A case for the diagnosis of Borderline Personality Disorder in children

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TAYA is a story of the life of my daughter, Taya Bruell, who died of suicide in 2016 at age 14 after suffering for years from undiagnosed Borderline Personality Disorder (BPD). Writing as both a father and as the CEO of a mental-health organization, I draw upon Taya's own prolific writings (journal entries, emails, and social media posts), which provide a unique first-person perspective on childhood BPD. TAYA is bookended by a foreword and afterword from two of the preeminent experts in the field of adolescents and BPD. The resulting book is a call to action for the mental health community, the education community, and, most importantly, every family who struggles with a child like ours.

TAYA opens on the morning I found Taya hanging in her bedroom, and then narrates her life, from a healthy, precocious early childhood through her gradual descent as a young adolescent into bizarre phobias and obsessions, hostility, physical aggression, self-harm, and some of the darkest corners of the internet – all of which, we realized too late, were manifestations of BPD that went untreated. The story, interweaving Taya’s voice and my own, includes a heartbreaking and frustrating litany of mental health practitioners, teachers, and counselors who either ignored Taya’s symptoms or refused to consider a BPD diagnosis.

Dr. Blaisse Aguirre, who wrote the foreword, is the founding medical director of 3East continuum of care for adolescents with BPD and related disorders at McLean Hospital and has written many books including Borderline Personality Disorder in Adolescents. Dr. Alec Miller, who penned the afterword / Call to Action, is the Co-Founder and Clinical Director of Cognitive and Behavioral Consultants and a Clinical Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. His clinical expertise has been highlighted by various media outlets including the New York Times, CNN, ABC News, CBS TV, MSNBC, PBS TV, and Fox News. As Dr. Aguirre wrote, “TAYA is a call to action for my community of mental health providers, as well as school counselors and the education community, to recognize that BPD is a serious mental health condition that leads to significant suffering.”

Until recently, BPD, a disease that has a 10% fatality rate (suicide) and represents one in five people admitted to psychiatric hospitals, was believed only to occur in adults. The medical establishment now confirms that BPD actually develops in childhood and adolescence and can be treated effectively, but many mental health practitioners continue to follow outdated guidance that children and teens cannot be diagnosed with BPD. TAYA tells the story of our daughter's tragic and unnecessary death in the hope of saving the lives of other young people struggling with BPD.

All author profits from the book will be donated to charitable organizations that support people with Borderline Personality Disorder.

Praise for TAYA

"One of the tragedies of this story, the loss of the Bruells’ daughter, was the failure of the mental health community to recognize her deeper struggle and to diagnose her with Borderline Personality Disorder (BPD). Her experience of reactive anger, self-injury, suicidal thoughts, and other dangerous behaviors are all too familiar to those of us who work with young people who are either developing or have established BPD. The fact that this prolific young writer had shared so many of her experiences in various media, writings that were then accessible to her parents, gives us the reader a rare insight into the evolution of despair, one that a young person should never have to experience, or if she or he does, then should have access to effective help."

Dr. Blaise Aguirre, MD.

Medical Director

3East DBT Continuum

Assistant Professor in Psychiatry

Harvard Medical School

Department of Psychiatry

"The good news is that in the past 25 years, we have seen progress that should provide us with reasons to hope, including the development and dissemination of evidence-based treatments, efforts toward prevention, reductions in stigma, and greater advocacy and education... Certainly, reading Taya, which synthesizes Harry’s paternal perspective with Taya’s own words, further reinforces the mission and call to action."

Dr. Alec L. Miller, PsyD

co-Founder and co-Director of Cognitive and Behavioral Consultants

Clinical Professor of Psychiatry and Behavioral Sciences at Montefiore Medical Center/Albert Einstein College of Medicine

“I just finished the book that you all courageously wrote. Taya was a truly special and gifted young lady. The dedication and willingness to provide her with the care she not only needed but deserved is admirable and it is heartbreaking how she was missed by the larger mental health community. I just wanted to reach out personally and say thank you for the work that you are doing to raise awareness and for your courage and strength to share your story. Taya, and your entire family hold a very special place in my heart.”

Dr. Kimberly Vay, LPC, CPCS

President, DBT-Linehan Board of Certification™

DBT-Linehan Board of Certification, Certified Clinician™

“This book is both heartbreaking, and essential reading. It is sad to read of the Bruell family’s efforts to help their beautiful daughter, Taya, not knowing that she – and they – were suffering due to her Borderline Personality Disorder. It is upsetting to read of professionals who denied that anyone under 18 could have that diagnosis, ensuring that she didn’t get the evidence-based help that she desperately needed and could have benefited from. It is, most of all, tragic to read about Taya’s despair, both in her own words and in those of her father, whose love wasn’t enough to keep her alive, because love isn’t enough for someone with BPD. This book is also essential because children and teens can be diagnosed with Borderline Personality Disorder, and they can be helped, using the gold standard of treatment for BPD: Dialectical Behavior Therapy. I feel so lucky to have been afforded this view of Taya and recommend the book to parents and mental health professionals.”

Dr. Kristin B. Webb, PsyD

Licensed psychologist specially trained in Dialectical Behavior Therapy

“Never have I seen a child more carefully tended, more resoundingly loved and respected. But, in the moment, as this beautiful child was growing up, the distractions of Taya's age seem to have blindsided many of the adults around her and, in the beginning, lulled her hopeful parents into an expectation that all would be well. The strength of the child, her ability to mask her turmoil so that her teachers, her friends' parents, her camp counselors do not perceive it, should sound an alarm. Mental health care providers and educators owe greater attention to the perceptions of parents who are fearful about what appear to simply be children trapped in difficult developmental stages. In hindsight, the sorrowful ending of Taya's life story becomes clear, perhaps inevitable. But without thoughtful, dedicated research into the psychological and physical structures that lead so many young people to contemplate and to sometimes choose ending their lives, we do not know. Surely our common humanity demands more. I loved this little girl. I love her family. I hope that the story of what has happened to the Bruells will lead to a recognition of what we owe to all our children.”

Dr. Helen P. Becker, Ed.D.

High School Principal (Retired)

What a beautiful book you have written about your brilliant, gifted daughter Taya and what a meaningful contribution you are making to the understanding of BPD when it manifests in children and teens. It’s shocking that no one was aware or willing to entertain the possibility that Taya had BPD How heartbreaking for you and your family, and what you went through. I thought telling her story through so much of her own writing and poetry was brilliant and so powerful. What a gift that you were able to access all that after her death, and now can make such a meaningful contribution to others by sharing your heartbreaking family story. In addition, the foreword and afterword written by national experts were both full of very helpful information."

Patricia Snyder

Visiting Nurse & Hospice Care (Retired)