How to encourage BPD daughter to do DBT therapy

[Rachhach]

My 25 year old daughter has BPD. She now only has access to online psychotherapy services due to a lack of insurance and cost. She has been told of the importance of DBT work but has expressed a reluctance in the past to do DBT worksheets, and expresses doubts about the effectiveness of her current online therapy. She does feel, however, that yoga is very helpful to her. She takes an antidepressant, as well as Vyvanse to help with focus issues.

I find myself wondering how to encourage her to take part in DBT therapy since I've been told of its importance in the therapy process.

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

[kells76]

Hi Rachhach, glad you found us.

Ugh, this whole "telehealth" thing can't end too soon, IMO. In person would be so much better, but they didn't ask me to run things 

That being said, there are a lot of moving parts with your D's story, and I think I'm hearing some positives -- she does have access to therapy, albeit online, she experiences yoga as helpful, and she's medication compliant. This is a good foundation.

Can I ask, does she live at home? Did she ever move out and then back, or...? It can be complex when an adult child with MH issues lives with you.

Also, did she get officially diagnosed with BPD? How long ago? Has she seemed accepting of the diagnosis (if so)?

It's really, really hard to be in a position where you SEE and KNOW how helpful an intervention could be (DBT therapy and workbooks), yet the person isn't fully on board.

Even encouragement to do something healthy can be responded to by a pwBPD with resistance, argument, and conflict, and putting up a wall/defending against doing the thing.

As difficult as it may be, when we're in a close relationship with a pwBPD (parent, sibling, spouse, etc), we often can't be the ones to tell them what to do (or even suggest or encourage it) -- we're just too emotionally close. She may take the "encouragement" better from a third party (therapist) or peer (friend group also doing DBT).

That being said, if she's still living at home, it wouldn't be crazy to have a "live at home" contract where one of the "requirements" is doing DBT. I don't know if I'd start there, though -- could backfire. It's really hard to be in these situations where you're asking yourself "is it healthier for my child to live at home but not engage in the therapeutic process, or angrily leave home and live... somewhere... and maybe engage in DBT?" Not entry level stuff.

Lots of food for thought; but before I sign off, can I ask -- how does your support system for YOU look? Dealing with pwBPD is draining. We need to take care of ourselves in order to "make things less worse" at all. Do you have a counselor/therapist, solid friend group, understanding family? Take time for your own interests?

Looking forward to hearing back;

kells76