response to them. So, for example - if you hit me again, I will leave the room and not bring you dinner/take away the car/turn off your phone plan/not drive you to class/call the police. Those are all things you do because you control you.

I've struggled mightily with boundaries. They are still hard for me, honestly, so I get it. No one really tells you how to do them. I found it helpful to read a few books: My Daughter has BPD, Boundaries by Henry Cloud, Stop Caretaking the BPD. But I did have to get myself a therapist.

Like you, I have been most worried about making sure my daughter feels validated and loved, but when they are in a flare-up and dysregulated, our love or kindness often fuels more dysregulation and reinforces the behavior. That's not me saying it, but the official literature.

In DBT, they say reinforce the behaviors you want to see and don't reinforce the ones you don't.

There's a lot to unpack in your story, so I would highly suggest the Family Connections class by NEA BPD as one option and a BPD-experienced therapist as another. It's impossible to parent our kids as we would parent regularly because the things that show love and connection are not interpreted by them in that way for all sorts of reasons. Hang in there.

[CC43]

Hi Trying,

I know it's really tough.  I have an adult stepdaughter with BPD, and at 20, she was basically an emotional terrorist in the home.  She went "nuclear" with suicide threats.  She wouldn't eat with the family or help out one bit.  Her room and person were a mess, a reflection of her mental state.  She'd stay up all night and sleep until after noon.  She'd blame her family for all her problems.  Though she could pull herself together to do things she wanted, like go on spring break, at home she was passive-aggressive and extremely moody.  The irony was, it's wasn't spring break because she wasn't even enrolled in school.  She was NEETT--not in education, employment, training or therapy.  I think she was NEETT for far too long, to her own detriment and to that of her entire family.  If person isn't studying, working, volunteering or doing anything but watching screens all night, what are they?  They're doing nothing, which very quickly feels like becoming nothing. 

If your daughter manages to pull herself together enough to attend school and keep some friendships intact, then I'd say, that's a sign she's high functioning.  But the stress of it all is probably wearing her down, and when she's with you, she shows it.  My concern is that she's being violent.  Look, just because she has BPD doesn't give her a free pass to be violent.  That includes violence against you, your family and herself.  No violence should be a firm boundary in my opinion.  If your daughter is violent, I think you call the police, every time.  Now, pwBPD do NOT like boundaries.  It's likely that your daughter would up the ante with her behaviors, becoming meaner and more violent.  Because she has a victim attitude and uses projection, she would probably claim that YOU were violent, and that YOU started it.  (My stepdaughter did that, saying that family members "assaulted" her when she was violent.)  This is called an "extintion burst."  But if you are firm and call the cops every single time she's violent, she should learn that violence isn't tolerated in your home.

I think you are spot on in your analysis of your daughter's maturity.  It helped me to think of my adult BPD stepdaughter in terms of intellectual/chronological vs. emotional age.  At 20, she was bumping up against a complex adult's world with the emotional skills of a young teen.  She simply wasn't equipped to handle the academic pressure, social dynamics and expectations of autonomy of young adulthood.  Her emotional brain was still at the level of a young teenager, ruled by self-centeredness, impulsivity, desire for instant gratification, intolerance of discomfort, difficulties handling setbacks, a quick temper, lack of empathy.  She also lacked perspective and had a very naive, childish understanding of how the world works.  Worst of all, she didn't really know who she was or where she fit in.  I think she was terrified about the future and completely shut down in avoidance.  Yet thinking in terms of emotional immaturity gave me some hope.  My stepdaughter needed some extra time to mature, as well as therapeutic support to learn some better coping skills.  I think that's why DBT therapy can help people with BPD, provided that they commit to the process.

If your daughter is calling you useless, mean and stupid, when you are clearly not any of those things, that is code for what she thinks about herself.  She is so ashamed and preoccupied with feeling inferior that it colors everything she sees.  She interprets the world through that distorted lens.  Based on what you wrote, I'd say she's projecting her insecurities onto you, which is a common BPD behavior.  I'd say she's extremely insecure, and she needs tons of reassurances from you.  My guess is that she's finding college extremely challenging with a full course load and much less support than what she was used to as a younger school girl.  One thing she might try is a reduced course load, until she gets a better handle of it.

I'll wrap up by saying that it sounds to me like you are over-functioning for your daughter.  I know, you want to reduce the stress in her life, in the name of keeping her stable.  But if you protect her too much, she'll never feel the natural consequences of her behavior, and she won't learn.  I'd say, she's the one responsible for her mittens, and all her clothes in fact.  If she can't find her mittens, then she'll have cold hands for the day, which is the natural consequence.  If she's late to class, she bears the consequence, not you.  If she doesn't face any consequences, she'll never learn.  And if you treat her like an 8-year-old girl, she's going to act like one, and slowly she starts to feel like one, too.  If she wants food, she needs to come to the kitchen like everyone else.  It's not your job to provide her room service.  You don't have to tell her your plans, just stop acting like her personal maid/short-order cook/butler/chauffeur and start treating her like an adult.  Adults have responsibilities, too.  In my opinion, she needs to help out in the home, and when she starts helping out, she'll start to feel more competent and part of the family.  Just because she has BPD doesn't give her the right to be a demanding freeloader, correct?  But if you start to make these changes, my advice would be to proceed in baby steps, with one change at a time.