From things with my sister who is diagnosed and getting amazing therapy, an episode for her used to be threats of suicide while splitting my mother, her boyfriend and me black. They might have started in rage, but can often end up in “just leave me, I’m a terrible person and I don’t deserve your love”. So they’re more extreme fears of abandonment episodes??

For us this has meant a lot of family therapy sessions that run alongside her private DBT sessions. Additionally she has sessions with another service to specifically address sexual assault and PTSD. We have a care plan so we know how to behave when she’s not herself and disassociates.

Additionally, she’s been linked to a vocational counsellor who has helped her get into a course so she is working on things in her own life so she’s not at home all day on disability payments and brewing over everything her boyfriend does while he’s not around.

Before any of this was successful, she had to go to therapy for ages and finally accept taking medication that stopped her substance abuse.

I don’t know if any of this helps, but basically it’s an attack on all aspects of her identity, who she has relationships with and what she does with her time. So far it’s going well and they have a high bullshit radar and she hasn’t been able to deceive them which has been great.