Advice needed about boundaries and self harm

[Elolia97]

Hi,
My 15yo non binary teenager (born female) has been suffering from anxiety, depression, suicide ideation, self harm, psychotic thoughts and an eating disorder for about a year now. They are getting professional help with two psychologists and a psychiatrist who recently diagnosed them with emerging BPD. I am struggling with saying no to them for any requests as I feel powerless due to being crippled by fear of more self harm or worse. At the moment the requests are not unreasonable like getting energy drinks or hanging with their friends after school but I worry that I'm not saying No and am setting myself up for more difficult times ahead! Do you have any advice?
Thank you!

[Elolia97 · Accepted solution]

Dear one,

Thank you so much for your long and extensive response to my rant!
I haven't had much of a chance to reply properly which is why I haven't answered you yet but I just wanted you to know I was very grateful for your advice. I still am unable to respond as much as I'd like to to each paragraph but am on the bus about to pick up my child so again, limited time
But quickly, I hear you and am sorry it's been so hard for you with your daughter...
Regarding boundaries, I agree working out my values is important and making the boundaries around those makes sense!
I have my coaching coming up this Monday so will hopefully get help with these.
And I have done similar to your friend... part of me has accepted the worse, just in case, as hard as that is. Perhaps it's our mind's way of coping
Lots of love back at you

[Marimo-RO]

Hi @Elolia97,

Welcome to the forums and thank you for opening up about your concerns on boundaries with your teenager. I can see that your teenager has been going on what sounds like a very complex mental health journey. It's understandable that this has made it harder for you to say no due to concerns about future self-harm.

I am glad to hear that you have sought professional help for your child and I can see that you're doing your best to provide the support they need. Are you currently working with your child's mental health professionals as well?

I can understand the fear you have around setting boundaries with your teen, especially knowing how vulnerable they are right now. We have some resources on hand around setting boundaries and hope they might be helpful as you navigate this. Here are some articles on setting realistic boundaries and on open communication with your teenager. ReachOut also provides a parent coaching service that can provide you with free one-on-one support. 

I also understand that supporting your teenager through their mental health journey can be very stressful and I wanted to check in on you. How are you managing it so far? Do you have any supports for yourself?

I hope you find the support you need here on the forums.

Looking forward to your reply!

[Jade321]

If your teen is only asking for reasonable things, then there’s no reason not to say yes. My teen has become very reasonable and responsible and the only legitimate denial I typically have is financial.
While your teen’s mental health supports have a duty of confidentiality, they can still (and are best positioned) to give you some guidance on how best to support your teen at home. You don’t need to walk on eggshells, the whole family could probably learn some new skills. Ask if there are any family DBT groups in your area. DBT is the gold standard for BPD.

[Elolia97]

Hi Marimo,
Thank you so much for taking the time to respond to my post.
Yes indeed, their mental health challenges are very complex.
I'm trying to get in touch with their mental health team to get some specific advice about recent behaviour such as being disrespectful to me by getting angry at me for little things like spilling water on them accidentally or not getting their food/snacks right ( they have anorexia so I have to be the provider). I feel like I'm walking on egg shells with them. I seem to be the one they treat the worst but their sister something gets that behaviour too. I believe I need to set consequences but I'm really not sure what consequences to set for rudeness or disrespect.... if I restrict their phone use, they immediately say they need their phone for their mental health all the time 24hours a day unlocked. If I say they will lose their privileges of visiting their girlfriend, again this will impact their mental health.
I have organised a one on one counselling support for myself which is coming up in a couple of weeks, thank you for that heads up.
Thank you again.

[Elolia97]

Thank you Jade for taking time to reply. It's true so far the requests are not unreasonable so I don't need to worry too much. As far as DBT my child did try that themselves but refused to participate as they said it didn't work for them. Family based might be a good idea but I'd have to see if they were willing or try to see if I can participate in the next session with their psychologist! The hardest thing I'm finding is the rudeness at times and irritability, consequences are difficult as I don't know what to set with them, restrictions on their phone would make sense as they are addicted but they say they need it for their mental health support.
Thank you again for your response.

[Bel_RO]

Hi @Elolia97,

Thank you for your response. It can be really taxing to be experiencing disrespect. I can see that you have tried to set consequences but were told that their mental health would be impacted if you followed through. This can be daunting as you do not want to escalate their distress yet cannot maintain these consequences. I encourage you to explore Carers Gateway and Parent Helpline SA for advice and additional support around setting boundaries and consequences. 

I am glad to hear that you have a counselling session booked in for yourself in a couple of weeks. I really hope this helps you feel more supported. I also want to remind you that you aren’t alone, we are here to listen and support you!. 

[sunmoonstars]

Hi Elolia97,

I'm just hear to offer understanding and a virtual hug (((HUGS)))  ... I can relate to the inability to set boundaries with my 16yo daughter, diagnosed with BPD, and also the rudeness / irritability ... this was how our journey started, but even with meds, the blow-outs are now more like rage and viscous verbal attacks. When she goes from zero to 100 with her disregulation, the attacks are personal and I am enemy #1. It's really difficult.

We've only had a diagnosis for a couple of months, but I've attempted to research as much as I can about BPD and there are two stand-out things (in my opinion) that are of the utmost importance: validation and boundaries. However, that being said, the boundaries seem to cause the most problems. Last week I turned the wifi off (which I do every night), however my daughter was already in a state after not being home for a week; what ensued was a trip to the hospital for 8 stitches as she cut her leg in frustration

Should I have just let go on the wifi? This time, probably. But neglecting to set reasonable boundaries over time has cost me in the long run. Including the phone .. the excessive use of it is definitely not helping her healing, and perhaps like your child, she doesn't really want to heal yet anyway. We don't have DBT in our area, but willingness to seek help and commit is paramount.

Whilst my daughter is staying away from home (we are communicating about this and finding solutions, and at present, are on good terms), my goal is to look after myself as I'm completely burned out, and learn as much as I can about how I can support my girl. Carer's Gateway have been in touch and are looking for a BPD-trained psychologist to offer me 6 sessions to support my goal of being able to learn about BPD and how to look after myself, my daughter, validate her and set boundaries .. no small goal .. they are also offering a coach for this too, I've said yes to all the support I can get. I've decided that "I" need to learn DBT .. until she's ready to. If I can learn what she needs, and learn the best way to communicate with her, that is a constructive use of my time, rather than perpetual worry. I was pondering this morning that the only thing that is keeping me sane is finding possible ways to help that are in MY control. I guess while I am doing this, my daughter might sense that I'm not incessantly focusing on her and using that against me (more on this below - they are really still intelligent humans despite their emotional difficulties).

If I can offer any advice, take some time to reflect on what boundaries are REALLY important to you. This will come down to your values .. and other things, see if you can let go of. I know what it feels like to be reactive to absolutely everything, especially when it comes with demands and disrespect. Learning to not take it personally and get on with things I need to do, whilst difficult, is key.

I would say I'm on the cusp of acceptance ... still rollercoastering with all that is going on, but accepting what I can't control and what I can. Self care is paramount. They know how to push our buttons and manipulate, and yes, they do feed off our pain, even if it is not conscious... its more like just how the brain is wired... the familiar chaos preferable to the potentially better unknown. I have had to remind myself this is not because they are bad in any way, but their brain's survival mechanism is kicking and and doing what it does - keeping it surviving.

So if we view their tactics as attempts for survival; it may help us detach from it being too personal. I read somewhere it is our brains job to keep us alive, not to make us happy. So you are right to intuit that not setting boundaries can lead to bigger problems down the track, its neurology, its science .. because those neural pathways of "getting what they want" will keep getting well worn, and those brain receptors will keep needing more and more of a dopamine hit. Like addiction.

I also think there's an element of "survival of the fittest" .. if we don't set boundaries, and hold them with love and care first and foremost for ourselves, its like an invitation for someone else to be the "leader of the pack" as we are weak. This may be a poor oversimplification but I really like the book by Joe Newman called "Raising Lions" that describes this well. Granted, his book does not cover all the influences in our society that seem to be "hijacking" our children, but I did speak with Joe personally via a 15 minute free consult, and his view was that his approach (all about loving boundaries, which might not be his words to describe his approach, but how I sum it up), still does apply to those with mental health diagnosis. But its nuanced of course, and beyond my capacity to elaborate further here, so I will just say that I found the book helpful in hindsight, of what I had not achieved in setting boundaries and why they are so important.

I also read recently that it is not our job to keep our children happy, it is our job to parent based on our values, and sometimes they won't like our decisions. It is OK for them to hate us for it (they may say it, but don't really). But again, I do get the difficulty of putting this into action when there is a threat of self harm or worse, suicide. I know what its like to want to say yes to absolutely anything if it means I'm appeased she will not harm herself or take her life.

One mum who went through hell last year when her daughter wanted to commit suicide, shared with me that the most defining moment for her was when she finally accepted that her daughter may actually end her life. That it was possible. And that despite everything she was doing .. watching over her, giving in, being over-bearing etc .. that if it was going to happen, it would. For her this was an absolute moment of reaching rock-bottom despair and deciding that the only thing she had control over was herself. From that moment she shared that something shifted within her daughter. A year later her daughter is doing well, is happy, a fairly normal teenager, and they have a great relationship.

Stories like these give me courage.

I hope you don't mind me rambling as it helps me too.

Lots of love

[Elolia97 · Accepted solution]

Dear one,

Thank you so much for your long and extensive response to my rant!
I haven't had much of a chance to reply properly which is why I haven't answered you yet but I just wanted you to know I was very grateful for your advice. I still am unable to respond as much as I'd like to to each paragraph but am on the bus about to pick up my child so again, limited time
But quickly, I hear you and am sorry it's been so hard for you with your daughter...
Regarding boundaries, I agree working out my values is important and making the boundaries around those makes sense!
I have my coaching coming up this Monday so will hopefully get help with these.
And I have done similar to your friend... part of me has accepted the worse, just in case, as hard as that is. Perhaps it's our mind's way of coping
Lots of love back at you