Beth,

Ive always liked that name, I have a few great friends named Beth. Being a great friend must be a given with people named Beth! You sound like you have been a great friend to this person. Still be her side despite her choices in life. The unfortunate truth is Beth, we have no control over other people. You may want to feel like your kinship and sister like bond is strong enough that she will see the errors of her ways and see the light. However, in my experience having dealt with self destructive people daily in my work they will only change when they are ready to. You hear of an alcoholic or a drug addict “hitting rock bottom” this also is often required for behavioral issues. To me, as someone trained in human behavior. This sounds certainly compulsory and behavioral. Its not so much conscious choices she is making, but something deeper causing her to do the things she is doing. She sounds like she is in a lot of pain and dealing with some repressed trauma.

You can lead the horse to water however can not make them drink. I like what Cherry suggested about trying to quietly influence her into self esteem building activities. Generally most behavioral problems stem from some form of PTSD and self image issues as the result of trauma early in childhood. However, you can not make he see the value in these activities so do not become discouraged if she balks at the suggestion.

The problem with behavioral disorders is they are like the trojan horse of the mental health plane. They develop to indirectly cover over or seek reconciliation of a deeper issue. People are generally so entrenched in their way of thinking as it is hardwired into their personality. Their behavior alone, serves as a complex network of denial and defensiveness, that no one act of compassion or plea for sanity will break. The light may be shining brightly but subconsciously they will deny it is there as they do not have the proper emotional sunglasses to stare into it and accept it for what it is.

I would search the internet for more resources from professionals who are more credentialed in this type of topic. A lot of good books out there helping people in your position to deal with people who are self destructive in their own lives, and by proxy are negatively affecting ours as well. Best of luck, im sorry this is happening to your friend.

-Chad