Recently diagnosed daughter refuses to accept diagnosis

[Trust5]

 I have a 27 year old daughter who has been hospitalized 14 times in the last five years and put on over 60 different medications, but seems to be making progress in her recovery recently. It is heartbreaking to see the side effects of her medications,  such as addiction and massive weight gain, but she is slowly tapering off some of them  and working with a dietitian to improve her eating and overall health.   She is living in her third apartment since living in a residential facility for seven months. It seems to be a good fit and she is able to work part time.  We are mostly able to have daily conversations without a lot of anger or conflict, however at her last visit she had a full-blown “tantrum “which brought her illness right back to the surface The issue was when cleaning out a box of books and I asked to keep the one about BPD so I could read it, she adamantly yelled that that is not what she has and got very angry and upset.  So the problem is that she refuses to except this diagnosis even though a therapist and psychological evaluation confirmed it.   She tore up the evaluation and screamed, cried,  and never excepted a copy of the report. She also  had issues with her therapist and her DBT therapist and refuses to see either one of them anymore.  I know it’s important that she establishes a trust relationship with her therapist, but she continually  says they are rude to her and not empathetic.  So now she’s on to a new therapist that the psychiatrist referred her to.  We have noticed patterns in the last five years, one of which she gets worse after or during the time she sees us.  So I need help with setting limits and boundaries when we are together. For example, I tried to tell her that  she could not sleep longer than an hour in the bed during the day in our house but on two visits  she did not cooperate.  I hate that we are “walking on eggshells “ and my husband believes I should not make her upset, but I am trying to make her responsible.   Over and over we disagree: He says it’s her illness but I say that she needs to be held accountable.   With the recent baby step progress mentioned earlier I am hopeful, but I want to be more proactive to  effectively handle conflicts the next time we get together.  My husband and I did see the same therapist that my daughter was seeing once and she tried to explain that I am the “fixer” and my husband is the “rescuer” but change is hard and my husband believes “all you need is love .”  

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

[FaithHopeLove]

Hi Trust5
Welcome to the group. I am.glad you reached out. It sounds like you have really been through a lot with your daughter. She does have lots of strengths though. She is able to live independently, hold down a part time job, and maintain a reasonably good relationship with you and your husband. That really is reason for hope. It is not unusual for people with BPD to reject their diagnosis. No one likes to be labeled, particularly those whose emotions are raw to begin with. You really can't force her. She has to come to it on her own time. I know it is tempting to try to be "pro-active" but the truth is you can't change her. The good news is you can change yourself so you don't have to walk on eggshells and you can have a better relationship with her. The first step is your own self care. What are you doing for you? Have you thought about therapy for yourself? Maybe couples counseling too? The stronger you and your husband are the better chance your daughter will have.
I hope you will stick around and keep posting. There is a wealth of wisdom here. Many of us have seen great improvement in our relationships with our children. Things can get better for you too.
Hugs
Faith

[Trust5]

 Thank you so much for your speedy reply! I think I’m taking pretty good care of myself and actually relieved that she doesn’t live here and that I don’t worry about her constantly like  I used to. My husband is very uncomfortable with therapy but I have gone myself last year for the six sessions my insurance provided.  When I say “proactive “I just want to be better at communicating with her. For example, she hung up on me on my last phone call today because she said I was criticizing her. I tried to explain to her that that is her perception, but she just didn’t take it that way.  She constantly needs validation, saying things like “I miss you “or “I need a hug “.  She constantly asks me questions for advice and I try not to give it to her directly but give her choices or give her options to choose from without directly telling her what to do but if I say  something in a different tone of voice or in a way she perceives as negative, she gets mad.  What is the best resource for getting better at our conversations?  I have made several attempts to allow her to do DBT family therapy but she is not open to it.

[FaithHopeLove]

Maybe this article by Shari Manning (one of my favorites) will help. You say your daughter needs validation. Manning really gets into the nuts and bolts of how to do that.
Validation

[once removed]

hi Trust5 and

The issue was when cleaning out a box of books and I asked to keep the one about BPD so I could read it, she adamantly yelled that that is not what she has and got very angry and upset.

there is a great deal of stigma around BPD. if you skim the vitriol on the internet if you havent already, youll see it. a lot of stereotypes, urban legends, myths, stigma.

She also  had issues with her therapist and her DBT therapist and refuses to see either one of them anymore.
...
she continually  says they are rude to her and not empathetic.

if shes aware that DBT is the treatment of choice, its possible that that had to do with her not wanting to see that therapist anymore. its hard to say. people with BPD generally rely really heavily on validation...need an extra dose of it, and empathy is probably the most important skill to have when you have a relationship with someone with BPD (whether it be parent, therapist, or spouse). a good therapist will know how to walk the line between establishing trust, challenging the patient, but also being "on their side".

Over and over we disagree: He says it’s her illness but I say that she needs to be held accountable

youre both right. people with BPD generally do not have adult developed life skills or coping skills. tough love, for example, can often be counterproductive. at the same time, accountability, as well as strong boundaries, are really a must.

so youre both right, but it sounds like you disagree in terms of your approaches. whats really important - for her and for you and your husband - is that the two of you are on the same page, and working together.

I did see the same therapist that my daughter was seeing once and she tried to explain that I am the “fixer” and my husband is the “rescuer” but change is hard and my husband believes “all you need is love .” 

would your husband be open to going back? working to get on the same page?

[Trust5]

Thank you for the article which was a good read.  I found the part about masking feelings because they have learned that others don’t react well to their sensitivity and then they are not acknowledging or naming their feelings to be interesting. I feel like I am successful some of the time in conversation but I still wish she would consent to family therapy so we could get better at it.  We had a bad conversation this evening.  She called me to say she was sad so I asked her what she had done today to feel better. Then she said she took Ativan. That made me so upset because I know how addictive it is and how it causes suicidal thoughts.  Every 3-5 months I go into panic mode that she’s going to end up in the hospital on more drugs.   I asked her if she had checked with her psychiatrist (she has a stash of this drug from the residential facility where she lived).  My husband was in the background telling me to stop making her upset and then when I handed him the phone she tells him to make sure I don’t contact the psychiatrist (pitting us against each other).   When her sister arrives to see her, she texts me to say that she was putting on a show and she’s fine (always worse around us).  My husband listened to what I had to say but won’t go back to see our daughter's old therapist.  I’m not sure how things are going to get better without us all working together.  

[FaithHopeLove]

It really is important for you and your husband to be on the same page.You will need couple strength for the days ahead. Is couples counseling, even for a short term, an option?

[Trust5]

How do I find a therapist?  Should we try to connect with her new therapist she is starting with, her old DBT therapist (our daughter M is still participating in group DBT therapy, just not individual) or the one who M was previously working with (K)?  My husband is not open to seeing K but I thought she was good even though she was straightforward. H was a little put off and in disagreement to what she had to say.  We are located 1 1/2 hrs away from M and these counselors.  I would choose K because she has the history and the family dynamic. If H won’t go, does it make sense to go myself?  Do you think couples therapy would be more helpful than family therapy?

[FaithHopeLove]

How do I find a therapist?

I usually start with my insurance company.

 Should we try to connect with her new therapist she is starting with, her old DBT therapist (our daughter M is still participating in group DBT therapy, just not individual) or the one who M was previously working with (K)?

  Couples or individual counseling for you and your husband are a separate matter from your daughter's counseling.

 

. If H won’t go, does it make sense to go myself?  Do you think couples therapy would be more helpful than family therapy? 

Yes, it would definitely make sense for you to go to counseling on your own. Couples counseling with your spouse would also be great. These are things you can do for that sake of your own SELF care. If you don't take care of yourself you won't be able to take care of your daughter so you really have to put this first.

[Trust5]

 Thank you for this advice. I will look into it. This is an amazing support group!