Intro and question

[lake]

I have a 20 year old son who has never been diagnosed but has strong BPD traits. I noticed the first signs of unusual emotional dysregulation in him when he was 15 months old. Up till then he had been an exceptionally easy, happy baby. By age 2, he would stiffen his legs and wring his little hands and scream the loudest and most piercing scream I had ever heard if he was stopped from doing something unsafe. His distress was heart-wrenching and I responded by trying to help him learn how to handle frustration in a way that was easier for him. (I did not give in to these screaming episodes and allow him to do the dangerous thing, so there was no obvious “gain” for him and when he calmed down he would mind that he had gotten so out of his own control.)

The behavior continued and when he was about 4, I got him to make up a list of all the things he could think of that helped him calm down and then guided him to become more aware of when he was just starting to get upset and chose one of the calming activities instead. (On his list, he asked me to write things like “take a bubble bath” or “listen to story tape” or “hugs”.) Despite this sort of attempt at helping him, and my reading every book I could find over the last 18 years that related to this in any way and trying every suggestion that made sense, the behaviors persisted and intensified as the years went by.

When he was not dysregulated (or gearing up for an episode by relentlessly provoking a family member), he was a loving and caring boy. He had a remarkably long attention span, even when he was tiny, and loved to learn. It was almost like there were two of him — an adorable, gentle, helpful boy and an impossibly difficult and wildly out of control one.

Things got vastly worse when he was 16 and discovered he could calm himself down quickly with marijuana. I had done all I could to lay the groundwork for his not using drugs, explained about genetic vulnerabilities to addiction (and that people with these vulnerabilities do not really have the freedom to “experiment” because the experiment can go so wrong so quickly).

Long before he ever saw a drug, I told him about the toll addiction can take on both the addict and the family and he was interested in this and asked all sorts of very perceptive questions. From a very young age, he was quite fascinated by contradictions in people … how a person could hold a strong belief yet behave in ways that did not align with this. He started asking questions about this when he was only 2. His verbal skills and level of emotional awareness always seemed far beyond his years. With friends, he was sensitive and gentle and generous. Other mothers loved to have him over to play because he was so well-behaved and had a skill for including their younger children and keeping the play peaceful. At 12, he began volunteering at an animal shelter and chose to do this about 20 hours a week while still staying on top of all his academics. I’m explaining all this to try to give some sense of what a range of behaviors he had and how, under the right circumstances, he had high levels of self control and kindness.

In high school he met lots of drug users and drug dealers who opened up a whole new universe of aggressive and menacing behavior to him. It was as if he saw this and thought, “Oh THAT’S how you show anger and dominance! I’ve really been under-doing it all these years.” Coinciding with this, he became much, much stronger than me. His “bad side”, if you can call it that, began to take on the precise speech patterns and arms gestures and style of threats of people at his school who had been raised by violent crack addict mothers in the most impoverished cities near ours. He began talking to me (and still does, when angry) as if I am a threatening gang member who is blocking his way and about to rob him in a back alley when in fact I am his mother who has never once even smacked him and I’m handing him his dinner. I mean this literally — he goes into a flawless impersonation of a person who has about a 2nd grade level of education, has no understanding of basic grammar, and has spent his life trying to survive amidst violent drug dealers, pimps, and thugs. Then, with no transition, the next time I see him he may talk to me, in a humorous and friendly manner, with the level of vocabulary and insight of a highly functional university teacher (which he most certainly is not!)

His triggers at 20 are just what they were when he was a child: my saying no to him, my insisting that he stop doing something dangerous, and my trying to get away from him when he is raging.

I still do not know if this is BPD. When he was 2, I had the sense that a kind of storm was taking place in his brain — a bit like a migraine, yet instead of creating an agonizing headache and nausea, the storm was creating wildly out of control behavior. I still have this sense, 18 years later — that his problem is primarily neurological … yet it is all tied into predictable emotional triggers.

The most pressing question I would love to get some feedback on is how to best handle his rages. It is to a level now where he truly seems crazy when he is angry and it can be very scary. Yet he can, on rare occasion, pause briefly and say he is trying to scare me by pretending to be a sociopath. (?)

I have tried kicking him out, but when he was homeless he began using meth and became much more reckless, suicidal, and threatening. His homelessness made things much worse for him, and more dangerous for me because he was angrier, extremely destabilized by dangerous mixtures of drugs (like molly, alcohol, and cocaine), and he felt he had less to lose. He did not finish high school (despite being a brilliant student until he took up drugs) and has been unable to keep a job. At present, he is living in the home is a separate little studio I had made for him last year to try to keep him safe from homelessness while also trying to keep my younger children and myself safe from him. I have a restraining order which I felt was my only recourse last year and this has (so far) stopped him from breaking into the main part of the house, though I may have invalidated it by letting him live in the studio. He is both devastated and enraged about not being allowed into the rest of the house and he goes into raging tirades at me about my cruelty, screaming swearwords at me on the sidewalk and telling me things like, “You are so cruel! You will die alone because no one likes you! You f@#$%^$ b&^%$! You f#$%^&^ w!@#*”

Might anger management help? (He has so far been unwilling to consider this but I could say he can no longer stay at the house unless he does this.)

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

[Blaublau]

Hi,
I think you need a hug! Thank you for sharing your story. I believe, many here are in similar situations.

My d is 16, and she seems similar in many ways that you described. We had her in local treatment for years with her, because something was just not right. The aggression, the drugs, and cutting school. We actually placed her now in a residential treatment (against her will). She will probably stay there for a long time, as we cannot control her at all at home. I am almost scarred of her. She is not safe (stealing credit cards, cars, using drugs, and possibly offering sex for drugs.) I am worried for her safety and ours (younger brother). d was diagnosed with traits of boarderline, bipolar, opossisional defiance, depression and anxiety. Under 18 you don't get a firm diagnosis, just a list of traits.

Did you ever go to a parents or family group meeting for BPD parents? That could be helpful.
Find a psychologist that deals with BPD's. DBT might be helpful for him. That is the typical therapy they do for boarderlines.

In some states, family members can legally force addicts into rehab. In Florida there is the Marchman Act.

I do think, it is important, to keep you and the rest of your family safe. I am not sure, if there is a way to truly control your son's rages, especially if he is on drugs. Only by giving in to his demands, and giving him what he wants.

Hang in there, be safe. He might need to face natural consequences for his behavior.

[lake]

Thank you, Blaublau, for your warm response and kind words. I'm sorry to hear of your difficulties with your daughter.

I have been going to NAMI meetings and Al-anon but have not found a group in my area specifically for parents of BPD kids. My insurance does not cover the DBT program in my city ... .I called and talked to the people who run it and it is $500 a day, 5 days a week, for many months (if you don't have the right insurance). I am hesitant to take out a huge loan to pay for this when my son is dead set against going for any kind of treatment let alone this kind of time commitment. The therapists who are covered by my insurance are not DBT people or trained to treat BPD.

In my state, kids have the legal right to refuse treatment, even when they are minors -- or that was what I was told every time I tried to get help for my son. When he was 16 and starting to have substance abuse problems, I took him to the pediatrician, the counsellor at his school, and to a drug counsellor and tried to get him into an adolescent rehab program which was covered by our insurance. Everyone I took him to told me they could only treat him if he wanted help -- it was his choice, not mine. He was adamant that treatment was pointless and he still feels this way. He has had friends who were put into very expensive out-of-state (forced) rehabs for long periods, other friends who have been extensively treated by psychiatrists and had stints of residential care (no expense spared) and he claims they are all still drugs addicts and just as crazy as they were before the treatment. He has a sense of hopelessness about it. He told me a couple of weeks ago that if he told a professional about his thoughts, he'd be locked up indefinitely -- which he dreads -- and if he lied, there would be no point in going.

Two months ago he decided to stop using drugs. I have no idea how long this will last. He has tried so many, many times to quit, starting a couple of months after he first started smoking marijuana, and each time he would be clean for a while (usually only a few days) and then start using. It is unsettling to see that with no drugs in his system for weeks, his thinking still seems bizarre at times (which it never once did prior to drugs). He has told me, in despair, that he is sure he has done irreparable damage to his brain with molly. (He first used only marijuana, compulsively for about two years, but when he tried molly he realized he preferred it and his marijuana addiction faded and was quickly replaced by a molly addiction.)

 

[Gorges]

Wow, sorry you are going through this.  My daughter lived alone starting at age 18.  It was tough to watch her do bad things, but it did make her want to change her behavior.  However, every person's journey is different and I did take her back in because my intuition told me she was ready to change.  If your son has given up drugs for two months, that is promising.  I hope you are getting help from a therapist for yourself and the rest of your family.