BirdDancer, again thank you for the quick response. You seem very busy. I have considered the tough love option but I can remember a story she told me where her father had her committed when she was thirteen for writing some dark poetry. This still bothers her to this day. I need to be careful that no matter what I do, it is not a betrayal of her trust. That is why I am looking for more evidence based treatment than talking and using positive thoughts. I can assure you the severity of her condition is very advanced and chronic. I am not at the desperate point right now but I am aimless. That is why I posted on this site. I need evidenced based help more then comforting and encouraging words. This is not a demand for help (you have been very kind!) but you would think in 2020 somebody out there who calls him/her self a doctor would have better answers.