When you post, it always sounds like there is so much energy which is driving your chaos and destruction that you seem ironically full of vitality, it just shows itself in downward spirals. I imagine that if you could inhabit your adult self then you would have great capacity for using that energy to move forward. It is really sad for those of us who didn't have adults to help us harness our vitality, but here we are. At some point, we have to come to realise that no one is better placed to care about our wellbeing and our life more than we are. I think you are trying - this focus you have on how you can best play the chase me game with your therapist/care manager is real evidence of your mobilisation. Invest a bit of that energy into engaging, being honest, dropping the façade, etc and things will change.