New here - have many questions, but 2 for now

[Intergalactic]

Hello everyone!  I'm new to this group, and grateful to have found such an informed and supportive community.  Brief summary: my son (24) was recently diagnosed, tentatively, with BPD - he's been in various forms of therapy since the age of 10 when he was diagnosed with ADHD, but we always knew something else was up.  He is extremely high functioning in terms of his intellect (genius level IQ) and got through high school with top grades, but crashed and burned when he got to college and has never fully recovered.  He works part-time in a bar and abuses alcohol and other substances pretty regularly, which is one reason why his current therapist was only tentative in the diagnosis -- but having educated myself a bit about BPD in the past few weeks, I know that's what it is.  He had a terrible episode of explosive rage this weekend when we accidentally damaged something that was precious to him (a lighter, of all things) and my DH and I used the various tools we've been reading about to defuse the situation, instead of reacting as we would have in the past... .

Anyhow, to my questions.  First, his therapist, who is trained in DBT and seems to have a good rapport with my son, shared the DX with us in a private session, but has not yet shared it with my son.  He feels that my son will react very poorly to the DX and that telling him right now be a terrible blow that will set him back.  He also has a deep aversion to protocol, is suspicious of diagnoses and the mental health field in general, thinks he's smarter than everyone and knows better, and resists the DBT tools and methods - yet he goes to therapy (twice a month at the moment, with many missed sessions.)  I tend to think that telling him will help him gain better understanding and hopefully encourage him to engage more deeply with therapy, but I understand the risks and won't substitute my judgment for the therapist's.  I wonder whether anyone else has dealt with this challenge -- i.e. knowing that your loved one has BPD but not disclosing it or discussing it openly -- and/or about the general disclose vs. not disclose conundrum.

Second, my DH and I are looking for a family support group in the NYC area, or other resources where we can learn more and interact with other families in this situation (I'll be active in this forum but DH is less inclined to do that). I submitted a registration for Family Connections over a week ago and haven't heard back.  Does anyone have recommendations?

Thanks!

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

[livednlearned]

Hi Intergalactic,

Welcome and hello

Congratulations that you were able to diffuse a potentially explosive situation! That deserves a high-five!

And it's wonderful that your son will see a therapist, especially given the doubts he expresses about the mental health field. That he is both down on it, yet continues to see the therapist is great. Having a rapport with someone trained in DBT is priceless.

People with BPD have a very fragile sense of self that can be hard to truly understand for those of us who are so-called neurotypical. Plus, the first thing your son might do is look up BPD on the internet, which is filled with hate and ignorance and vitriol towards BPD sufferers.

What I have found more helpful than anything else is exactly what you are already doing! Talking to people who understand, learning skills to validate his emotions, and setting limits.

It took about a year for me to hear back from someone in Family Connections (I'm in NC). It's led by parent volunteers trained to lead the workshops where I live, so it was offered when there was someone in a good place to teach it.

In NYC, you might be able to do a TARA class: www.tara4BPD.org/ which is an initiative led by Valeria Porr (author of Overcoming BPD).

Is there a DBT program offered for families of BPD loved ones in your area?

[Intergalactic]

Thank you, livednlearned! I think there’s a TARA workshop coming up so we will explore that. Not sure if there’s a difference between their approach and that of Family Connections. Can anyone enlighten me?

[dubiousraves]

Hi - we are in the NYC area and participated in a Family Connections weekend workshop in October. It was tremendously helpful to not only discuss all of the tools you will find on this website but also to meet other parents who are having similar struggles. I know that there were two couples who taught the course together. I don’t when they will do it again.

We looked at TARA and the primary difference seemed to be that Family Connections was taught by other parents of BPDers and TARA was taught by a professional. Also TARA was expensive.

My daughter was relieved to hear the diagnosis. All of her problems made sense to her for once and rather than having the burden of multiple diagnoses, she now had one. Maybe your son will react similarly. I think internalized stigma is what makes us reluctant to discuss this diagnosis.

In order for my daughter to get BPD treatment she had to get sober first. Luckily in NYC there are lots of free low cost ways to do this: AA, NA and Smart Recovery are usually walking distance or a short train ride away. Please PM me is you have specific questions.

[Intergalactic]

Dubiousraves, thanks so much!  Tara is indeed expensive, but I'm not sure I can wait until we get a slot in the next Family Connections workshop (which I'm told will be sometime this spring.) Tara has one coming up in a few weeks.  Anyhow, I will definitely DM you because getting sober is going to be one of my son's challenges too. Right now, it's not something he's willing to consider, though this is his therapist's area of expertise. If I so much as mention AA or NA to him, I get my heat bitten off.  He also works in a bar so he's exposed to alcohol all the time.

To be clear, I'm not at all reluctant to discuss the diagnosis with my son. It's his therapist who thinks it will be more harmful than helpful right now. So I feel torn between believing, in my gut, that it will help, and my need/desire to trust the judgment of a therapist that my son has been seeing, on and off, for nearly 2 years. Anyhow, so glad that the information was helpful to your daughter and that she's getting treatment.   

I'm trying my best to hold it together despite all of the terrible stuff that's happened - including the blow-up last weekend, in which he injured his hand so badly that he had to go to the ER (and this was with all the work with did to defuse the situation and keep it from getting worse.)  We know the sweet, kind and gentle soul is still in there -- it emerges from time to time -- and for the first time in a long while I feel a bit hopeful that we can help him figure out a way forward. 

[livednlearned]

How might you tell him? How do you think he would respond? What is the T's concerns in telling him?

As an aside, Pete Davidson, a young comedian/actor on Saturday Night Live, is diagnosed BPD. I believe he smoked pot, too, prior to his dx, and with treatment managed to ween himself off it.

He talked about his struggles briefly on a Marc Maron What the heck podcast, and he was very open about the dx.

Sometimes knowing of a celebrity who struggles with the same dx can help destigmatize it, just in case your son is an SNL fan 

[Scout206]

Hi   I am relatively new as well.  I just discovered that my daughter (30) is likely BPD.  She is receiving Dialectical Behavior Therapy from her therapist and seems to be pretty stable as far as I know.   She cut her brother and I out of her life a year and half ago and we had no idea why.   It has been extremely painful for both of us.  I have had some limited contact with her over the last month or two.  I came upon her probably diagnosis over New Year's weekend by researching DBT.  Although it is devastating, alot of things started to make sense.  I experienced some initial relief at not being totally in the dark anymore.   I have never had any interaction with her therapist and I don't know if my daughter has been given a diagnosis.   I am trying to learn what I can by reading books, participate in learning activities and online discussions and am seeking a therapist for myself.   I have no idea how my daughter would react if she does not know and I was to tell her.  I could see her going any which way - maybe good, maybe terrible.  So I am choosing to not broach that subject unless she does.   I have to have faith that her counselor is making the right decision - whatever that is.   It's not necessary for me to "know that she knows."  She seems to be doing well, so I'm going to concentrate on myself and mastering some of the communication skills that may help us talk to each other again.   Only you know what is best for your son in your situation.   Just wanted to let you know that I am facing the same dilemma and how I have chosen to handle it at this time.  Take care and let us know how it is going.   

[livednlearned]

Intergalactic and Scout206,

There is a good article on the site about getting a loved one into therapy, and the same article touches a bit on whether to tell them their diagnosis. Maybe there is something in the article that helps you with your own dilemma:

https://bpdfamily.com/content/how-to-get-borderline-into-therapy

From the article:

Unfortunately, many people with a mental illness do not fully grasp that they are afflicted.  What is often viewed by family members to be immaturity, stubbornness,  or defensiveness, is really a much more complex problem -

Minimization, Abnegation and in some cases, Anosognosia.

"Anosognosia" is the clinical term for having a deficit of self-awareness, a condition in which a person who suffers a certain disability is unaware of its existence.  According to Edwin Fuller Torrey, M.D, Anosognosia is the single largest reason why individuals with schizophrenia and bipolar disorder do not take their medications.

"Abnegation" is a defense mechanism postulated by Sigmund Freud. When a person is faced with facts that are too uncomfortable to accept, they are rejected - despite what may be overwhelming evidence.

"Minimization" is an exaggerated or irrational thought pattern that is believed to perpetuate the effects of psychopathological states, especially depression and anxiety.

The idea of impaired awareness of illness is very difficult to comprehend.

And... .

What can we do for a loved one with Borderline Personality Disorder traits?

If we want to help a loved one to get into therapy and, more importantly, to embrace the therapy, we need to "plug in" and understand both the perceptual filters that our loved one has, and their motivations.  This generally requires a great deal of listening.

Studies show that there are three areas that are most productive for family members to focus on.

*Building trust. Not blaming or not finding fault, but rather respecting our loved one's point of view, listening without telling them that they are wrong - especially regarding their point of view that they are not ill if that is their thinking. Amador says that family members and clinicians should listen carefully to the loved one's fears.  "Empathy with the patient's frustrations and even the patient's delusional beliefs are also important", remarked Amador, who said that the phrase "I understand how you feel" can make a world of difference.

*Reinforcing the developing awareness.  Reinforce the struggles that the loved one perceives as concerning. One of the most difficult things for family members to do is to limit discussions only to the problems that the loved one with the mental illness perceives as problems - not to try to convince them of others. Work with what you have. It is important to develop a partnership with the loved one around those things that can be agreed upon.

*Our belief that the loved one will benefit from treatment.  Our loved one may be happy with where they are and moving them from this position is as much art as it is science - and it may take time.

What Not To Do

Professionals do not recommend that you tell a loved one that you suspect that they have Borderline Personality Disorder. We may think that our loved one will be grateful to have the disorder targeted and will rush into therapy to conquer their demons, but this usually doesn't happen. 

Instead, this is difficult advice to receive and more likely to sound critical and shaming (e.g., you are defective) and incite defensiveness, and break down the relationship trust.  It's not like a broken leg where the affliction is tangible, the cure is tangible, and the stigma nonexistent.  While we are grateful to learn about the disorder and the pathways to recovery - for us the information is validating and represents a potential solution to our family problems- to the afflicted, it is shaming (you are defective),  stigmatizing (mental illness in general, Borderline Personality Disorder specifically), and puts all the responsibility for the family problems on the loved one's shoulders.

Very often when we say we want to help a loved one with Borderline Personality Disorder, we mean that we want the loved one to stop being a burden to the family, and to better attend to our own needs and expectations.

*Not good for us. If a loved one enters therapy or alters their behavior mostly to please us or out of fear that we will abandon them, are we helping them or are we being selfish and emotionally manipulating?  If so, this is not the best starting point for healing and recovery - and even if successful in getting someone in - will likely see pushback in the form of passive aggressiveness and resentments.

*Not good for them. Loved ones often see these efforts to help as threatening or condescending - even bullying.

[Intergalactic]

Livednlearned - Thank you!  That article was super helpful and really resonated with me. My son is self-aware enough to realize that therapy is, or at least should be, beneficial.  He tells me that he finds it helpful to have someone to talk to, so that's my starting point with him.   
I think we will probably do the TARA program for families that's coming up in February.
Scout206 - I'm with you. Not planning to tell my son anything right now. So good to hear that your daughter is doing better now... .   

[Scout206]

Dear Livednlearned and Intergalactic
Thank you both so much for your support.  I hope I have been supportive to you as well.   Livednlearned, that article was wonderful and touched a lot of the problems that I am having.   I really don't have much contact with my daughter and miss her terribly.  But that is her decision and I've got to learn to live with it.   I don't know if she loves me or her brother and don't know if she ever did.  My heart is broken and I need help in putting it back together.  I hope to find a way to help my son begin healing as well.  My first appointment with the new counselor is this afternoon.  Why am I feeling so anxious?  Thank you for being there to support me when you both have your own problems to deal with.  Scout