BPD Sister

[Fatigued]

Not quite sure where to start with this - so will start with now and fill in history (hopefully relevant) along the way.

1.  One of my elder sisters, now 59, has been diagnosed with BPD.  She has for years been treated for BiPD, and at one point, the doctor added schizo-affective to the BiPD diagnosis.  Her current therapist believes she suffers from BPD.  Her cycling is extremely rapid, so the BiPD aspect of her illness appears to have worsened as well.

2.  I have one other sister, the eldest in the family, who is 61.  Both parents are deceased, and none of us has children.  We are a family of three siblings.  BPDSis and the eldest sister live in the US, and I live in Asia.

3.  Physical and sexual abuse were features of our childhood.  My eldest sister and I have worked through the abuse issues, with the help of able therapists.  BPDSis has not addressed those issues.  BPDSis was also born with a visible marking, and that has plagued her all her life.

4.  BPDSis recently had a bout of lithium poisoning.  Renal function is down as a result, and she has changed medications.  She has applied for social security disability, and on some level appears to understand that she cannot generate enough income to maintain her lifestyle.  She cannot pay her rent, utilities, food and basic necessities, let alone have money for medications and therapy (yes, she let her insurance lapse as well).

5.  The three of us have been in mediation with her current therapist for a couple of months now, trying to work out an agreement with BPDSis.  If we can work out an agreement, my elder sister and I are willing to provide financial support during the period prior to BPDSis getting a disability award.  The agreement has been through three drafts, and the mediator/therapist has been involved in the discussion throughout the process.

6.  BPDSis has been told that if there is no agreement in place that all three of us are comfortable with, there will be no more financial support.  In prior years, first our father, then my sister and I, would always relent and send money to BPDSis -- without really having enough information to know if she was accurately representing her needs. If the check or the wire transfer did not come instantly, she would get abusive -- ranting about how horrid we are and so on.  And of course, only a forced "thanks" when the money arrived... .  or no thanks at all.

7.  Over two years ago, we got a cry for help, and we went to BPDSis's home area for a week, to help her put her life back together.   You would not have believed the condition BPDSis had gotten to -- it was horrid.  And unhygienic, to say the least.  We got her back on her feet -- car, appliances, debt paid, garbage and refuse removed and on and on. She had previously recovered from two psychotic episodes, each about a decade apart, and we were happy to restore a baseline for her.  This episode was a bit different that the two priors.  In involved visual hallucinations.  Previously BPDSis had only reported auditory hallucinations.

8.  Now, we're back in crisis.  The agreement contains two things BPDSis finds unacceptable: (1) full disclosure regarding her disability application, and (2) her commitment to weekly therapy with a qualified licensed therapist that all three of us are comfortable with, and an express right for the therapist to communicate with all of us, as he or she deems appropriate.  The first item is key because the amount of outside financial support we may agree to provide could jeopardize a disability award for BPDSis.  The second is key because BPDSis has a history of associating with therapists who are quite unorthodox and do not challenge her at all.  They just collect their consultation fees, and do nothing to assist her with learning to live with BPD (or BiPD with schizo-affective disorder).

9.  BPDSis will quickly (in a matter of days) run out of money.  Rent and utilities are due shortly, and she is also claiming that her phone and internet connections will be shut off.  She has revoked her permission for her therapist to speak with us about her situation, and she has said "goodbye" to me (via email).  (This is not new -- when she does not get what she wants, on her terms, she usually gets nasty and then goes silent, after saying we don't love her and such).

So, against this background, here's the dilemma: do we pay rent and sundry expenses again this month, even without any agreement in place?  Or should we stick to the position we've articulated?  I know the answer is we should not cave -- we would be enabling her BPD once again.  But it is not easy, particularly since we've been enabling for years.  I suppose that makes BPDSis's reaction even stronger -- are there any specifics on how to deal with the potential escalation in her reaction?

Many thanks -- it's good to have found you, and to know that there are thousands out there who are coping with family members who suffer from BPD.

[ScarletOlive]

Hi Fatigued,

Wow, it sounds like you're dealing with a lot right now. I'm glad you found us, and feel comforted knowing that you are not alone.   I'm sorry for all of the abuse you received as a child. Many here can relate. The situation with your ill sister sounds very tough. You're trying to make sure she gets adequate care, while trying to protect yourself and hold to the agreements. How are you and your sister holding up?

You mentioned that you weren't sure whether helping her in this instance would be enabling. I can't tell fully because I'm not fully aware of your situation. This article may be of some help, because it discusses the difference between support and enabling. Self-Aware: Are you supporting or enabling? There are many here who have been through similar, and can offer you advice on this.

I'm glad you found us. Keep reaching out for support here-this site has so much to offer. Please take good care. Sending you warm thoughts and lots of support.

[Suzn]

Hello Fatigued  

Welcome to bpdfamily.com. I'm sorry things are difficult with your sister. It's painful to watch someone you love be so out of control. I understand your frustration. As hard as it is, a person with BPD has to be willing to accept their disorder and be diligent about their recovery for therapy to work. Recovery can't be forced.

This article explains more in detail:Helping a loved one with BPD seek treatment

I'm glad you have found us. There are many supportive members here who are dealing with a sibling with BPD. You are not alone. I'm looking forward to hearing more of your story. Keep posting, it helps.

Take care of you.    

[Fatigued]

suzn, ScarletOlive,

Thanks for your replies, and the links.  The one discussing enabling and support was very useful, and the article on supporting a BPD loved one was helpful, too.

I think we have to hold this line this time with BPDSis, and let her fail.  Just handing over money on demand is enabling -- I've become her personal ATM.  And if financial support is to continue, I think she needs to learn how to engage in constructive treatment, and stay away from charlatans who are just after her (my) money.

The residual concern is what happens when several months down the line there is an eviction hearing.  Do we rescue then, or do we let her go? I've not found any posts yet that address similar situations -- might you know of any?

Fatigued

[Fatigued]

Ok, it's been a day or so now, and eldest sister and I have just spoken.  We are now getting the silent treatment from BPDSis -- another form of punishment (or complete lack of judgement).  The frustration is almost unbearable, and BPDSis seems to be taking over my emotional life (indirectly).  It is very difficult to disengage -- and to not rescue -- when it has always been about rescue.

Any thoughts about how to break the rescue cycle, and all real life examples, would be a big help... .  

Fatigued

[Fatigued]

Well, more news.  Don't know if it is good or bad.  BPDSis has disengaged from the constructive therapist, and from the person who prescribes her medication.  (Without insurance, it's difficult to know whether she intends to find another source for the medication -- that's particularly troublesome.)

No news, no email, no call to eldest sister.  Looks like she's gone from us --

Feeling a bit of guilt, but not really in an overwhelming way.  Just very, very sad that she cannot seem to understand or accept that we want to help, but in a way that respects limits and does not destroy us, our lives and our finances in the process.

Anybody out there who has been through this?

Thanks --

Fatigued

[Suzn]

The first item is key because the amount of outside financial support we may agree to provide could jeopardize a disability award for BPDSis.  

This is reasonable and very true.

(2) her commitment to weekly therapy with a qualified licensed therapist that all three of us are comfortable with, and an express right for the therapist to communicate with all of us, as he or she deems appropriate.   The second is key because BPDSis has a history of associating with therapists who are quite unorthodox and do not challenge her at all.  They just collect their consultation fees, and do nothing to assist her with learning to live with BPD (or BiPD with schizo-affective disorder).

A commitment to therapy, which it seems she's made, though lacking your approval for her choice in therapists,  would seem reasonable while you provide all her funds. The problem with this situation is (and not limited to... )

1. Are you qualified to judge the treatment plan for a pwBPD?

2. Do you understand there needs to be trust between a therapist and their patient?(especially with a pwBPD)

3. Can you see your involvement in her therapy could be viewed as a violation of your sisters trust in you?

4. A demand for full disclosure from a therapist in lieu of financial support is illegal in the US. (privacy laws)

Your sister's refusal on these points are reasonable and her right as an adult.

I understand your frustration. I have gone through a similar situation with my brother, not as extreme, nevertheless similar. It wasn't till my brother lost his son to the court system did he make changes. Myself and my mother helped him financially for yeaaars and it never helped, it only enabled his behaviors and kept him stuck in his expectations of his entitlement. It took something happening that shook "him" to the core. And "he" decided to get serious about his own life choices. He has his son back now but it was a very long road for him.