I'm a psychotherapist... and not handling my sister's BPD well

[EJ529]

This is my first time here and first post... I feel like I'm writing on a whim after a couple of recent interactions with my younger sister (diagnosed w/BPD about 12 years ago) that have left me feeling super flustered and I feel like I just need help. One of the things I'm having a hard time with is this: I am a licensed psychotherapist. I work in mental health full-time. I can definitely talk the talk when it comes to my patients, helping them with effective communication, setting good boundaries, using coping skills, etc. I can teach DBT with my hands tied behind my back. But when it comes to interacting with my own loved one... I feel like it all goes out the window and I turn into an awful version of myself who I can't stand. That is what's most frustrating. Of course my sister's diagnosis is frustrating, but I realize by this point that I cannot change it and I cannot change her. I get most agitated by my own responses and how intense my own emotions get during and after my interactions with her. I feel like I should be better at this considering what I do for a living. Anyone else out there who's a mental health professional and can relate?

[Couscous]

Welcome! 

I’m not a psychotherapist but one thing I can tell you is that unless you are trained in systems theory and have done considerable family-of-origin work, your training will not help you. I recommend you get into counseling with a systems trained family counselor — although I do not advise going with your sister, at least not at first.

[Mommydoc]

Welcome EJ529. I think we can all relate.

I realize by this point that I cannot change it and I cannot change her. I get most agitated by my own responses and how intense my own emotions get during and after my interactions with her.

Though I am a healthcare professional, I too feel like I do way better with other peoples dysfunctional family members than my own. It is different with your FOO than with a patient. I hope we can give you permission to let go of “I should be better than this” and direct some self compassion and self kindness in your own direction. I love this site as you will find you are not alone and there is so much opportunity to learn from others in similar circumstances.

I find that the more specific you can be in sharing the situation, and any specific questions you have for others, the more useful the responses will be. What is currently flustering you with your Sister wBPD?

[cranmango]

I can totally relate. I’m also a psychotherapist and have worked with all kinds of patients. Yet when I’m with my dad (who has features of BPD/NPD) it all falls apart. All my clinical training goes out the window!

So I hear you, I think it’s totally understandable, and I encourage you to give yourself some grace.

[NarcsEverywhere]

I mean, it sounds like you just have a lot of resentment and baggage surrounding her, probably a lot of bad habit patterns too. I think you judge yourself, because you take it as an attack on your professional prowess, but it's just not the same. You can stay detached with patients, and clear headed, but all your emotions will cloud you, when you're with your sister. Also, if you're dealing with her before you're ready, then you'll lose patience.

So I think the solution is to find ways to work through your baggage, such as, therapy/journaling/creative writing. Not take it as a personal attack on your abilities, so that you stop shaming yourself, which will compound the problem. And try to deal with your sister when you're ready, or only when you have to, so your patience is higher, and you'll feel less triggered.

[EJ529]

I find that the more specific you can be in sharing the situation, and any specific questions you have for others, the more useful the responses will be. What is currently flustering you with your Sister wBPD?

Thanks all. Mommydoc, to answer your question, it feels like a long story. Long term, ever since she was diagnosed (and even before that, when she was showing signs and symptoms), I have been trying to grieve the sister I had hoped for and come to terms with the fact that my ONLY sibling has this lifelong condition and sometimes it feels like I have no sibling at all. Obviously, that process has not yet come full circle and I'm not sure it ever will. Short-term, my most recent frustrations have been from two patterns, 1) her tendency to be the "help-rejecting complainer" and then blame others when they call her out on that, and 2) her tendency to play the victim without ever acknowledging her role in issues or conflicts. Granted, these types of patterns can show up in anybody, whether they have BPD or not. I think for her, these things exacerbate her splitting tendencies and black-and-white thinking, and going from relatively calm to emotionally volatile in a matter of seconds. And that's when she starts throwing out insults and such. I think when she is in a calm or (somewhat) agreeable state, I get a tiny bit excited because she wants my help or advice or wants to talk to me, and then inevitably it all goes south at some point and I'm left feeling disappointed and frustrated, and that's when I get annoyed with myself because I feel like I got fooled again.

I feel like that was a ramble and I'm not sure if any of it made sense. I'm happy to share more details if that would be best.

[Mommydoc]

It makes total sense.  I feel like I am in the same situation as we speak! 

Granted these types of patterns can show up in anybody, whether they have BPD or not. I think for her, these things exacerbate her splitting tendencies and black-and-white thinking, and going from relatively calm to emotionally volatile in a matter of seconds. And that's when she starts throwing out insults and such. I think when she is in a calm or (somewhat) agreeable state, I get a tiny bit excited because she wants my help or advice or wants to talk to me, and then inevitably it all goes south at some point and I'm left feeling disappointed and frustrated, and that's when I get annoyed with myself because I feel like I got fooled again

The tricky part is that pwBPD are such chameleons. Often to outsiders they seem totally normal, and perhaps charming and dynamic.  We never know however, when they are going to get triggered given the volatility of their emotions.   Our inner desire to “ believe” their words when they are kind and calm, tricks us into being hopeful. We then let down our guard and  show up as the sibling we want them to be.  It is at that moment, when we become vulnerable that we are likely to be manipulated and attacked. It seems to me that one of the differences between people with BPD and those who don’t, has to do is their  self awareness and self regulation is limited.  Therefore, there is never any ownership of their actions, interest in common understanding or ability to change the dynamic.  All we can do is own our own reactions, how we contribute and make changes in how we show up, so that we are taking care of ourselves and putting our energy and attention in the right place.  Dealing with a family member with BPD can be very draining.   

My family and Therapist have pointed out to me that my expectations of myself, “ to be the bigger person”, to “ let it roll off me” and always trying to “ not react” may be directly related to my role as a health care professional.  As health care professionals, we are always taught to focus on patient, and we really don’t have the option to walk away.  It is also 1000 times easier to have boundaries with patients than with family members.   This may or may not be true for you, but I may “over intellectualize” the situation which leads to having unattainable expectations for myself. I was not recognizing the difference between my situation/interactions with my sister and with a patient.  Beyond that, I struggled with getting angry with my sister and tended instead to be upset with myself for not managing her better.  As I have allowed myself not only to feel my anger, but to express it ( not towards my sister but to vent here and with friends/family) I am beginning to be less judgmental of myself and more confident about setting boundaries.  Most importantly, I am beginning to realize that my anger is a healthy emotion that can be channeled to taking actions to protect myself and my needs.  Your needs, my needs, our needs matter, even though our sibling will never ever see or acknowledge that.   So the only one who can prioritize our needs in this situation is us.  We are in this together.

I am not sure if this is helpful, but hope you will continue to post as well as explore the many readings.   I have grown so much through participation in this forum.   I am a fan of Kristen Neffs work on self compassion and the importance of recognizing the common humanity of our situations.  This forum fills that for me and I hope it will for you. 

[Notwendy]

I am not a therapist, but I have heard that pwBPD are challenging kefor therapists so it makes sense your sister is a challenge for you.

My BPD mother is resistant to therapy. It has not been effective. She's elderly so there have been many attempts with many different ones. Although my father was reluctant to discuss her issues with me, eventually, I got old enough to ask if my mother has had psychiatric help. His reply was that it didn't work. I then asked why and he replied "she lies to the therapist".

From what I know, therapy depends on the client being transparent about their issues and agreeing to work with the therapist. My mother doesn't do either. She's also not compliant with her medical team. She wants to maintain control and she does that by deciding to not let anyone tell her what to do. So, no medical provider, no therapist, and probably no other helping professional has been effective with her.

My BPD mother's strong need to maintain control lends to her sabotaging, not cooperating, or refusing attempts to help her even in ordinary things. Even trying to help her by picking up her car at the repair shop leads to her refusing to call the shop to see if it is ready or telling us where it is so we can get it for her.

There is no place in this for self criticism. This is not a failure of your capability or your training. It's the nature of BPD which plays out the most in an intimate or close relationship, which makes someone close to them the most ineffective. My mother will trust her hairdresser's suggestions and not trust mine. It is what it is.

[Woolspinner2000]

Welcome EJ529, 

Thank you for trusting us with your story as you share. You've gotten some great responses so far. 

My mom was an uBPD, so I can understand the struggle that happens with a pwBPD.

The closer we are to something, the more difficult it is to deal with. If we step away from the family dynamics and peer into someone else's world, we can share our wisdom and hopefully help them. When we get closer to center, our family ring/circle, then the family system kicks in and we are part of the core of our family once again, whether it's healthy or not.

One time I spoke with my dad about my uBPDm, and while they fought terribly and were physically abusive to one another, he was closer to my mom (his wife) in relationship on that family circle, and he took her side. A lesson learned for me. We tend to go back to what we know and learned from our family structure. You aren't failing because you default back to that place. It takes a lot of work to step out of our family system.

 
Wools

[So Stressed]

EJ529, I really related to the following comments that you made: "1) her tendency to be the "help-rejecting complainer" and then blame others when they call her out on that, and 2) her tendency to play the victim without ever acknowledging her role in issues or conflicts." (I confess I don't know how to copy an excerpt correctly).That's what my Mom does.  It is so frustrating.

I am interested that so many people here are psychotherapists...me too.  I apply my training to psychology at work, but I thought I should be much better at this.  I know that we can't really treat our own families and friends, but I thought I should be better at coping.  Instead, sometimes when Mom has one of her episodes or my sibling loses their temper, I get scared right out of my body and I can't think or focus on anything.  Since finding this site and getting more counselling and recognizing that I am not alone, I am learning to respond better.