BPD and physical illness

[outhere]

Hi all.  My wife has BPD along with OCD/anxiety and multiple chronic health problems.  It is often difficult to distinguish between a real health problem that requires a visit to the hospital and a BPD/OCD flare-up. 

An example of an impossible situation:  She regularly has a discomfort in her chest that is being investigated by a cardiologist.  We have been to emergency many times for it and most of the time they find nothing significant, however 2 years ago similar symptoms turned out to be a blood clot in her lungs that probably would have killed her had we not gone to see about it.  Last night she was on the couch and said she had discomfort in her chest.  I tried to validate and asked if she would like me to take her to the hospital or call 911.  She said no because she is tired of going to the hospital and being treated poorly so she would rather die.  It was late and I was falling asleep so I told her I was going to bed but if she felt worse she should wake me up or call 911.  I suppose the "mistake" I made at that point was to not validate, but I was exhausted and needed to take care of myself.  This morning I am evil because I did not take her to the hospital.  I told her that I can't be responsible for whether she lives or dies, goes to the hospital or not, although obviously if she turned blue or had other signs of emergency I would call 911 in a second.

Does anyone else have a BPD partner with true physical illnesses that add an extra layer of confusion?

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[waverider]

Yes, my wife has ailment anxiety disorders (new name for hypochondria). Usually several major issues running consecutively every day. Unfortunately this sometimes masks some serious ailments. Many of these real ailments are indirectly self inflicted due lack of self care. It is hard to tell the difference. Even if she has a real ailment she will still not turn up at Drs appointments, even though she is always on the phone making appointments and claiming its an emergency, nor attend any tests/scans etc she is referred to. Bottomline is I believe one of these real conditions will rear its head, get unnecessarily worse and could even end up terminal. Reality is, there is nothing I, nor the Drs, can do about it. This is something you have to come to terms with and not let yourself feel overly guilty about. It is what it is.

The validation comes from seeking help and the process of it being offered. It is not about the end goal of fixing any problem, imaginary or real. It is about climbing aboard the needy train with them and playing along that makes them feel valued..

What she probably wanted to hear was not you are going to bed and for her to wake you if there was an issue. She probably wanted you to say you would check on her in the night to see if she was ok..ie continuing the helping process. Not saying you should have done that, but that is most likely would have been her preferred response. As it was in her mind, it sounded like you have switched off the caring switch for the night deciding there was nothing more to be done. The payback is to then claim in the morning that it was very serious and you should have done something. Playing out the 'what if card" if you like.

[outhere]

Thanks for your thoughts, waverider, I really appreciate it and am happy to hear I'm not the only one dealing with this gnarly combo.  My wife is pretty decent at following up on doctor's appointments and tests and taking care of herself (sometimes to a fault e.g. "eat a low sodium diet" = fear of eating too much sodium).  I think the thing that she struggles with the most is the impossibility of absolute certaintly regarding medical diagnoses, so there's always the possibility that there is actually something critically wrong with her body despite tests showing otherwise, magnified by the fact that she does in fact have real medical problems that took years to diagnose properly and were initially misdiagnosed, often as anxiety, so she has good reason to doubt.