1.05 | Telling Someone You Think They Have BPD
TCarlisle:
The phrase "getting someone into treatment" implies that another person can influence a BPD into treatment. I was an optimistic non, always thinking that the yellow brick road would lead to a place where the BP makes the self realization that treatment could restore their life to normalcy. I always thought I could "help" the BPD come to that realization. I was very, very wrong.
BPD is a disorder very similar in nature to an addiction, specifically because part of the disorder includes strong denial. Most people that are told they have a clogged artery, don't react in denial (sure some do) but instead react by saying "I am glad it was caught now, how can it be fixed doc?". On the other hand, no BPD will react to a mental health diagnosis in that manner -- the BP won't say "Ok, how is it treated" but instead enters strong denial. That is the nature of their illness -- denial is probably central to the disorder. Just like addiction to drugs or acohol. Maybe BPD is just an addiction to BPD behavior? But instead of being addicted to coping with life through drugs/alcohol, they have developed their addiction to living life behaving exactly as they do. So just as you can't force someone into rehab for an addiction and expect it to work, it is the same for BPD? And just like an addictive illness, maybe the wall of denial can't come down until the individual hits proverbial rock bottom?
After 5 years of trying to find a way to make a BPD see there is a problem and urge to get help, I am left realizing that this particular BPD is much more mentally ill than I ever realized. This particular BPD is willing to risk losing her children to continue the BPD behavior. She has lost her husband, has lost her home, has lost 50% of the time with her children, etc. Yet still she insists "I'm fine". She will go to the grave living her life status quo. She simply cannot allow her mind to think it possible to live without the defense mechanism that her mental illness provides.
JoannaK:
Excerpt
Maybe BPD is just an addiction to BPD behavior? But instead of being addicted to coping with life through drugs/alcohol, they have developed their addiction to living life behaving exactly as they do.
I think that is a very good observation, T. I just quoted something by Emmie in the Workshop "inside the mind of a borderline", in which Ennie describe the conditions of the BPD in her life and how that impacted her behavior... . The difficult behavior is a coping mechanism that may have worked for the child and may work sometimes, but increasingly does not work as the years go on.
I think that if you read this particular Workshop as a whole, it is clear that you can't "get" a BPD into treatment. But this is one of the most commonly asked questions from new members here: How do I "get" my BPD into treatment? Which is why it is the topic of a Workshop.
Thanks for your contributions!
Skip:
Amador urged family members and mental health professionals to understand that collaboration with treatment by someone who has a severe mental illness is a goal, not a given.
According to Dr. Xavier Amador, professor in Clinical Psychology at Columbia University, denial is a powerful deterrent to recovery in mental illness. What is often thought to be immaturity, stubbornness, and defensiveness is a much more complex and difficult problem. His book talks about how delicate a process this is, as well as do's and don'ts. Amador has written about getting people with serious mental illness to accept treatment in a book he coauthored with Anna-Lisa Johanson titled, I am Not Sick, I Don't Need Help: A Practical Guide for Families and Therapists, https://bpdfamily.com/content/support-child-therapy
This are an excellent videos
Part 1 https://www.youtube.com/watch?v=Lstn6WNnCRc
Part 2 https://youtu.be/Lstn6WNnCRc
It is important instead to develop a partnership with the patient around those things that can be agreed upon.
Amador said that family members and clinicians should first listen to the patient's fears.
Empathy with the patient's frustrations and even the patients delusional beliefs is also important, remarked Amador, who said that the phrase "I understand how you feel" can make a world of difference.
The most difficult thing for family members to do in building a trusting relationship, he said, is to restrict discussion only to the problems that the person with mental illness perceives as problems - not to try to convince them of others.
JoannaK:
As I mentioned above, we also have a book review on the Amador book that Skip mentioned above:
https://bpdfamily.com/message_board/index.php?topic=61716.0
SeekerofTruth:
Sharing of the above referenced perspective is helpful to consider now... .as mine began her 1:1s, just 2 sessions ago, while we have been in couples counseling last 8 months... . The kicker appears to be, as a very high functioning acting out pwBPD, she's using her individual sessions to individuate from me, as just another man in a series of relationships who has hurt and betrayed her... .and in her "codependence" taking care of me financially---which is being translated now as my taking advantage of her financially... .greeeaaaaat. Am hopeful, that i might be able to accompany her to possible session with her therapist (to at least help with firming up the dx so she can avail her self to possible treatment, transformation, including functional and happy intimacy... .and potentially... .mitigate the destructiveness with which her vindictive, punishment, vengence is about to unleash on my masochistic aXX.)
{OK, so now how have i hurt you worse than anyone else in your life ever has... .
your last husband who suprised you out of the blue with a demand for a divorce with his core reasons as to why... .being you are "too self-absorbed, too hard on him" -- ah, i think he might have meant verbally abusive... .just sayin... .After which both of your sons chose to stay with him, not you... .including your eldest born from a different biological father who didn't really want to talk to you... .which might have had something to do with all the basketballs of his you punctured with knife one day in a rage ... .okay was it 1 basketball as you say... .or every single ball in the house as he says... .does it even matter--- am i being too literal... .
Ok, so how have i hurt you worse than anyone else in your life ever has... .including the guy who you got pregnant with in high school, whose family rejected you and did not want a thing to do with you... ."don't ruin his life" resulting in raising your son while in high school with your parents functioning as defacto primary attachment figures... .?
Ok, so how did i hurt you worse than your first BF who raped you at 13... .?
Ok, so how did i hurt you worse than "something else you never told anyone else before that"... .?
... .Oh... .i hurt you worse because "WHEN WE FIRST MET, I THOUGHT SO HIGHLY OF YOU, I IDEALIZED YOU--- yup, I was your knight in shining armor--- and "BEFORE I MET YOU I WAS A MANHATER" yup, and my EGO, my HEART, (my narcissim... .really?... .ugg) thought wow man, i can help you love another man again... .watch this... .
"AND THEN 5 YEARS AGO WITH ALL YOUR INFIDELITIES... ."
ALL MY INFIDELITIES? Yes, there was that one... .which we talked about, and talked about and talked about, in which i apologized, and so on... .that one? Or the times we had officially broke up, and you brought me over a bag of condems, or you told me some of the kinkier sides of how you wish you could have been there and joined in, or the times we would reconcile and in the heat of passion you would tell me "bring it all back"... .
What about yours... .OH, THAT WASN'T THE SAME THING... . OK, but that was 5 years ago, didn't we talk through all that? So why did you marry me again?
(again ... .banging my head against the wall... .how in the HXXX did that happen, since marriage of one year/but together 8)... .(all set to begin business out of home 1 year ago after marriage, ready to hit the ground running... .after 2-3 years of preparation, high level training, expenses... . essentially being ALL IN and READY to hit the ground running... .with the expectation/assumption wife would be helping out a few hours a week, more or less as a co-record keeper/financial manager/money counter (she's the one with the dual degress ///MBA and others which i was instrumental in helping her achieve) to track monthly cash flow/expenses that i was to be generating... .learning the business herself so as in the event something happening to me... .she could potentially carry on the gift or any potential legacy as well as passing it on to her sons... .oh, the road of good intentions... . And she knew essential for my success-was an emotionally controlled environment- calm, with a concentrated focused mind... . So as i am growing increasingly frustrated... .with one distraction or disruption or argument or new worry/anxiety after another... .I realize I am losing my Mind... .in which 95-99% of my stressors are correlated with maritial strife. AND STRUGGLEING NOT TO BLAME HER AS THATS NOT OWNING MY RESPONSIBILTY FOR MY APPARENT BUSINESS FAILURE... .And this is coming from someone who is pretty mentally tough, trained, very much reality oriented, highly educated/sophisticated in his of own right, etc... .except now in the mornings rather than having an empty relaxed stateOFmind... I'm replaying these crazy making arguments in my head, where I am confused about my own sensibilities of what is and what is not... .in trying to refigure out what the heck and how the heck did that just happen... .as my grip slowly begins to loosen... . i revert back to 1. taking care of my marriage-trying to fix it, 2. caring for my wife, and 3. struggling not to forget taking care of my self... .and not being too selfless... .not forgetting to own my own ADD issues--including self-medicating with thc and moderate etoh (which as a previous high achiever, usually i kept managed with a highly structured environment, supportive environment, lots of excercise, healthy diet/sleep cycle, and Wellbutrin... .) which are now suddenly off - the - hook, owning my anger issues--- A LOT of crazy making on this one -- i.e., ("YOU'RE THE ONE WITH AN ANGER PROBLEM"- honey, we both have anger problems, don't cha think?---"YOU'RE NOT SUPPOSSED TO GET ANGRY"- "YOU CAN'T BE ANGRY"---"YOU CAN'T RAISE YOUR VOICE"--- Ok, so i can't get angry, but you can get angry, and raise your voice and yell and scream?--- as the circle of reality getting ever more whacked.---The near constant threats of divorce---
Fast forward: so i go get an eval, in addition to couples counseling... .start up on adderall - 3 months ago- and instantly any urges for thc essentially cease... .and my thought processes begin to improve... .oh-oh... .
So what ever happend to OUR DREAM and my cheerished DREAM CAREER... .our plans for this type of shared financial achievement based on our family business that I would lead which would take us beyond just your income... .the more immeadiate profits used for a downpayment toward the house of your choosing... ."THAT WAS NEVER MY DREAM! THAT WAS YOUR DREAM!--- said in a condescending, you loser tone of voice"... .Oh, you mean, WE were never on the same page?
Oh... .so when i'd come home after a week intensive of training ready to hit the ground running... .and all the new material my brain was processing ready to focus on , discuss and share... .meant we'd find a way to argue about something something or argue that we were arguing,,, huh?
(that was kinda disruptive)
Ok- so finances are tight-- you have proclivity of impulsive overspending, previously been in bankruptcy, I'm the one with a pretty clean financial background... .except that now my procrastination/ADD also means some bills aren't getting paid... .so I/we really need to get on top of things
Ok-- so finances are tight, so we can't wait till our first anniversary to go on our honeymoon until we square away our finances... .WE HAVE TO GO ON A HONEYMOON TO HONOR OUR MARRIAGE... .ah, ok
OK--- so while on our honeymoon, did you really need to buy a time share?
Ok--- so 3 months after our honeymoon, and while on honeymoon your purchase of a time share... .did you really need to go on yet another cruise ship vacation with your youngest son... .12 years old (AGAIN---his 4th?)in order to "bond with him"
OK--- so did you really have to buy a new pet... .a puppy... .without discussing it with me first? But, honey we already have a dog? THAT'S YOUR DOG-- YOU NEVER DISCUSSED GETTING HIM WITH ME WHEN YOU GOT HIM-- honey, that may be true... .i adopted/rescued him 3 thanksgivings ago... .he is very well adjusted... .he's overcome his startle response... .his temperment is excellent... .i immeadiately invited you and your son over, for bonding with the dog... .i waited 3 years after my last dog died (oh yeah the one you were jealous of... .) WELL, YOUR DOG IS TOO MASCULINE, I WANT A NONMASCULINE DOG LIKE THE KINDS OF GREW UP WITH... .OK, so you went to a high end breeder, got a pretty puppy of this somewhat possibly potentially neurotic breed if not handled well, with out telling me... .ah, and so now you are going on a cruise... .and i'm going to take care of your puppy?
Honey, bringing a puppy into the home is like bringing a child into the home (oh, yup, her exhusband and his new wife just had a newborm child... .that coincides with a week of two of her puppy being born)... .Ok, so you really like this breed cus you grew up with them as a little girl and those are some of your fondest memories? Ok so , how many of these dogs did you have while growing up? 9 or 10? Sequentially? Well what happend to them? ah this one ran away, oh that one bit someone and got put down, or that one got hit by a car... .HUH?
Ok- now you are back from cruise... .now can i focus on business? Oh you are having surgery... .Oh... .now recovery is more complicated... .oh okay so you will now be home for another 2 weeks and i get to care for you... .oh and I can also go with you to your other doctor appointments to show my support and understanding?
And on and on... .
So finally the light goes on... .there is always going to be something that comes up... .if by september... .i am not full on engaging in business something is wrong... .oh maybe not all me... .oh could she have a passive-aggressive thing going on... .
Begin to bring that up... .gets even worse... .I realize my head/heart/mind are way flipped flopped... .and i have a 10 day spiritual retreat that i decide to attend in October... .renew, reconnect, rediscover... .my own body-mind restorative practices... .
Become informed of BPD (high functioning acting out)... .when i only knew of BPD in the context of cutters/suicidality... .as now unmistakenly accounting for what's going on with my wife in the context of our close relationship,,, and how after we got married... .the sXXX really started to hit the fan... .
2 weeks into her individual therapy: she's now more resolved than ever to end marriage and "WEAN ME OFF"... .and stop taking advantage of her financially... .
Ok-- got it... .6 months from now, I'm the one who could be broke, not afford house payments, as i search for A JOB -- (dream career on hold... .) to help make ends meet in my recovery of self-sufficiency... .my regaining sense of self, sense of soul, sense of career, new housing? and you go on with your 6 figure salary--- I helped you achieve--- big high profile career (which i am proud of you for, etc)--- and your distortion campaign of my being an abuser you finally got rid off... .
Well-- I'm getting ready... .and radically accepting... .and still gonna show love and patience... .but as my mom/shero/incredibly wise old woman (my dad was my emotional abuser) --- you have to be independent... ."i'd rather be a little mouse, with a little roof over my head... .than go through this every time"... . deep breath... .courage... .determination... .flow... .responsible to do and be my best for me, for her, for whatever the future brings... .becoming a better more whole person again... .
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