My Daughter has diagnosis of bpd: What boundaries/rules do you suggest?

[HoldinOn2Hope]

     

My 19 year old daughter has been diagnosed with BPD, although this was a recent "official diagnosis" we knew for years she had BPD. She has been through two inpatient programs, start three different php programs (never finishes - longest was 3 days!). She recently started a php program out of state and was living in a hotel; however, she got COVID so now can't participate for 14 days or when she gets a negative COVID test. Now she is not interested in doing PHP. We really don't want her home because of the stress, anxiety and frustration she creates in the house. Her sisters want to come home for the summer from school, but are afraid  - she is that intense. I am reading all about setting boundaries for when she returns. I need your help! What sort of boundaries do I need to have in place before she comes home? Or do we force her to participate in a php program that has housing? I am hoping you will have insight. Thank you!
KQ

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

[Oceanfish]

I think it's extremely important that you establish boundaries that you are fully able to enforce. For example, if you tell her that she is welcome in your home but you will not tolerate specific behaviors, you will need to describe those behaviors and articulate what "not tolerating" looks like. Discuss the skills has she learned to control the behavior(s). Let her know your expectation is she uses what she has learned and if she chooses not to, "here's what's going to happen." Will she be asked to leave? If so, make sure you let her know what other living arrangements you are willing to help with, if any. And if you decide that she will need to make those arrangements on her own, help her be proactive. "You will be asked to leave. You will have 24 hours to pack and leave the house."  You should also make sure she has a specific, do-able plan. "Before you move in, you will need to have a viable plan that is available on short notice and you will need to let me know what that plan is." No plan? Not telling you what the plan is? That's a deal-breaker if that's one of your rules and she won't get in the door. That's just an example, but my point is that you have to think it through to the smallest detail and make it very clear that there is no wiggle room. If she chooses to not have a Plan B, then I think it's important that she understands what not planning could look like and you have also considered the worst-case scenario if she is not allowed to move in or has to leave.

If you set boundaries and don't honor them, you will have taught her that they are meaningless and she has free reign to be as disorganized and disruptive as she wants. It's like telling a small child "no" but after being asked eleven more times, you finally say "yes". The child has just learned that "no" doesn't really mean "no", they just have to ask twelve times before they get to "yes". It's much less stressful to teach the child that you mean what you say. The child will feel more secure knowing that you honor your word and you will have eliminated a battle every time you need to say "no".

You know her typical behaviors and triggers. Plan for what's likely going to occur. This is a great opportunity for her to experience the natural consequences of not doing what she knows to do and to honor boundaries. Not just yours, but all boundaries. If she is going to enjoy any kind of success as an adult, she has to understand that she is ultimately responsible for using the tools and strategies she has been (and will continue to be) taught. 

[Isabel2]

Hi HoldinOn2Hope,

We are in the same situation and know the stress you are going through!  Our oldest was diagnosed about a year and a half ago although we knew long before that something was wrong.  She is almost 19 and currently in inpatient about to transition to a PHP program.  We have told her she cannot come home this summer. There are two younger siblings at home who are also afraid of her coming home and the stress is a toll on all of us.  She was at college prior.  Since she is scheduled to be done with the program in May we have told her she needs to sign up for summer school, live in the dorms, and just take one class to start making up for this missed semester.  Which may or may not be an option since she will not call the university to take a medical leave for this semester. If she does not call she will fail all of her classes rather than get withdraws and might not be able to go back.   We have told her if she chooses not to go back to college she has to get an apartment (which will be financially covered for her for a year) and get a job.  So far she she will not work.  She did get two jobs last year that only lasted a couple of days each. 
I agree with Oceanfish.  Everything needs to be clearly spelled out.  Prior to our daughter turning 18 we wrote up several "adult contracts" that spelled out exactly what our boundaries are.  We signed them and had her sign them. It states what we will and will not do for her as well as what her responsibilities are to receive our help...especially in terms of paying for college, buying her a car etc. So far, she has mostly refused to "adult" and we have made it clear that we are not going to just fund her life. We have seen a therapist to help us with the situation and gone over the contracts with the therapist who has helped us think of all possibilities and be clear with our boundaries.  I would also suggest communicating with family.  Several times she has called family members or posted false information on social networking about our "abuse" to get money or things from other people. Therefore, we have communicated with our parents and some other family members so they clearly know the situation, how we are tying to help her and that she does have money for food and housing right now (and even college and her first car as long as she takes steps towards becoming an adult).
So now we are just hoping the program she is in can get her back on track enough so that she can finish college and have a little more hope of being able to take care of herself in the future.