How do I ...encourage treatment for adult son with BPD ?

[losttrust]

He has 8 of the 9 traits of BPD and he's not getting any better as time passes.  I've found a residential treatment program after tons of research that treats and uses DPT, located in my state, that my insurance looks to be  willing to partially cover and a bed that will open soon (in the month).  Problem now is to get my son onboard with going.  He's back peddling-  at first is was yes please try to get me in and now he has a intake appointment he's getting agitated.  I can see the idea is beginning to trigger him.   

He has lost faith in the industry after several  "diagnosis" over 5 years with medicine trial/fails. any one have any words of wisdom on how to "sell it" to him to go?   he's 24, I'm worried he's running out of my insurance time wise.  And at 24 he's very aware of his live being lived- vs his friends. this too triggers depression, feelings of abandonment, and suicidal thoughts.  Which then he becomes obsessive and clingily.  He tries desperately to do what others do daily to be "normal"- finds and gets a job, to then lose the job,  lose the girlfriend after a inappropriate comment or reaction from a trigger-  one to many "i hate you don't leave me" and eventually they wary to the roller coaster ride and leave.  Often he quits the job after he's used up every excuse for his irrational behavior or inability to retain and follow instructions.  For these reasons I am aiming for him to attend residential but how to push without appearing as such?

What i am thinking to say-    "you might be thinking that your being dumped off to be rid of -Your family will not abandon you. Think of this as you taking a work trip for training or class.  I can appreciate you might to be fearful that this treatment will fail, like others you've tried before.  I cant make promises but I can say they have resources for you that others didn't have,  and alumni that do provide mentorships.   You will have input in your future goals and after treatment plan too.  Your family will be part of your after treatment support and we too will take classes to better understand how to help support you. 

thoughts?   Be as critical as you can.  I really feel i'm up against the clock and finding treatment has been beyond challenging.  If they understand bpt then they don't have openings, if they are open they really don't use dpt.  And dozens just never reply...   

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

[KBug]

I'm sorry that you and your son are having such a difficult time.  I really hope that you can find something that will help you both. It sounds like the dialogue that you have worked out is supportive and addresses his fears. I'm wondering how you can convey the idea is a way that would work for him that he's not happy with his life right now and that he doesn't have much to lose except for getting his hopes up and being disappointed again. The worst case scenario is that it might not help and he will be in the same situation he is now. It might also help if you talked about how it would help you to understand BPD better and support him better.

[losttrust]

I like your idea. And I am in need of learning skills and better understanding of all.  Feel like I’ve been sustaining but not truly living my life since this took center stage. 

[KBug]

It's easy to get lost in loved one's struggles, at least it is for me.  Have you considered going to CODA?  https://coda.org/

[losttrust]

Thank you I’ll attend this Wednesday - to learn more.  It’s such a challenge as one minute my son is hopeless and my instinct to help him,  the next minute he’s triggered and Im either trying to listen with empathy and use skills I’m learning  to calm waters for a more productive dialog.  But there are too many times my words /actions fall short and All I can do is to announce he’s crossed boundaries and escape while he is in full rage.   

[Resiliant]

Hi Losttrust,

Your post got me thinking.

In the business world, salespersons are taught to plan responses to anticipated objections ahead of time.  And, encouraging him to go to treatment is essentially a sales pitch one could say.  

When he is not dysregulated and open to discussion of some sort, would you be able to pull this information out of him?  Asking him, tell me more... what are you afraid of?   Or, if you think it would actually be detrimental to insinuate that it is fear keeping him from getting help then maybe it would be better to ask him what he thinks are the pros and cons.  

You have already identified some of his fears.

He could also have answers such as:
- fear about abuse or mistreatment
- fear of being "locked up"
- fear of feeling abandoned (as you already recognized)
- fear of other people in the program
- fear of being like the other people in the program - I'm not one of them!
- fear of future labelling or being considered a weak person because he had to go through this
- you are my mom, I need you and I can't do this without you there
- I can't do this, sitting in a room of strangers isn't going to make me happier and won't take away my pain

Salespersons are also taught to find the "real" objection covered up by an excuse.  For example "I'm not in a hurry, I don't really need it right now" could mean "I want to shop around".

Likely there are fears he won't want to admit such as:
- pressure to have to be better after he gets out
- pressure to have to be better because you spent all this effort and money
- don't take this away from me!  

What are some of the pros?
- a place to rest and heal
- no pressure to work, food and shelter are provided
- surrounded by people who understand, people who "get it"
- new friends and relationships
- skills that he can take with him
- maybe there are testimonials from people he can see are real, normal people.

The important thing is to imagine all of his voiced objections and prepare your responses.  See if you can figure out how you can validate his fears without necessarily agreeing with him.  I'm not sure which method you want to use, SET, SHIFT, DEARMAN are all good communication techniques.   If it was me I would do some homework and even write them down in a safe place so that I was as prepared as possible.  Practising them in my head might help me come up with more objections and anticipated responses.

The hard part for me would be how to validate the fears without making those same fears somehow "bigger".   What does work for me (in other conversations - we are not there yet in terms of treatment) is to ask more questions, leading to a more rational answer that comes from him and not from me.

In the end, it would be great if he could be open to the question of what is the bigger mistake - getting treatment that only helped a little bit, or not getting treatment and never knowing if it would have helped.  Trying and failing, or failing to try?  Maybe remove some of the pressure to perform?

Maybe he won't want to talk about it.  It will be a balancing act not to make him feel "pushed".

Hope this is somewhat helpful.  Congratulations to you for accomplishing the conversations that at least get him to consider it thus far!

All the best.  Please keep us posted and let us know how it goes.

R

[losttrust]

Thank you so much for your thoughtful response and suggestions.   
 
He has shared a few nuggets of his concerns over the past few days such as  (how do i explain where i've been; i cant share a room with my ocd, i cant smoke marijuana and its the only way i can sleep, its going to be like every other medicine and not work, your spending money that could be used to move me out or buy me a car)   He seems to be working through the pro's too.  Just mentioned last night wish he would have not done this or that and how he now will never know the outcome and feels he "may have missed a opportunity"...  so the logic thinking is there at times. 

I've tried to paint the picture that this is a resource to learn tools, get a third party input and build towards a goal of less pain and less suffering.  My hopes are he finds a mentorship and learn from others that understand and share similar challenges he's had.   There are limited staff and patients who are all men.  Its not a lock up facility, rather a voluntary environment.  and they blend therapy  with physical wellbeing which he has priority as he works out daily.  He agrees He isn't living a enjoyable life now and his patterns of current learned behaviors has him stuck in cycles with his female relationships ending in him feeling mis understood, unfulfilled, disrespected.     

I do also believe i am to blame for his impairment.  I've allowed him all the comforts without real boundaries. Ostridge style. Its been a long road of learning and coming to grips with all.  He  has expressed his belief to be mentally ill he feels others should  "take care of me, do it for me" - the residential center does both DBT and CBT therapy.   

thank you again for your ideas.

[losttrust]

Update / son has agreed this is a opportunity not punishment and he now is looking forward to the help.  While we wait to see if we passed the intake interview.  Waiting on Pins and needles for the yes.   Saying prayers it’s a match and a bed is available sooner then later.   Will let you all know.   

[losttrust]

Son has been been given the go ahead for residential  - much gratitude and high hopes for some:any - improvement   .   

Now to get insurance to pay beyond the large deductible and for enough time to allow for treatment.  Son struggling nightly and it’s been rough lately. This  Forum has been a very helpful source and sad, yet comforting for me to realize I’m not the only parent feeling these feelings.  I learn from your posts.  Thank you all.  Hugs

[KBug]

Thank you I’ll attend this Wednesday - to learn more.  It’s such a challenge as one minute my son is hopeless and my instinct to help him,  the next minute he’s triggered and Im either trying to listen with empathy and use skills I’m learning  to calm waters for a more productive dialog.  But there are too many times my words /actions fall short and All I can do is to announce he’s crossed boundaries and escape while he is in full rage.  

Yes.  I know this dynamic all too well.  You are not alone here. Don't blame yourself for triggering.  We can all learn more effective ways to communicate with our loves ones, but many times the triggering isn't about what you've said but what the pwBPD is already thinking and struggling with personally.  It's really common for them to completely misinterpret what you have said to match whatever's going through their minds.  When in crisis, the alert/safety system in their brain is hypersensitive and detects threat where there isn't any and their rational brains aren't functioning well so there's nothing to reign in their fear/anger reactions.