Expert: Caroline West - 1/14/2009

Question
QUESTION: Hi Caroline..............
   My 24 year old son, EJ,  called us last evening to let us know he was using
heroin. He lives outside our home but in the same town. When he was 17, he
was diagnosed with Borderline Personality Disorder, so it's been a roller
coaster ride for his Mom and I not to mention EJ. He didn't ask for help but
just felt that we should know soooooo now what?!!! What do we say and what
do we do now that we have this horrible news. My wife and I are at a loss. Is
there any way we can help him or anything we can say?



ANSWER: Hello James. Drug addiction and Borderline PS are very,very closely linked. Addicts and BPD's share almost identical symptoms. There is a type of treatment available which is THE branch of therapy/psychotherapy to go for in treating both the disorders and its called 'Dialectical Behavior Therapy'.

Depending upon where you are located will vary the readiness of this treatment but I can assure you it is extremely effective. However it is a long process as any therapy is and also your sons recovery from Heroin addiction will be a long process. So for you and the rest of the family it will be a matter of patience and acceptance at where he's at and let the professionals out there do the bulk of the work in helping his recovery. There is not much else you can do until EJ is ready to start the process of recovery.

Also he may well need medication to help ease the symptoms of the Borderline. There is no cure for it but the following types of meds may be offered to him: Anti-Depressants;Anti-Psychotics;Mood Stabilizers and perhaps anxiety and sleep medicine depending on his individual needs.

I don't know what type of care he is receiving but I will mention the type you need incase you don't have any in place yet:Psychiatrist:Drug and Alcohol Team;Keyworker and General Practioner. It is paramount James that you try and get him into this kind of treatment and 100% investigate DBT. The bad news is that he may well reject your offer of help as getting BPD's and Addicts into treatment is a huge battle. Just let him know you are there for him and let this run its natural course. Emotionally take a small step back to protect your frame of mind.This will be a long and hard journey but it is not as hard as it will be for EJ-he is the one who is going to suffer the most so bear that in mind.

I'm very sorry that this tragedy has come upon your family and if you would like any other support or questions then please don't hesitate to write in again. Try and get him into DBT. There is an online DBT skills group which is fantastic so please have a look at that. I don't know the full address but if you go into Yahoo! Groups and type in: dbtclass -have a look and get EJ to look at it and start using it. It is highly professional and I have recommended it on several occasions.

I wish you nothing but the best and again I'm here if you wish to ask anything more. Take care, Caroline

---------- FOLLOW-UP ----------

QUESTION: Thanks Caroline, your answer to my question was excellent! EJ grew up going
to therapy and taking medication for ADHD and depression etc. When he was
a teenager he experienced a couple of visits to the psych unit at Danbury
Hospital and a week at Silver Hill in New Caanan. My wife and I began seeing
a therapist who specializes in DBT to help us with our interactions with EJ. My
wife has actually studied with Marsha Linehan and the therapists who "wrote
the book" on DBT. She now runs a support group here in the Danbury area
for families who have loved ones with BPD. Our relationship with EJ improved
immensley because of what we learned and how we utilized it to have a
relationship with him. The issue now with EJ is he denies he has BPD that in
fact there is absolutely nothing wrong with him. It goes without saying that
he refuses to see a therapist or take any medication. Mindy and I realize you
can't make an addict or someone with a personality disorder seek treatment.
Thank God we now have the tools to help ourselves and pray that eventually
EJ will realize he needs professional help. Thanks for reading this and a big
thanks for your helpful response. I'll check out the online DBT skills group. All
the best.

Jim Wilson

Answer
James you have made me so happy and feeling positive about the life of DBT! We always said with the therapist that the whole worlds population needs to learn DBT because it can be effective for anybody. You learn to communicate better,think and feel more in control and know how to ride through hard times-who wouldn't want those kind of skills under their belt! Everyone could benefit from it.

I am so thrilled you and Mindy are doing DBT yourselves. How fascinating your wife worked with Marsha Lineham-the lady who gave birth to DBT and thank god she did.

With EJ its hard for any young person to accept they have an illness. I knew it would be difficult getting him into treatment-to me thats another sign of him having Borderline. I just hope the time will come sooner the better when he is ready to put his hands up in the air and admit he needs help.

Keep doing the DBT which as I said I am thrilled about and as you and Mindy grow and learn hopefully it will rub off on EJ. At least it will improve the situation as you said it had but keep going,keep repeating the modules over and over until it becomes second nature.The more you learn and apply the skills then the easier it will be for you two to cope.

I know it hurts to see your son like this,just let him know often that you love him and that you are there for him.Whatever you do regardless of how tough it gets for you both don't give up on him. Inside EJ there is a lot of pain and sorrow,anger,confusion,depression,the lot so be patient and keep doing what your doing with the DBT and continue to be there for him.

I wish you all the best and if possible let him know there is someone he can come and talk to that will be able to offer him some support and advice. I am always here too if there are any other questions.

All the best, Caroline