Mila was 17 and her parents described her as having a big heart and a knack for relating to the elderly and to young children. She had worked in a nursing home at one time and frequently babysat. But she was struggling to regulate her emotions, so her parents enrolled in a 12-week group program with me.

As a kindergartener, Mila’s parents said she was having trouble in school, but she was athletic and participating in sports helped to counterbalance the struggle of academia. Unlike her older sister Sonya—who excelled at everything she tried, made and kept friends easily and was liked by most, Mila was anxious, had low self esteem and found it difficult to make and keep friends. She experienced significant distress when she wasn’t in close contact with her family. She started to avoid school more and more, and eventually she began to self-harm.

During early middle school, Mila’s anxiety and lack of self confidence imploded. She was unable to tolerate being separated from her mother even for sleepovers with close friends. She quit sports.

By early high school, she began to engage in promiscuity and was introduced to alcohol, marijuana, and hallucinogens. When self-harming, it was not unusual for Mila to leave blood on towels or in pools in the bathroom or toilet/shower. Her parents were terrified with every trauma.

Mila struggled with body image and weight concerns. She engaged in extreme caloric restriction and/or binge eating over a period of several years. While she met criteria for an eating disorder, she was never diagnosed as such.

In 10th grade, Mila attempted suicide. After an inpatient stay, her parents decided to place her in an out-of-state residential treatment center. Without any warning, they packed the car, said the family was going on vacation and moved Mila into the treatment center.

Despite expected initial resistance, Mila had an excellent experience in treatment. However, the cost of treatment left the family bankrupt, leading to Mila’s abrupt return home, and her mother’s immediate return to full-time work.

The next two years of high school were messy, filled with drug and alcohol abuse and inability to maintain activities of daily living such as maintaining good hygiene and completing chores.

Mila’s relationships were intense and short lived. She constantly interrupted Mom’s workday by firing off dozens of hysterical text messages at a time. She stole from the family home. She failed her online school program. Random vehicles would show up in front of the home at all hours of the night—Mila’s parents were certain she was selling drugs and they rarely slept through the night. When Mom and Dad were at work, Mila had friends over to the home, which was strictly forbidden.

During these tumultuous years, Mom and Dad tried everything to limit Mila’s access to dangerous and impulsive activities and friends, but it was impossible to manage. Their other child, Sonya, had long been resentful of all the time and money they spent on Mila, and she was openly critical of them, which only escalated the shame and guilt her parents already felt.

Mila, by then almost 19, moved into an apartment with her boyfriend and his alcoholic father. She was unemployed and spent most days sleeping, watching television, and smoking weed.

Since their 12-week program, Mila’s parents had continued to attend a monthly support and psycho-education group, where they were relieved to find understanding and quality information to lean on. They began to understand why Mila was behaving the way she was, and as a result they were able to balance their own demands for change with true acceptance how difficult all of this was for HER, and what a huge risk it must have felt like to her to make these changes. Day-to-day interactions gradually became longer, less contentious, less one-sided, and more respectful.

Her parents continued to use the skills they’d learned in our group, even inviting Mila and her boyfriend for weekly family dinners. At first, Mila and her boyfriend rarely showed up, then they would come and stay for a few minutes, and gradually they began coming regularly and staying longer.

Mila’s incessant texting began decreasing and finally, Mom was able to be less stressed at work and stop harboring resentment for Mila.

Mila and her boyfriend now live together on their own in an apartment complex near her parents’ home. She got a job as a caregiver for homebound elderly and received positive evaluations of her performance. Mila had stopped self-harming and reduced her weed consumption (which she stopped completely as soon as she confirmed she was pregnant!). 

Mom and Dad were finally able to sleep through the night and their relationship with each other improved as they were able to carve out time for themselves as a couple. Sonya became less resentful (and less critical) of her parents, and more accepting of her sister.

Mila’s parents came to respect her boyfriend and built a relationship with him. They were delighted when Mila agreed to attend church with them.

They remained connected with the group members through monthly support meetings and additional education and volunteer opportunities, and they even formed close friendships with other parents in the group.