Q. I adopted a girl who was taken from her biological parents because of extreme sexual, mental, and physical abuse. She has been diagnosed with borderline personality disorder. Three times lately we have had confrontations over her use of alcohol, drugs, and tobacco. Each time we have had a confrontation she has done three things. One will be self abuse of some kind usually cutting herself, two she will file false complaints of sexual abuse by me or others, three she ends up hospitalized. I have four basic questions:
1. Is this a normal thing for borderline personality people to do?
2. Is this an attempt to manipulate me and others around her?
3.Does she really believe this lie ?
4. How can I help her and myself?

A. I will answer your questions as you ordered them.

1. This is a totally normal way for a borderline to behave. Cutting is a part of the illness, just like a fever is part of the flu or wheezing part of asthma. She is supposed to cut or self-injure.

2. This is not a way to manipulate others. It use to be defined as a way to manipulate, but it is not. It is part of the illness, and not under volitional control.

3. Yes, she really believes the lie. Borderlines convince themselves that nontruths are truths, and adhere to these beliefs. It is part of their way of thinking. Never assume she will think like you, as she will not. Not all borderlines are tuned/think the same way, so do not over generalize this, but your child will always have some problems with interpreting reality most likely.

4. Get her on the right medications ASAP. She has the problem, not you. You are doing nothing wrong, but she is. Fix her and the problem will decrease. She will have some impairment, and hopefully will get better and better with time. Medications start the process, they are not the complete answer. She will still need therapy and appropriate rearing.