Defiance& Anger,I 'm living with Jeckel and Hyde

[jannie]

It seems like our home has turned into an armed camp. My almost 15 year old daughter constantly argues about everything. Two months ago she walked out of the house and we didn't know where she was for about 4 hours. She did come home that night before bed. We have told her that if she leaves the house again without permission we will call the police and report her as a runaway. While she still threatens to do this and has even made it as far as the front yard, she has not actually left again. She says she doen't care if they take her to "juvie".

To our knowledge she does not do drugs, has not been in trouble with the police, does not skip school and has not had sex. But her grades are all D's, she does no homework and acts so uncaring. She says she hates school and just doesn't care.

In the past we have been very hard on her especially concerning grades. Her father is very strict. (She says she feels like she's been grounded since she was 12.) With the introduction of a family counselor he has gotten much better. But she says she will never forgive him for all his past actions. (punishments)

on the other hand, there are times she is happy and gets along. (usually when she wants something). I can still make her laugh and she loves to sleep with me as a special treat. Basically, as long as things are going her way she is happy. but when things don't she becomes another person. sometimes I feel like I'm living with Jeckel and Hyde.

Recently she and her father had a disagreement. In the course of the arguement, he told her "one more word and you are grounded this weekend. " She said "Fine then I'm grounded" but did not continue with the arguement. Now, she is argueing that even though she said "fine then i'm grounded" she shouldn't be because she didn't continue argueing. our counselor says "if tell her she's grounded then you have to stick to it" What is your opinon?

[Mike Bradley]

Unfortunately, I do agree with your counselor, which is why it is so very critical to not issue threats of punishments in the heat of an argument as a way of trying to control a brain-challenged teenager. If your daughter was just badgering (and not being verbally abusive) grounding was excessive. But now you are committed. Being inconsistent with a teen is asking for extended trouble. She’ll never know when you are serious, and she’ll keep agitating in the future.
In your next family session, say that you hate those situations and ask father and daughter how you guys can all avoid that happening again. I do think that if you stick with counseling, you guys have a great shot at getting past the old pain.
Good luck!

[jannie]

Thank you so much for answering so quickly.

When we told her the grounding stands she threatened to leave. But she didn't because "of course, I have to have parents that will call the cops". (Her way of not leaving and still saving face.) She says she will NOT be grounded because it's not fair. (see previous posting) She ranted and raved, locked her self in her room and threatend to leave on Friday. (grounding is for Fri, Sat nite) Thank goodness for you book. It keeps me sane. All I keep saying is "I love you very much and I'm sorry you feel that way, but you are grounded. I love you very much and I'm sorry you are unhappy but you are grounded. I love you and I'm sorry you are angry but you are grounded. I love you very much but you stepped over the line and this is the consequence."

Eventually we got past the anger. Now we are to the buttering up Mom and Dad so they will cut back the punishment for a Friday night event. She's willing to do Sat. I told her not to do this as the grounding still stands. She says we'll talk about it later so, I know she will continue up till the bitter end and then when doesn't get her way the fireworks will start again. I wish I could give her a “reward” and let her go Friday for good behavior, but I know buttering up is not necessarily good behavior. Boy, this is hard!!

I'll keep you posted. I'm sure I'll need help again. I feel like I'm going through a jungle blindfolded and never know when the tiger is going to jump out at me, but I know it's there somewhere.

Thanks again.

[jannie]

Well, it was as I expected. We had a big blow up Thurs nite. She didn't get her way and walked out. I followed her for about three blocks. Then I told her she had 30 min to be back home or her cell phone service was being stopped and we'd report her as a runaway. she was back home in 28 min. She sat in the car for a while then came in an acted civil.

The next morn it started all over. She told us she wasn't coming home after school. Dad went to pick her up (I was at work til 9pm) and she didn't come out. Called on cell and told him she wasn't coming home. We gave her about 30 min then canceled the cell and called the police. She called from home about 15 min later. Dad got home and she was locked in room.

The next morn we left on a trip to see my mom. (it had been a year since we lost my dad). She got up early pretty well. Was co-operative on the trip. was nice to her grandma and great aunt. I was so proud of her and told her so.

When we got home, she brought up the cell phone issue. We told her that the cell phone was a privilege not a right. She could earn her cell phone back next Sat morn if she went to school with no problems, went to her tutors with no problems and did not run away or theaten to run away. (the first two items she'd been doing for about 6 week w/ no prob. we were trying to give her some easy success)

She started yelling and said she didn't want the the phone then. She wasn't going to wait a week to get her phone turned back on. (ok I don't understand that either)

she tries to control what car her father drives. She considers one of the cars "hers". before her grandfather died he "gave" it to her, but it's in my name.

we are obviously having control issues. She rebels against any form of what she considers control. To the point of cutting off her nose to spite her face.

any suggestions?

[Mike Bradley]

Dear Mom,
Yes, I have a suggestion--keep doing exactly what you are doing. She is testing your fences to see if you say what you mean and mean what you say. Keep DISPASSIONATELY to your rules, and stop getting wounded by her behaviors---DO NOT TAKE THESE PERSONALLY. This is just the occasional "business" part of parent/teen relationships where she will see what she can get away with by getting dramatic. The less you react to her, the faster she will abandon those tactics of getting what she wants.
Frame her behaviors with her 2-year-old tantrum face and it might help you to relax a bit. It's pretty much the same thing, just bigger and louder.
Hang tough. Your kid needs you to be strong right now.

[jannie]

Thank you, Dr Bradley!!.

We are still not quite sure what to do come Saturday morning. Our intention had been to turn the phone back on if she complied with the stated responsibilities. (she has) Of course, her last communication on that subject was that she wasn’t waiting a week for her phone. (see prior post) My inclination is to wait for her to approach us on Saturday, asking when her phone is going to be turned on, in order to have a discussion on what happened last Friday. Or should we just turn the phone back on like we had intended, thus demonstrating that we keep our word?

I can’t tell you how much I appreciate your forums and your book. I’m only on Chapter10 but it has taught me so much already. Thanks again.

[Mike Bradley]

Just turn on the phone without a word if that was the deal you struck. You've likely made your point about the fences. But be sure to look for some ways to reach out to her, asking to spend time or to do something that she enjoys. Even if (or when) she rejects this, you will have made the point that you continue to love and appreciate her regardless of her "crazy" behaviors, and thus give them less power in her own eyes.
Keep us posted

[jannie]

Dr. Bradley,

Thanks so much AGAIN!!

We did just turn her phone back on, but without saying anything. Later, when I suggested she give a friend a call she said, rather sarcastically, “my phone doesn’t work, remember.” I smiled and said, “try it”. You should have seen the look on her face. It lit up all smiles as she kept chanting “my phone, my phone, I got my phone!”

Two nights ago, she blew up at the counselor, told her she hated her and that she (counselor) had no right to pry into her life. She hates us talking about things that have happened. She says it’s none of the counselors business. We have told her this is family counseling (that’s how we got her there and we continue to be counseled as a family, she has not spoken to the counselor alone) but she says all we ever talk about is her. She says she doesn’t want to be a part of this family. She’s not happy in this family and never has been. Since she can’t leave physically, she wants to leave emotionally and move to the basement. I told her no as the basement is a family area. Then she wanted our bedroom. Then she wants a bigger house so she can have a larger room. Then she wants us to rent her a house close by. She keeps coming up with these wild demands that she already knows the answer to and then gets mad when the answer is “I’m sorry, no, that won’t work”.

Last night, I spoke to her about treating us with respect. If she is not getting her way or we are discussing something she doesn’t like, she is very disrespectful and dismissive. Some of her stock comments are “I don’t care what you think” and “I didn’t ask”. For example, she brought up driving yesterday (she’s about to turn 15 and can get her permit) we have told her she must be making at least C’s (down from our original requirement of B’s) in order to get her permit (she’s making D’s now). She just rolled her eyes and said “yeah, right” When I spoke with her about treating us with respect her reply was “and if I don’t?” I said that there may start being consequences for blatant disrespect.

I feel very taken advantage of and wonder if I’m just a sucker. I drive her where she wants to go as often as I can. Usually the stables, where we have leased her a horse or the mall. It’s a 40 min round trip or I sit there for a few hours in the car. (usually reading your book and chanting "she's crazy, don't take it personally")

I just re-read your chapter on respect (pg 128-132). I understand you can’t force respect. Your description of the “black hole” scared me to death. We had been very controlling and now have lightened up a lot but I’m so scared the damage has been done. We’ve been going to counseling 3 mo now and things are slightly better but everyday it’s something else.

Should we continue to overlook the disrespect or should we talk consequences? (I’m pretty sure we won’t be able to negotiate this one)

[Mike Bradley]

Ignore eye rolling and mild sarcasm. You'll get pulled into quicksand if you attempt to stop every minor form of disrespect; however, if she is verbally abusive, tell her ONE TIME that no one is disrespecting her, and to please not do that. If she continues, then walk away without a word. When she next asks for a ride to the mall or barn, say that she lost that privilege when she decided to keep provoking after you asked her to stop, and that she must control that behavior from now on or similar consequences will follow each outburst.
You'll earn your kid's respect if you show her that you cannot be pulled into stupid arguments, but that you also will not tolerate blatant abuse.
Good luck!

[jannie]

Dr. Bradley,

What do you do if the child refuses to talk? As I understand it, we are supposed to negotiate consequences before imposing them. What if she refuses to talk?

I understand that after these rage episodes they usually don’t want to talk about what happened. They are embarrassed and scared about how they reacted. But when the episode escalates (maybe my fault?) to other acts.

Here’s what happened. She refused to get off the cell phone at the pre-agreed upon time at night. I gave her one warning, waited 5 min and then went back in and told her she has lost the phone for the next evening. (This consequence had been previously discussed). She threw a 2 yr old temper tantrum. It was almost ludicrous. She proceeded to try to keep us awake with a flashlight and singing until she got her phone back. We sang with her! After about 10 min she slammed out and went to her room.

The next day, after school, she asked to use my cell phone. She was told no and to use the land line. She proceeded to pick up my phone and put a lock code on it so I couldn’t use my phone. I calmly told her to unlock my phone. Which she refused. I told her then she had lost all phone privileges. Then she locked herself in her room with the land line. I picked up the extension and told her to get off and told her friend to get off. After a lot of yelling, calling me foul names, she left the house. She came back later. (I have greatly condensed this and it sounds calmer than it was)

Now how do we get to the negotiating the consequences? She says she’ll never talk about this. (I still have her phone). How long do I keep it? Open ended punishments are not good.

Do we just overlook all this as teen anger? Shouldn't there be some consequences?

Everytime I feel like we are making progress something else happens. I'm getting very discouraged and scared.

[Mike Bradley]

You need to have your therapist answer these questions for you, since she/he knows your family best. That said, here are my thoughts:
Keep attempting to negotiate consequences (and rewards) in advance. If your daughter refuses to participate, then hold unilateral discussions where she sees that her silence gets her nothing. Say that without her participation, you'll just have to carry on these "discussions" alone, and that you'll take her silence as assent unless she says otherwise.
Then make and hold to your rules like they were the Constitution.
Always let her know how she can get lost privileges back. For example you might say that if she does one week without an explosion, she gets her phone back on day 8.
Beware of trying to issue consequences for "anger." She must be allowed to be angry, but not permitted to be abusive.
If she hasn't already, I do think that your therapist should consider the possibility of a medication need (via psychiatric evaluation) to see if your daughter's rages are more than just limits-testing.
By the way, I loved your "sing-a-long" response. That's a great example of how we can diffuse adolescent rage with sidestepping and humor.
Keep us posted.

[jannie]

Dr. Bradley

Thought you might like to hear some “good” developments. The day after the 6 hr rage episode (3/19 post), she refused to go to school. I called her in truant. I hated to since her grades are so poor (she gets zeros for the day and has to do a 4 hr detention on a Saturday) but I felt she had to know I wouldn’t be a party to her skipping school.

That day she sat down next to me and said “Mom, when I’m doing all that stuff, it feels right at the time, but after I calm down I think “what was all that I did?” Do you think I need some medicine to help me?”

I thought “Oh my, straight out of Dr. Bradley’s book!” I quickly asked if she wanted me to make an appt w/ her pediatrician to talk about this. (she still refuses to talk to the counselor and we are thinking about switching) She agreed and went in a spoke with her Dr. alone (first time she has spoken with a professional on her own concerning this). I told her how proud I was of her realizing she may need help and talking the responsibility to get it.

Her doctor prescribed an anti-anxiety medication. From talking with my daughter, she believes the problems may be related to anxiety from starting high school. Apparently this anxiety can manifest itself as anger. We gave her the choice and responsibility of taking the medicine. She’s been on it for 10 days and things have been going pretty well.

As a matter of fact, she negotiated a deal with me. If I did what she asked, she would clean her room. If room didn’t get cleaned, I got her cell phone for an additional week. At the last minute she realized she was not going to get the room clean within the 3 day time frame. I was expecting an argument, but she just said “I’m too tired to clean my room; you have my phone for another week”. I saw both maturity and responsibility.

There have been a couple acts of defiance that lasted about 15 min and we still have the disrespect but no rage episodes. I want to thank you for your support thus far, both through your forums and your book.

[Mike Bradley]

Dear Jannie,
I'm sure that this is advice is not needed, but I wanted to be sure that you lay on the praise and love for her newfound maturity as heavily as she will allow. Tell her daily how proud you are, and what a wonderful young woman she's becoming. Kids often act like they hate hearing that, but don't believe that for a minute.
Take care.

[jannie]

Dr. Bradley,

We had been doing pretty well for the past three weeks. Last night my daughter made some very poor decisions concerning the rules at the barn where we lease her a horse. The people at the barn have set some very strict rules for the remainder of her lease (about 10 days) and have told her they will not lease her a horse again. She is devastated and depressed. She went to school and came home soon after, she's so up set. Right now she's just lying in her room. She has ridden at that barn for eight years. I realize that the decisions were hers and the consequences are a natural part of those poor decisions. She has a poor self esteem except where the horses are concerned. She has now lost the one thing in life that she loves. I’m afraid this will push her over the edge to the “dark side”. Now there is nothing to strive for. (more horse leasing or even having one of her own) How best can I support her and help her through this? I’ve told her she may be able to win back their trust but it will take a long time. In addition, her best friend boards her horse there and the mom limiting contact with my daughter. This may mean she may not even be able to ride her friend's horse. My heart is breaking for her.

[Mike Bradley]

Dear Parent,
Use this crisis as a learning opportunity. Ask your daughter to think of ways she could perhaps win back her slot at the barn by meeting with the manager.
Ask her what would convince her if she were in the manager's position. Suggest that she think this through and then prepare a statement (perhaps a letter) where she acknowledges responsibility for whatever went wrong, and then offers ways in which she could restore the loss.
It's critical that she use this pain not to get depressed, but to stop and think about herself and how she ended up here. Whether she wins or loses at the barn, this process might help her to have a better chance at winning at life.
Keep us posted.

[jannie]

Dr Bradley

Well it took her a whole week but she finally went back out to the barn. She gathered up her courage and apologized to all concerned. One person told her that making mistakes is part of growing up and they hoped she learned something. The other (a fairly critical personality) said they appreciated her having the guts to apologize face to face. On her last day, she told them she appreciated them allowing her to complete her leasing time. It was hard for her but I really saw some maturity there and told her how proud I was of her.

Then she got her midterm grades and did poorly. She was grounded for 7 days (through the next weekend). She put forth an effort during the next week (going to the library to study). She got a B+ on a math test (a class she is currently flunking) and wanted off the grounding for a few hours. I held my ground and said “no, the consequences are for the past few weeks when you didn’t study enough to keep up your grades”. She ranted and raved, said she worked hard and didn’t get anything for it, she was just going to flunk out of school, etc.. This is when I realized that all the studying was just manipulation to try to get out of grounding. She hates school but there are times she seems to realize she still must do well in order to have a shot at a decent life. Most of the time she just doesn’t care.

I praised her for the study pattern she was beginning, encouraged her to keep it up. She has quit going to the library to study so it’s really evident that week was just manipulation. She won’t study at home.

Re-reading my posts, I feel we have made progress but now have reached a plateau. How can I make her realize how important school and grades are to her future?

Sorry this is so long, I couldn’t log on for a few weeks.

[jannie]

Dr Bradley,

Things have been going pretty well. Two months ago, we had an appt for our daughter to get tested for a learning disability (ie test anxiety or something) since her grades were so poor. She walked out and refused to co-operate. Then the next day she walked out of counseling. I decided then, that I’d had it. I calmly explained that in the past we gave privileges and took them away as consequences when things happened. Well now, she was at rock bottom. As far as I was concerned she had NO privileges. Our trust in her was gone. I would provide food, clothing and a place to live. She had no other privileges. I informed her she had better shape up and start earning them back. If things did not start shaping up and she didn’t start talking to the counselor, we would be forced to look into alternative arrangements. I was rescheduling both appts and she would not get her cell phone back until she had cooperated with both ditched sessions. ( the testing couldn’t be scheduled for almost a month). We also told her the rest of her privileges would not begin to be restored until she began talking to a counselor on her own and we saw a sustained, ongoing effort.(I’d let her pick another if she wanted)

We went in and told the counselor EVERY LITTLE DETAIL. Our daughter sat and cried the entire time. Then my husband and I left the room. Apparently, my daughter talked the entire time. She has now decided that our counselor (who she hated) was who she wanted to keep. She has had about three sessions with her alone. While, as you know, we are not privy to the conversation, the counselor did tell us that our daughter wishes she could redo this past year.

We are still having problems with decision making and a bit of sneaking around especially if there is a boy involved. But she is trying. Due to the sneaking around, when she is out of the house, she now has to call me with any teeny change in plan, people involved or location. If she doesn’t, (I call her to check on what’s going on) I go and pick her up immediately. This happened once with an “I forgot to call”. She was angry about being picked up, but it hasn’t happened again.

We just discovered though the testing that she scores in the 86th percentile in math assessment. ( a class she was flunking). So with the counseling and the knowledge that she has the intelligence we are hoping for a better year next year.

[jannie]

Dear Dr Bradley

Well I guess I spoke too soon. Last Friday my daughter wanted to go to the mall. I asked if her boyfriend was going to be there. She said she told him to call her if he was because she didn’t want to get in trouble with her parents. He hadn’t called so she assumed he wasn’t coming. ( I found out later this was a lie, she knew he was coming, just not when) I instructed her to call me if he showed up so I was aware and she couldn’t be accused of sneaking around. I warned her that if she did not do this, she would be grounded from the mall for 2 weeks to a month. (OK I’m not dumb, I fully expected her to call and tell me he’d “unexpectedly” showed up) But I didn’t get a phone call. I got to the mall early and guess who was there?! I grounded her from the mall for a month. Then her dad added on no friends and no cell for a month. ( I felt this was excessive, but once you’ve said it you have to do it, right?)

Yesterday she wanted me to drive her to the small town where her boyfriend lives (20-30 min away) to give him his birthday present. While I did initially consider it, I finally said “no, you’re grounded”

This started a long drawn out angry conversation where I told her I knew she’d been lying about the boyfriend meeting her at the mall. (the boyfriend had confirmed this when I told him I wasn’t mad at him but at the decisions my daughter made concerning him)

The conversation escalated to where she told me she didn’t care if she lived or died. She wanted to die before she was 20, maybe 16. I told her if she really felt this way, we needed to go to the hospital. She stormed out and about 2 min later, came in and said (defiantly) “ok then take me to the hospital”. And I did.

They determined she has major depressive disorder. They did not think she was in immediate danger to herself as she didn’t have a plan to kill herself. She just feels worthless and doesn’t care if she lives. (oh yes, I re-read the depression part of your book and don’t know how I missed the "in your face" anger as a sign) They gave me a choice to admit her or take her home and treat as an outpatient. I took her home and pray I did the right thing. We have an appt with the psychiatrist that saw her in the hosp in 7 days.

We have been dealing with all this for 8 months, and while some things are better, (rages and leaving the house), this is worse (not wanting to live). I feel like I’m starting all over again.

Any insight, words of wisdom, or encouragement would be greatly appreciated.

[Mike Bradley]

Dear Mom,
Congratulations! No, I'm not being horribly insensitive to your trauma. I'm celebrating the fact that you guys have finally gotten to the real issue that's been haunting your family all of this time. Knowing that she's so depressed makes her behaviors finally make sense, and gives you guys a clear avenue of treatment.
What to do? Tell her that you are so sorry that you didn't understand that she was suffering so. Offer as many hugs and treats as she'll accept. Then stay very close with her for the next few weeks as the treatment starts, especially while she begins her medication.
You're not back to ground zero at all. You're far down that path of recovery. Don't lose heart now.
Be well.

[jannie]

Dear Dr Bradley

Thank you for answering back so quickly. My husband and I are VERY concerned and wanted to ask you what the prognosis for Major Depressive Disorder is. Acting out is one thing but this has gotten us VERY scared.

The counselor had tested our daughter on learning and social/emotional scales. Our daughters IQ came up at 97 (WSC III) and all of her standard scores were 101 to 116. (W/AT) On the first social/emotional test,(100 questions) our daughter wasn’t completely honest. On the second one (30 questions) she was more so. The counselor said that the second one showed depression. (a score of 60 indicated depression and she scored 61 on Zoloft) When she told us this, my daughter responded with an incredulous “WHAT !!” She just sat there for a few minutes and then said “I need to go the bathroom” Her brother came in and said she didn’t want to come back in right now and maybe would later. The counselor said she was tearful when she walked out. ( she came back in very briefly as we were leaving)

Later that night, she angrily said she wasn’t depressed. Everyone was full of bull ****. She was tired of everyone trying to change her. She liked herself the way she is. She wouldn’t talk to the psychiatrist on Thursday. She was tired of having to talk to so many people. She hated that we were making her see these people.

She says she only feels that she doesn’t care if she lives or dies, not that she would ever do anything to kill herself. And she only feels that way if she is “bummed” about something or angry. To me this looks like poor coping skills, but it is the chicken or the egg?

She chose to bump up from a Basic Geometry class to a regular Geometry class this year. I know she can do it academically, but am worried about the stress level and emotionally, but don’t want to discourage her.

HELP!!

Thanks for all you do.

[Mike Bradley]

Dear Parents,
Depression is one illness that we have lots of effectiveness in treating, so her prognosis is good, but that statement rests on the assumption that the client is cooperating with treatment. And when teens are depressed they often cooperate with nothing.
The thing to do now is to dispassionately ignore all of her protests and quietly and lovingly insist that treatment will continue. Over time her resistance will likely diminish as she starts to feel better and she forms an alliance with her docs.
Hang in there, guys. You're getting close to the finish line.

[jannie]

Dr Bradley

Just thought I bring you up to date on my daughter. I know that reading about other parent’s difficulties and solutions has helped me tremendously. It also helps to know that we are not the only ones going through this. Thank you for this forum.

In the last six weeks, we have been to the hospital one other time. She came to me and said she was having bad thoughts and needed to go the ER. Then she started to panic, thinking she may have to stay. She was sobbing, clinging and scared. The hospital did nothing except determine she was not a danger to herself and send her home. They told us to see her psychiatrist. Even she observed that she went there for help and got nothing. I’m afraid this will keep her from asking for help when she needs it in the future.

All these “bad” thoughts always seem to result from her boyfriend putting pressure on her when she’s grounded. Or rather, not getting her way concerning him. ( we are approving of him less and less) She says we hate him and that's causing all the problems. I have told her that our opinion of him is based solely on how his actions effect her and though her, our family. If he has a positive impact, our opinion of him will be positive. Conversely, if he has a negative impact, our opinion will also be negative. (guess where we are so far)


We went through a recent 10 days of extreme moodiness and surliness. This culminated in an act of defiance where she ran off and went to another boy’s house. (after being specifically told not to go there) She refused to come home and I called the police. They spoke with her and she came home, crying all the way. Said she was sorry, that it seems like when she does things like that it just bypasses her brain. At counseling, she blew up at the counselor and said this is how she is and we’d better get used to it. The counselor said it was like we’d lost the past 8 months. She felt something had happened, but we don’t know what. After the session, my daughter said to me, “do you think she bought my little act?” What I want to know is…..which is the act? The “good” problem solving child or the verbally aggressive, disrespectful, non-caring child.

Her counselor now is considering borderline personality disorder. She is basing it on the impulsiveness and the fear of growing up that we sometimes see. Any info on this would be appreciated.

We started a new psychiatrist who doesn’t think she meets the enough of the criteria (based on one meeting). She has been great for about a week. (she was warned there would be no Homecoming Dance if we had any problems) Followed all the rules and has made some very adult decisions and gestures, which we’ve praised her for. Her grades are all B’s and C’s right now, a great improvement from last year.

But, I still don't trust her. It seems she is always trying to get away with something. I keeps real close eye on what she's doing so she rarely gets away with anything. I feel like I have to think 4 steps ahead of her all the time, and sometimes I just don't think of everything she could manipulate.

[Mike Bradley]

Dear Parent,
Borderline personality is a tough diagnosis to call with adolescents since they are so wrapped up in the identity issues of adolescence, problems which mimic what borderline personality looks like in adults. Even if that turns out to be the case, don't listen to any expert who tells you that borderline is a permanent and untreatable condition (as many do). Check out this month's issue of the Harvard Mental Health Letter (vol.24, #3. Sept. 2007) where they cite studies showing that not only is borderline personality treatable, it typically goes away on its own (without treatment) in mid-adulthood.
Regardless of the diagnosis, stay on the path that you are on with counseling, medication, and structure (staying 4 steps ahead). That likely will lead your family out of the swamp of fear in which you feel stuck.
Hang in there.

[jannie]

Dr Bradley,

Thanks again. After the last incident on 9/17, (10/2 post) the psychiatrist and counselor wanted to put her on Abilify. My husband and I don’t like to use drugs unless we really feel they are necessary. ( she is on Zoloft). We decided not to start the drug as long as things were going OK.

Two nights ago was a very stressful night for my husband. I worked til 9pm, so he had the kids. There was tutoring, a meeting and oodles of homework that my younger son needed help with. He got completely stressed out and in his frustration said he couldn’t take this anymore and if it kept up, he’d have to leave. (I knew he was just blowing steam and didn’t mean it) My daughter acted like she was upset and started crying (for about 5 seconds….to me it looked and sounded fake)

Last night, (I worked again, unfortunately) my daughter asked permission to go to a friends house after school. She even asked permission to go the park from the friends house. (followed all the rules) Then, when my husband went to pick her up, she refused to come home. Through multiple phone calls to me at work, she told me she had been crying on and off all day because of what her dad said. She refused to go home with him; she hated him. We considered insisting she come home (and call the police if she didn’t) but in the end allowed her to stay at the friend’s house til I got off work. She came home with no problem. Stated she was going to sleep in the basement because she didn’t want to be part of the family, she hated us, had always hated us and just wanted us to leave her alone. She could take care of herself. This morning, I found her in her room sleeping. She’s still distant this morning but not defiant.

OK, now for the hard question. Should we put her on Abilify? She went 3½ weeks without a problem, then we have the impulsive defiance again. I’ve read about the drug and it scares me. I’m not sure what I’m most scared of, the possible side effects or the fact that she may really need it.

[Mike Bradley]

I would have no problem with Abilify if this were my kid. It essentially helps facilitate that pre-frontal lobe activity which is deficient in many (most) teens, and that helps them to think better. The formal write-ups on the drug sound scary, but it's being used with great success in many less serious applications.
If it doesn't help or has bad side effects, you can discontinue using it (with your doc's oversight); however, if it gives her that control edge she needs, it might make a huge difference.
On another subject, ask your husband to please find other ways of venting his frustrations (as understandable as they are, speaking as one dad to another). As tough as they look, teens have huge abandonment fears that can explode when they hear those threats. Remember, these are not small adults, they are LARGE CHILDREN.
Please keep us posted.

[jannie]

Dr. Bradley,

My daughter has a boyfriend for about two weeks. He broke up with her on Christmas Day. She was very upset and crying. When she came down to “help” with dinner preparation she had three cuts on her left arm. She says she is not contemplating suicide. When we talked about it, she claims she has done this 3 times previously on her hips and arms. She attempted to show me the scars (I couldn’t see any). I’m fairly sure if she had done it on her arms previously I would have noticed. She almost always wears tank tops, even in winter. I believe she had just been drawing lines on her skin in the past. This time she came down stairs in her tank top, for Christmas dinner. She had done it on her upper outer arm. The skin was just broken, much like a dog scratch. When we talked about it, she said she liked it, that it made her feel better. We discussed that this can be an addictive behavior, like drugs, smoking and alcohol. (she has always stated she will never do any of those). She claims she is not hurting anyone. I told her she was hurting her self and she was hurting me. I loved her too much to allow anyone to hurt her, including her. She was defiant and denied the truth in this. I took all sharp things out of her room. She will not promise not to do it again. She did promise last night that if she felt like doing it she would come get me first.
Help

[jannie]

Dr. Bradley

Sorry should have put this with the previous post.
We did not put her on Abilify as things had been going pretty well (compared to this time last year). Her grades still are not what they should be. We've told her the “D's don't drive” She got a D+ in one of her classes so won’t be taking driver’s ed again next semester. She will turn 16 in the spring and under ideal circumstances would have been getting her license. But due to poor grades, (always one D) we keep pushing her driver’s ed back. Age wise, she should have been able to take it 2nd semester last year. I feel like she just keeps getting shot down.

[Mike Bradley]

First, be sure to mention to your daughter that we're now seeing some scary, medication-resistant infections in the teen world that can occur from cutting, so it's not quite as risk-free as she might hope. To help her to perhaps think out her impulse to cut (versus cut reactively) perhaps revisit your team's recommendation about the Abilify. Again, if side effects are a problem, it is easily discontinued.

[jannie]

Dr Bradley,

We took her to the psychiatrist yesterday and she started 2 mg Abilify last evening. She finds it very hard to accept she needs help. When he said he wanted to put her on the additional medication, two tears coursed down her cheeks. But she wouldn’t let me touch her. That emotion quickly gave way to anger, where she dumped out all her Zoloft on the wet ground and refused to take any medicine at all. By the time I got home with the medication, things were better but she still maintained she was not taking any meds. I calmly took out the Abilify and handed it to her with some water. She remarked on the small size and took it without another word! Boy, is she inconsistent! ( of course, in this case, I’m glad) We spent the evening playing Wii and Scene It. That is the first time in forever she has joined the family for some unstressful family time. Did I say she was inconsistent? If just the act of taking the medication can make her feel better, just think what it can be like when it really kicks in. Will keep you updated.

Thank you for riding down this road with us during the past year.

[jannie]

Dr Bradley,

Well, while things were going well for four months, they have now suddenly disintegrated.

She exhibits inappropriate behavior with boys. She has always, with any boy, gone from zero to sixty in two days. She will meet a boy that shows some interest in her and suddenly she’s like a leach. If they don’t call her by a certain time, she calls them…. And multiple times a day (or evening) The next thing you know he’s blown her off or refused to take her calls. Then she's depressed and has cut a few times. I’ve learned to just wait out her attachments to these guys (who, except for one or two, are losers), because it never lasts. She sabotages it before it gets started. Of course, in a month or so she calls him and suddenly everything's ok, and she forgets how he dumped her and then it all starts over.

The rages and disrespect have started again. She says she hates it at out house and doesn’t want to be there. Last night, using your book as a guide we allowed her to go to a friend’s house to chill. When she came back she was raging and disrespectful.

She refused to go to school and was called in truant. She refused to go to counseling. She did go get a drug screen at my insistence since things went so bad so quickly. (it was neg) She has continued to defy us which results in grounding. She has worked her way up to a month of grounding in the past two days. I was thinking about letting her earn back some privileges on a three for one deal. (for three days of good behavior you get back one day off grounding) But we can’t get one day, let alone three.

We are now contemplating a residential treatment center. This is not something we want to do, but we feel we are up against a wall. In some ways it is worse than a year ago. She constantly hangs out with kids who have been to juvenile hall and likes a guy who is back in for violating parole. Most of her decent friends have deserted her and I don’t blame them. Her counselor and psychiatrist have again ventured a diagnosis of Borderline Personality Disorder. She seems to fit five of the criteria.

Her younger brother is at the end of his rope. She is horrible to him and always screams at him. He has broken down crying twice in the past 10 days. He actually has seen the counselor on his own to try to deal with this. I have two children and don't want to lose one over the other.

Help

Jannie

[Mike Bradley]

See what your experts have to say about the residential treatment option. If she is in fact borderline, she may need that type of structure to keep her safe until she improves (and yes, borderline kids DO improve with time).
But I can't help but notice that she seemed to improve after you started her on Abilify four months ago. Which makes me wonder: (1) has she discontinued taking her med and (2) does she need more of it (2mg is a very small dose for her age)? Please review these and all other measures before going to that last ditch remedy of residential.
Keep us posted.

[jannie]

Dr Bradley

She has not discontinued her meds. I know because I give them to her every morning. And yes, she actually takes them.

She just got back from two weeks in a adolescent behavioral unit for uncontrolled anger and violence. Today was her first day home and as soon as I told her “no” on something she was angry, disrespectful and defiant. She did not rage and she did not actually go do it but I guess I was expecting more after two weeks of intensive therapy. When I remained her to use her coping skills, she said “no, I only went along with that bull**** to get out of there” . Her basic personality/ideas do not seem to have changed at all. She even said she would rather be there than home.

They did change her Zoloft 150 to Lexapro 10 and upped her Abilify to 10. Guess I will have to give that some time to work. I just hate it that we are back to the same old thing after having her gone so long and getting her so behind in school.

Thanks

[jannie]

Dr Bradley

It seems that things just keep going from bad to worse. My daughter met a boy about 6 weeks ago at the mall. She has seen him only the one time (to our knowledge), but he is her “boy friend” and she says she is only happy when she’s with/talking to him. She has finally told us that he has been in juvenile hall four times, has his lips, ears and nose pierced and has vampire fangs implanted. He supposedly is only 16. Just the juvenile hall thing is enough for us to forbid her seeing/talking to him, but it has become a real source of contention in our house. She sneaks around to talk to him and I suspect that she has seen him again at some point. We cut off long distance calling quite a while ago as she kept using it (for another guy) and the bill was going up (this guy is long distance too). Three days ago, we shut down the land line totally. She lost her cell phone due to behavior, defiance and sneaking around almost two months ago. But the defiance continues that she WILL talk to him and we can’t stop her. It all started last night because a DIFFERENT boy blew her off, then it progressed to wanting to talk to the juvie guy. When we refused, it went on for almost two hours.

The two weeks on the adolescent behavioral unit didn’t seem to do a thing. It has been anger, defiance or raging almost every night. The last appt with her therapist, we told her that we were considering sending her to a boarding school (therapeutic) to help her succeed. She cried and raged. That evening was horrible. The next two days, she was very co-operative. She said she didn’t want to be sent off and she was going to try to change. Then last night (see above). She said we were sending her away no matter what, so she was going to do what she wanted. The therapist says that when she is angry she can’t control it, but she refuses to try coping skills. The hospital said she had traits of histrionic and egotistical personality and conduct disorder. The therapist is treating her under ODD but thinks she fits the criteria for borderline. The psychiatrist has her listed as intermittent explosive.

After 17 months, this has become exhausting. I keep thinking if this boy would just go away it would get some better. I know that’s not true, it would just be some other boy.

Please help. How should we handle this juvie kid thing?