What to do with this -

[maxsterling]

She just sent me a message telling me she is in a bad mood today, very depressed, severe anxiety, and severe pain.  She suggested I find something else to do tonight.

I'm okay with that.  But is that what she really wants? 

I replied that I was going to go out and get another heating blanket (old one broke last night) and that may help with her pain.  I then asked if there was anything else I could do for her. 

She replied to not go out and get the blanket, and there was nothing else I could do for her.

Thoughts?

I was thinking to just leave work, go do something such as an al-anon meeting on my own, and just let her know where I will be.  Good idea?  Or is there a possibility that she really wants me home and that I am supposed to read between the lines?  Or is she warning me that if I come home, she will be angry and mean to me?

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[vortex of confusion]

Take her out of the equation for a second. . .

What do YOU want to do?

[MaybeSo]

I would say I'm sorry you are not feeling well. :'(  If anything changes,  text me.  I will be thinking of you.  XXXOO

No mind-reading gymnastics. Don't infantilize her.  Move on with your day.

[maxsterling]

Well, i got the "i want to kill myself" next.  Looks like i will be staying home tonight.

[vortex of confusion]

Well, i got the "i want to kill myself" next.  Looks like i will be staying home tonight.

[Grey Kitty]

I forgot your domestic living situation. Is that staying home with her, or staying home and away from her?

Either way... .Time to involve professionals if you get a text like that. ASAP. Call a suicide hotline, or ask her to call one. Call the police for a wellness check if you aren't there, Be ready to get her to the emergency room, Dial 9-1-1.

I also forgot... .have you  dealt with acute suicidal thoughts from her before?

 Hang in there!

[KateCat]

Max, it's easy to forget, but this was just one week ago:

"Friday was pretty traumatic all day.  The culmination was my wife turning over furniture, throwing things, threatening suicide, screaming, and hitting herself until I called the crisis line and forced the phone to her ear.

Saturday was okay, but had a mild headache, and some ringing in my ears.

Sunday morning, I practically fell down from dizziness."



You may need to have a plan for these events that has almost military-precision-and-protocols in order to protect your health going forward.  

[maxsterling]

Yes, I face this regularly.  Sometimes we go a few months without this dance, sometimes is is weekly. 

My protocol now is when she talks about suicide to instruct her to call the hotline.  That's what i did tonight.  I don't think she called, but she hasn't talked about suicide since.  I was just leaving work when she mentioned this, and had I heard that when I was home I would have dialed and put the phone to her ear again.  She's really depressed.  I talked with her briefly about it, she said it's hard for her to have many good days and then a really bad one.  I mentioned that it seemed to me she was feeling sad before bed last night.  She agreed.

I think she has T tomorrow.  That's good.  I think I really need to firmly communicate to her that T should be top priority.

[KateCat]

 

I'm kind of wondering about the "putting the phone to her ear" part, since I think you've done that before. Would that be part of "infantilizing her," do you think?

[maxsterling]

I'm kind of wondering about the "putting the phone to her ear" part, since I think you've done that before. Would that be part of "infantilizing her," do you think?

Figure of speech - but I did dial, hand her the phone and instruct her to talk.  She later said that action helped her.  It's either that or call police.  And she refuses help from the police, and knows exactly what to say so that they can't forcefully do anything or take her anywhere (I'm not the first loved one to call the police on her - she's had a long history of that since she was around 10). Crisis line can't help if she won't talk.  My feeling is dial for her, hand her the phone, if she won't talk, then call police.  She will then get in her car and speed away, endangering others, until she gets pulled over and the helicopter chases her (that's what happened last time).  The couldn't hold her because she made no threats against herself in front of them, and had not broken any laws.   It sounds like they tried to get her to talk to crisis people, but she refused.  The crisis line does help when she calls.  The police trigger something bad in her and usually make things worse. 

[KateCat]

The police helicopter chased her? And still she threatens suicide? (Hmm. I kind of thought that wasn't supposed to happen in real life.)

[MissyM]

Max, I am so sorry to see you struggling.  I have to question whether your wife should be in the hospital?  This has been going on for a long time and it seems you have become desensitized to how unhealthy all of this is for you and your wife.  Just my input but it is concerning.  It is like being a boiled frog, we just don't quite get how bad it actually is.  When someone is continually threatening suicide, knows how to play games to manipulate with the police and you are jumping through hoops to try and keep her stable, then something has to change.  How is what you are doing working for either of you?

[Haye]

Max, your and your wife's situation sounds very difficult and overwhelming. I'm not sure a weekly (?) visit with a T is enough. She sounds like someone who can easily pretend sane and nice for an hour, and 'forget' to mention how she's actually been. Not in her own benefit and not in yours either  

Does she have good medication? I'm not a big fan, but sedatives like valium work extremely well when my SO drops into suicidalness. Something like 15-30 minutes and boom he is all fuzzy, slow, but fine.

And one. You mentioned in an other thread she has obsessive thinking. I wasn't sure if you were refering to intrusive thinking (in OCD) or obsessing about diets, details all similar ruminating. If true hard core intrusion, it might explain why she's out of control. My SO has OCD, especially intrusive thinking, and it's something extremely horrifying. I'm not sure what keeps pushing into his mind, but it's strong and frightening and something he refuses to talk about. He only said it's pretty much always something the person is afraid of doing something, going through or about the fear of entering pshychosis etc. He told me it's usually something that's in reality opposite of what these people are, but fear becoming or doing. It could be something like seeing very vivid visions of yourself abusing a child or something else as utterly sickening he or she wouldn't do. Just can't stop the thought/idea/vision and starts to think he/she is like and will act like in the vision they are seeing. (better explanation on intrusive thoughts on www.ocduk.org/types-ocd).

These intrusive thoughts are extremely strong and cause at least my SO to dysregulate. Earlier the thoughts would push him into self-injure (cutting) or suicidal plans as he had no other means to make it stop. It took a while, but now he has learnt to cull the worst down with sedatives. (Depression and hopelessness kept telling him nothing would help... .)

Keep yourself sane man. Take care of yourself. You are her husband, not her psychiatric nurse. It sounds overwhelming and something else needs to be done imo.

[sweetheart]

Hi max,

This must be tough, my biggest concern at the moment if I've read your recent posts correctly is your wife doesn't have a P. That has to be your starting point as a matter of urgency.

MissyM is right your wife's dysregulated behaviour is being somewhat normalised and accepted as 'this is what she does' Suicide ideation is anything but normal. It is important for the time being that you step in and take control here by involving emergency services, because this communicates a positive boundary message to your wife, that you will involve others to deal with this.

Anytime my h was threatening suicide over the las 18 months I called the police out of hours and his P in hours. The police every time took my h to the ED for a mental health act assessment with a view to detention and his P would do the same. So he was either hospitalised or intensively supported daily at home by mental health nurses.

My starting place would be involving a P, here in the UK a T would have already referred to a P if your wife was presenting as she is.

[waverider]

Do you ask her if she needs the time alone to think about something in particular, without you distracting her? In other words show interest and clarifications as to why she wants to be alone, validating and supportive.This avoids second guessing and opens an opportunity for her to vent a little instead of going off on a m ore detructive path

Also tell her you will be back in X time unless you hear otherwise and would she like you to bring something home.

[maxsterling]

Thanks so much, everyone.

I think I have become a bit desensitized to all of this.  I needed the reminder that she has BPD, and a pretty severe case of it, IMO (meets all criteria, low functioning, etc).  It also seems there is nothing to grab onto and build from - like there is no normally functioning part inside her that she can expand upon.  When I am down in the dumps, I usually fall back on a few things that help and give me comfort.  She doesn't have that.  Even our marriage - she has a hard time using that as something positive because she occasionally has those negative feelings that I am some kind of controlling monster.

Hospitalization - if that is what her T thought was best and she agreed, I would certainly support that.  Personally, if she is making suicidal statements, hospitalization needs serious consideration.  The problem here is, she has been hospitalized a dozen times before, sometimes for months at a time, and little long term good has ever come from it.  I think that is why she doesn't want to go.  She feels hospitalization is a setback, won't help her, will be one more thing to feel shame over later, etc... .

Today, I'm just going to try again to live for today, and do the best I can to take care of myself.

[sweetheart]

Max hospitalisation as a form of Crisis Management is the goal in and of itself. As you have realised your wife has nothing to draw upon internally to help her cope in times of crises and reverts to maladaptive coping strategies.

Short or long term hospitalisation for people with BPD is really only about preventing risk behaviours escalating and providing a place of safety until the person returns to baseline. Specific therapeutic intervention is not the focus of acute psychiatric hospitalisation.

I know when my h is in hospital it has also been a much needed break for me. This forum helped me realise the importance of pursuing a Crisis Management Plan for my h. My h agreed for me attending a meeting with him and his P to put this in place. Without this our lives would be lived just reacting to my h's internal chaos, lurching from one crisis to another. I tried living like this and that's what brought me here as emotionally for me I knew it wasn't sustainable long term. I can now live in the moment, using the tools learnt from here, and also knowing there is a contingency plan in place for when my h becomes dangerously dysregulated or threatens suicide.

I appreciate your life is not the same as mine, but given your wife's ongoing difficulties it might prove beneficial for you to have a plan in place for when this happens again. It will certainly go a long way to helping you feel less stressed, I know it has me.

[Grey Kitty]

I think I have become a bit desensitized to all of this. 

... .

Today, I'm just going to try again to live for today, and do the best I can to take care of myself.

max, I'd highlight both those things you said.

Yes, you need to take a deep breath, care for yourself, and make it through today's crisis with her. Do that.


This kind of suicidal breakdown every week(!) or even every few months seems to be way too high a cost for you.

It is time to push the issue and make it clear to her that YOU cannot live this way, without effort and progress on her part to address the fundamental issues that are driving her to these suicidal breakdowns.

You don't have to go it alone. Neither does she. But something's gotta change, and I only see two plausible directions leading to something different:

1. You make changes. (Perhaps with her medical team like sweetheart did)

2. Eventually a suicide attempt is successful.

If she stays with you, and you don't take the lead, I cannot imagine her changing this pattern.

 Take care of yourself today.

[MaybeSo]

This is very hard on loved-ones, and it becomes easy to get desensitized and frankly, it is hard to not become totally burnt-out.  That is why it would be good to have a plan in place that involves a team effort so everyone knows exactly what to do when she feels this way, and it doesn't land on you alone. If she is feeling this bad so often, she probably should be hospitalized or at least be involved in an intensive outpatient program. 

[maxsterling]

It is time to push the issue and make it clear to her that YOU cannot live this way, without effort and progress on her part to address the fundamental issues that are driving her to these suicidal breakdowns.

I see the same thing.  I just don't have the energy to think about this right now. Taking a deep breath and focusing on today is step one.

Clearly, I can't keep living this way.  Clearly, she can't either.  My issue is how to approach her on this in a safe way.  I can see huge potential for backfire here.  If I tell her I can't keep living like this, shame and abandonment fears almost certainly kick in, result will either be horrible rage, or even further depression and suicide ideation.  She's already on the edge now.  May be a good direction to take in MC next week.  At the very least put it out there about how I am having a very difficult time dealing with the chaos right now and that I will likely fall apart if it continues.  She's likely to feel an ultimatum, which would not be good.  I could (and have been) expressing to her that finding a new T should be her top priority.  So far, not much traction there.

[KateCat]

max,

When you've recovered a little, would you have the possibility of taking some legal counsel regarding your situation? (Maybe pay for a single, one-hour or one-half hour of an attorney's time)?

Maybe some direction would emerge from that angle of approach. (I can't help but worry for you when hearing that your wife has recently been in a police chase and been the caretaker of small children, however briefly.)

[sweetheart]

Max why is your focus on a new T and not a P or referral to a mental health team via your doctor ? I'm not in the states so I'm not aware of how the system works, but given your wife's presentation and mental state how will a new T be more effective than a P?

Here in the UK therapy is only effective for pwBPD, especially DBT if their mental state is reasonably stable especially with regards to suicidal ideation. Active suicidal ideation with ongoing dysregulation is usually a contraindication for T continuing.

Try not to think in terms of ultimatums but in terms of safety and risk to self.

What I thought would happen when I let my h know I would involve outside agencies when he was at risk didn't happen. I realised that he was relieved to receive crisis intervention because acting out in this way is also a form of communication letting us know that our SO does not feel safe and cannot keep themselves safe. This is a way of asking for help, letting you know they cannot cope. My h has experienced less suicidal ideation with the introduction of intensive support.

I can hear that you are stressed and overwhelmed by all this but it is possible for your situation to improve. It will be down to you to lead the way initially.  

[waverider]

Official crisis intervention sends her a clear message that her problems are being taken seriously and not just 'coped with".

Not demonstrably having her issues taken seriously can increase her feelings of hopelessness.

She can't cope, she needs someone else to, and so do you

[Grey Kitty]

It is time to push the issue and make it clear to her that YOU cannot live this way, without effort and progress on her part to address the fundamental issues that are driving her to these suicidal breakdowns.

I see the same thing.  I just don't have the energy to think about this right now. Taking a deep breath and focusing on today is step one.

Clearly, I can't keep living this way.  Clearly, she can't either.  My issue is how to approach her on this in a safe way.  I can see huge potential for backfire here.  If I tell her I can't keep living like this, shame and abandonment fears almost certainly kick in, result will either be horrible rage, or even further depression and suicide ideation.  She's already on the edge now.  May be a good direction to take in MC next week.

I think doing it in MC is a good idea.

I also think that being scrupulous in saying how you feel about it ... .  "I can't deal with this alone. I'm close to having a nervous breakdown." ... .and not saying ANYTHING directly about leaving/divorcing or any other ACTION you will take.

The point is that she's falling apart, and you can't keep her together alone.

That's what you want to get across.

I think it is more loving, more hopeful and more validating than constant crisis management with the least official involvement possible.

[Haye]

Max why is your focus on a new T and not a P or referral to a mental health team via your doctor ? I'm not in the states so I'm not aware of how the system works, but given your wife's presentation and mental state how will a new T be more effective than a P?

Me thinks the same as Sweetheart, altough of course I'm not sure which kind of therapy she is attending now. When a person is not feeling well, is dysregulated and out of control (like your wife is now) therapy can be too much and make things much much worse. One needs to be in a good stable condition to be able to dig out the dirt and deal with it. Therapy, the deep analyzing type, is hard. I had a major depression years ago, went to therapy and in the early stages of it I was doing worse than ever. Which is common. Which is why (at least in Europe ) it's recommended not to start therapy unless one is okey enough, balanced enough and capable dealing with that balance getting disrupted.

I'm with Sweetheart thinking your wife needs medical help to get the situation balanced. My SO is taking SSRI, lamotrigin and valium-type sedatives when he feels extreme anxiety/suicidal or self-injure thoughts. He's been declared to be doing too poorly to attend real therapy. What he is getting are weekly treatments with a psychologist giving cognitive-behavioral tips and talking. They say it's like putting on patches now so that he will be able to pull him in a better condition and then start to dig into history and such.

[formflier]

Maybe some direction would emerge from that angle of approach. (I can't help but worry for you when hearing that your wife has recently been in a police chase and been the caretaker of small children, however briefly.)

Max... .take some time to think about this.  In the Navy... .there was a saying that you never wanted to be the "senior man with a secret... "  Something that you knew the chain of command needed to know.  It usually sucked to have to be the one to say it... .but that was the price of seniority (higher rank).

Life with a pwBPD traits is so confusing... .communication is strained... weird (look at some of my recent posts)... .

Anyway... .my gut reaction is that she needs to be in front of a P... .ASAP.  Lay out the objective evidence of her mental health issues... .suicide thoughts... .police chases... all that.

There needs to be a plan... .if she tries to skip out on the plan... .there needs to be a plan for that. 

I would ask the P to "prescribe" a protocol for suicide talk... .hints... whatever.  I would follow that... .exactly. 

I have opinion on what that should be... .I'll post that next... .there is story to go with it.

[formflier]

 

Suicide talk and the fire warning light... .

I hope this analogy or story works... .

So... on the airplane I flew each engine had a fire extinguisher... .pretty decent system... .to put out a fire in the early stages.  So... the procedure was... .if the fire warning light came on.  You pulled the handle (shut off the gas and fluids)... .pulling the handles exposed the push button for the fire extinguisher... .you push the button... .and then watch the engine to see if there is evidence of fire.  All while trying to land... pretty quickly.

There was a time when there were some really touchy fire warning systems... .the lights went off a bunch when there was no fire.  Guys got lazy and guessed correctly that there was no fire.  This was never an official procedure... .but it was what was done.

So... .one day a plane went flying and right on the cat stroke (off the end of the carrier)... .the light comes on.  No big deal... they've seen this before.  They don't do the procedure.  While waiting to come back aboard the carrier (takes a while to move planes around to clear the landing area... )... .some of the guys say... ."hey... .why is the paint bubbling up on the engine nacelle?"  "and is that smoke... ."

Yep... .a real fire.

So... now they pull the handle... push the button... .but the smoke got worse... .the bubbles got bigger... .and eventually the flames came out.  They had waited too long... .

Luckily... they decided to bail out... .and the damage that was done was that about $100 million worth of airplane went into the sea... .because they decided to ignore the light. 

Max... .don't ignore the fire warning light.  Suicide talk is a sign of something very serious... .you have been lucky and "guessed" correctly up unto this point.  It sucks that the times you have called it didn't work... .or she got out of it. 

That doesn't mean you should stop pushing the button.


Max,

There are many parts of your story that gives me great hope... .moments of self awareness... .that is real progress.  One of the troubling things I see in my r/s is that we get more "normal" time... .but when she dysregs... .it gets weirder... .

I think you were seeing the same thing... .if I remember right.

Hang tough dude!  I'm rooting for you. 

[waverider]

Sometimes we are too close to see things objectively, and we make the wrong call.

Assumption can be the mother of all stuff ups.

Same old, same old is the same old story, until it isn't, then it's too late

[formflier]

  then it's too late

And with suicidal threats... .when it's too late... .you don't get a do over.

These are tough calls to make... .but once you look at it in the "right" way... .it kinda becomes easy.

Take my story about my decision to report my wife to dept of social services for the spanking incident... .

I kinda got to the point where I realized I would feel worse by not saying anything.  I realized that I could live with myself... .if I spoke up and the marriage failed or something else went wrong.

But I realized I couldn't live with myself if I kept quiet... .and something worse happened.