Is it really all just an illness? How about personal responsibility?

[pessim-optimist]

Ok, so I've been struggling with one thing. I agree with the books that BPs are impulsive, have a hard time controlling their emotions and are in a lot of pain and mis-perceive situations. I understand that we need acceptance and compassion for them. And I agree.

However, I don't hear much of the other side of the coin... .  

Where does them being the victim of their illness end, and where does the universal human responsibility and accountability start? Or does it even enter the picture? I mean, they are not clinically crazy, so they are responsible for their actions in some way.

I just posted on "wanted to connect with other grandparents" regarding our ud32 telling her kids we left the country without saying good bye (a total unfounded lie), as a part of a distortion campaign she's been waging against us in this last year.

And reading some books, and thinking about some of our past experiences with our BP, I am getting angry. The books basically seem to only emphasize that it is an illness and that they do not deliberately plan to manipulate or hurt us... .  

But in the "Rachel: get me out of here" book, Pdoc Pagget replies to her's - sorry, I didn't mean to hurt you- at one point "I accept your apology, but you very much meant to hurt me".

I have also seen our ud32 with my very own eyes plotting and thinking out loud for hours what she should or could do to get back at someone. And then she would go ahead and do whatever she thought up in spite of asking us for our input and hearing that it was not right, and then she would not admit any guilt or shame that I am aware of... .  

Now, I understand the part about impulsivity, but in this process we are also talking about personal responsibility and right/wrong, and the fact that people with BPD are not psychotic i.e. they are not clinically crazy.

Any thoughts on that?

I mean, if you disagree with me, please feel free to respond, but I would also like to hear if there is anyone out there thinking that BPD is just part of the picture and that there is also part of free will and/or spiritual context.

How do we separate the two? Where does the illness end and where does the human begin?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Survive2012]

Dear Pesim-optimist,

I often have the same thoughts as you.

I think there are a lot of differences among our kids: some of them just can't help acting in some ways that hurt themselves and their families. They are low functioning, they just can't cope with this world and the society. I remember reading some posts and asking myself "How do I dare complaining after reading this? My situation is so much easier... .  "

Other sons and daughters seem to function well on many things, but they are very disturbed when in their family. Is it, as some psychologists say that they feel free to be themselves when in a loving surrounding? Is it that we (the family) did "something" to them (they feel it this way) and they want us to pay for this?

My opinion is they are responsible for their behavior and our task is to try to make them understand what behaviors our society doesn't accept. However one thing is out of doubt: they are very unhappy. The strongest need I feel as a mother is, regardless everything else, to try helping our son feel life is worth living. I try helping him understand little joys are what life is good for. If you keep waiting for something greatly fantastic you will always be disappointed.

Me too, I look forward to reading your thoughts on this subject.

Good morning from sunny Italy,

Survive

[oglobaith]

Good question.  I sympathize wholeheartedly with your dilemma.     I really haven't been able to give myself an answer to this, and have ended up handing it over to God and just doing/saying whatever seems to alleviate the suffering of my uBPDdd now. We've actually battled to get some court Ordered contact with our grandchildren so we can try and mitigate the damage on them and it was worth it, though it obviously created conflict with dd at the time.  So sorry, it seems to go round in circles for me with this question. 

[crazedncrazymom]

I have been wondering the very same thing.  I believe my daughter is capable of plotting and carrying out a long-term malicious plan  regardless of what anyone says, thinks or the consequences to herself.  I don't believe the right/wrong of what she is doing even enters her mind.  She wants to achieve her goal and will go to extreme and cruel lengths to do so.  Once in awhile I can get through to her and get her to change her mind.  Generally it's only after her plan continually backfires and she's beginning to rethink it and needs an excuse to stop.

I know if I'm planning something mean to get back at someone I have a little voice in my head that says... .  hey crazymom... .  really?  You know it's not worth the effort and probably won't change the person's mind right?   You can't do that.  I think that little voice might be missing from my dd.

[sunshineplease]

Thanks for bringing this up, pessim-optimist. I believed for years (before learning about BPD) that my ud17's issues were existential/spiritual. I still believe it to some degree, but I also believe it's her brain that makes it so hard for her to tap into the spiritual/accountability side of herself. To riff on crazedcrazymom's example, I think my daughter does have that voice in her head ("don't do this mean thing", but she has another, louder voice in her head saying, "it doesn't matter what you do because you suck and deserve to suffer." Then she goes ahead and does the "bad" thing, and she beats herself up for it ("See? I'm terrible. I can't ever do anything right."

It's interesting to read about what seems to work for some BPD patients: DBT and CBT skills, validation, and clear boundaries. Though these strategies have psychological-sounding names, they strike me as a form of re-parenting. The skills and validation help pwBPD form new neural pathways, and the boundaries help loved ones find a way to stay present without burning out. In other words, something went wrong the first time around, and the brain needs more structured and formalized support so the pwBPD can learn to function more normally.

If a large part of what it means to be human is based in our ability to connect with others, empathize, and sense something greater than ourselves ("God" and our brains are broken so we can't do those things, it would seem to be both a medical and spiritual problem. But since the "cure" (distinct from symptom management) seems to be more relational than medical/surgical, I do think the spiritual component matters.

[cbcrna1]

I have wrestled with these same questions in relation to my dd36.  I have come to see that her horror/terror of abandonment is so real to her that it is a self protection for her to do the behaviors she does.  In her mind she sees many many things as abandonment.  If I, her mother, move, get well, have friends,  anything that does not involve her; it is abandonment to her.  She will do anything to try to make it better for herself.  I have to have boundaries for my own self protection. She will systematically break down my life, feel entirely justified, and then blame me for it.   Can she be accountable for her behavior;  I haven't seen it yet.  I think all healing begins with finding serenity where you are and then allowing God to heal your spiritual relationship with him, yourself, others and the world.  She is not evil although I do know it could look that way.  She needs to make peace with the distortions of BPD and then find the rest.  Thank God in one way she is high functioning; (I do not have to live with her) she does not physically self mutilate, but self mutilates the relationships of those closest to her who love her the most.  God bless my daughter I love her so much, but until she gets some kind of revelation or therapy or help, I can't love her in anyway she believes.

[jellibeans]

One thing I would like to add is that my family is not very religious... .  we go to church on Christmas but we really don't talk about god or anything close to religion. My dd15 has always talked about God... .  since she was a young child... .  always asking me questions like " is God in the car with us now" I find it so strange that she has this deep faith or it would appear... .  she is now in a Christian based school... .  I was hoping it would fill a void in herself that she feels. She is very interested in religion but maybe it is because of all the guilt she has to carry with her.

I don't know why she does what she does... .  why she lies so much... .  is it because she just has no sense of self? She seems like this empty person walking around looking for an identity. Her self esteem is low but she is a very pretty girl. She mimics all around her... .  

Tis is an interesting topic for sure... .  thanks for posting

[twojaybirds]

Great question and wonderful reflective responses. 

I just learned that my dd18 went to MoneyMarket and borrowed $500.00   Not to sure of how she did this with no job.  But anyways if she is unable to pay them back with their horrid interest you know they will hold her responsible to the letter of the law.

I have asked her about money and if she needs clothes and how she pays for her cell phone etc and what she needs.  Her responses are vague, distant and subject-changing.  Her b'day is next month and all she wants is a camera.

So yes she is responsible for making deliberate choices by borrowing money and yes will  held responsible by them

So yes she is responsible by not coming forth to me if she is in need or listening to options

So no she cannot make rational choices not even the one to get help

So as Shakespeare would say:

To sleep: perchance to dream: aye, there's the rub; For in that sleep of death what dreams may come,

[sunshineplease]

jellibeans, my ud17 just told me she lies because of the sense of control it gives her, especially over what people think of her. She seems so powerless in any meaningful sense that any control at all (even that based on manipulation) seems like agency to her.

[MammaMia]

My belief is based on what I have read and NAMI teachings:  people with BPD have neurological defects in their brains.  Their circuitry is broken.  They do not think like we do and never will.  It is not something they can control, although it can be improved by behavior modification.  Their low self-esteem, anger, and bizarre thoughts are based on distorted perceptions caused by their brain disorder.  

I believe they often "think out loud"... .  saying things they have no real intention of doing.  They are not evil people.  They are broken people.  When they rage, it is difficult to determine what is a real threat and what are just random thoughts that are verbalized before giving any consideration to what they are saying or the consequences.  

We have to sort through what is real and what is not.  Their ever-changing mood swings make this very complicated.  Are some of them mean and vindictive on purpose?    Probably... .  everyone is different, but over-all, we are dealing with a very frustrating mental illness.  

As caregivers, we need to sort through the craziness and try to understand how THEY think and react because they cannot grasp where we are coming from.  :)o they have personal responsibility?  I think they interpret responsibility within the guidelines allowed by brain dysfunction.  So my answer is yes and no.  Most of the time, they frankly just do not care about personal responsibility since everything is someone else's fault.  They are perpetual victims.

Are they manipulative?   Oh yes... .  

[pessim-optimist]

Ok, so a follow-up question:

So, they SEE themselves as victims and feelings create acts, their reality is just so different from ours.

What do we do? Just accept that theirs is THE only reality that matters in the relationship?

Do they deserve to "get away with murder" because of their illness?

Does that mean that their reality is more important than ours in spite of the fact that theirs is the one that is warped?

Would that not be validating the invalid? (recognizing as truth something that clearly isn't?)

I know, I am mixing up the moral issue and the issue of what works in treatment, however, can we really separate the two?

How?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Patty53]

my BPD daughter told us if she gets evicted from her apartment she plans to break her ankle to force us to take care of her.  She was already in a forced mental health lockup up.  My husband told her she would just land up back in the forced lockup, which she hated.  When I feel at risk I know refuse to talk or see her.  I hang up the phone when she calls screaming.  I hang up quickly.  It has slowed down her calling.  Yes it is a disease/disorder.  But we, my husband and I, have failed at consequences.  We have different opinions on it.  I think my daughter needs to suffer the consequences of her actions by us not helping her when in a mess.  Yes they calculate out of fear. 

[cfh]

I always hear that pwBPD are not manipulative... .  that they are not capable of being manipulative.

Yet when we sent our ds to the Menninger Clinic in Houston for a month long assessment and evaluation (they are a top rated psychiatric hospital with a specialty in BPD) their final report said at least 8 times how highly manipulative our ds was.  Menninger's is like McLean in Boston of the south.  They are supposed to be experts in this area.

So are pwBPD manipulative or not?

[mamachelle]

My T is also the mother of a BPD son.

She said to me the other day,

"Mamachelle these PD people are missing the "heart" connection."   

She said

"Some days my son is on top of the world and seems so  loving and caring. Other days, I think he would sell me for $5."

bPd folk can become psychotic.

Some are closer to sociopaths at times.

They can be some of the most violent people I've come across. Leaving my exBPDH was terrifying.

My NonH jokes he still would never walk in front of the car if his ExBPDW is driving.


It is a spectrum in terms of function. Also in terms of their ability to take responsibility. I believe if they do something there should be a consequence or punishment.

My exH has BPd

My NonH ex wife has BPD

I am raising a stepson 10 who is dx emerging bipolar but who I believe could also be dx emerging BPD

With all 3 of these people, when confronted with their moral faults or bad behavior I can expect:

A) denial

B) remorse, extreme at times

C) guilt and more guilt and shame

D) blame of others

E) blaming of me

It's very hard, but BT techniques, radical acceptance, all this stuff does help, even if it doesn't answer the original question.

Interesting responses all. Just throwing in my .02

[inkling16]

The way I think about it is this: my dd (17) is a much younger person emotionally than she is in any other way. That means that when that younger person is in control (which she is, way too often) I can't hold her accountable like an adult, but I can hold her accountable like a child. We have expectations for the behavior even of two-year-olds, though we are very forgiving and patient and we understand that we are going to have to go through the same scenario a lot of times before they get what they can and can't do.  I let a lot of little stuff go and pick my battles carefully. No question it's complicated, and it's a work in progress.

As far as the brain being miswired, I believe that is true, but I also believe that the brain is highly changeable and can be rewired to a great extent with appropriate therapy. I have some evidence of this because I have two close friends who had BPD diagnoses when they were younger and with therapy they're both leading respectable and fulfilling lives and are delightful people. I had no idea either of them had had this problem until I mentioned our daughter's diagnosis.

The trick is to get the two-year-old to go to therapy.

Part of my daughter's ordeal with this is that intellectually she's probably five to ten years ahead of her chronological age, even while ten or fifteen years behind emotionally. So she herself spends a lot of time frustrated with the child inside. I think of her as being trapped in the passenger seat of a car with a child at the wheel, who has no idea how to drive but won't relinquish the driver's seat to someone who does. Imagine how scary that would be. Fortunately for us, so far the adult part of her seems OK with therapy and the child has only succeeded in making her skip it a couple of times. She seems to be able to act more mature than she was able to do a year ago, and to see what she has to do even if she often can't do it.

[garthaz]

I think that the term "Broken" is an exact fit. A broken bike is not evil, although it may do evil things. If you ride a broken bike, it can hurt you.

The difference is that the BPD cannot be fixed. When we ride the broken bike, we have to be aware of the limits. We have to ride slower, put up with a bumpy ride due to the bent rim or walk the bike due to broken pedals or chain, etc. If we try to ride it like a real bike, we will get hurt and might hurt the bike even more.

[HarmKrakow]

I mean, they are not clinically crazy, so they are responsible for their actions in some way.

They arent clinically crazy?

[pessim-optimist]

Well, as I have read about it, it is a mental illness, but "crazy" technically is supposed to mean not just mentally ill, but ill to the point that they are not able to tell reality and right from wrong, and are in a psychotic state which is a more severe form of mentally ill.

So that's what I mean. Of course they are crazy as we would call it, but not clinically crazy.

At least that is what dr. Padget tells Rachel, when she asks him about her BPD. BTW, that dr. Padget seems like an awesome P.

Anybody found out his real name? (Just kidding, but would help to have more of those around, and more Rachel-like characteristics in our children... .  dreaming out loud here... .  )

[HarmKrakow]

Well, as I have read about it, it is a mental illness, but "crazy" technically is supposed to mean not just mentally ill, but ill to the point that they are not able to tell reality and right from wrong, and are in a psychotic state which is a more severe form of mentally ill.

So that's what I mean. Of course they are crazy as we would call it, but not clinically crazy.

At least that is what dr. Padget tells Rachel, when she asks him about her BPD. BTW, that dr. Padget seems like an awesome P.

Anybody found out his real name? (Just kidding, but would help to have more of those around, and more Rachel-like characteristics in our children... .  dreaming out loud here... .  )

I think someone with BPD does not know the difference between right or wrong ... reality or a fake life ...

[pessim-optimist]

yep, true, they can even become psychotic at times, but it isn't their general state of mind when they are emotionally regulated at the moment

[pessim-optimist]

Thank you all for the opinions, I'm trying to take it all in. I appreciate the comments.

Also, thank you inkling16, for the reminder of the child, (duh, right? we read about it all the time) it takes a while to keep that on the front burner.

It helps to keep that picture in mind and set reasonable expectations and appropriate reactions (I see that now, I have married into this situation and don't have children of my own but have spent time with step-d's children, and know how important it is to not get upset, remain in control of myself, impose loving but firm consequences, while nurturing that little guy or girl - how similar that is to the BP world!)

It's just hard, because they have so much more opportunity, and we cannot control their environment and therefore we cannot protect them from themselves... .  

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[cfh]

My ds knows right from wrong in very simplistic terms ie "thou shalt not kill".

But the world he lives in and his reality is so far off the mark that the lines get really blurry.

One of the RTC's he was in kicked him out because he "branded" a girl with a hot paperclip.  To this day, in his mind he did the right thing.

He said that she told him she was preparing to kill herself that night. He thought he had an idea to steer her away from that kind of thinking.  

So he told her that he would brand her and it would hurt, but that would help her realize that she wanted to feel pain but didn't want to die.

That way of thinking makes no sense to any of us right?  But to my ds it made perfect sense and even now he believes he saved her life.

I don't think he was psychotic at the time it was just his twisted way of thinking. I call it twisted but he thinks he did a really loving thing.

This was four years ago and he has had so much therapy since then and been in many other programs but his mind still thinks the same way and he would do it again because he believes it was the right thing to do.

How do I or any T help him with this?

His life is a series of mistakes and poor judgement yet he never learns anything from it even when the consequences are dire.

[pessim-optimist]

hi cfh,

I can see how your son may have thought that... .  even though I might disagree with his method of trying to save her life.

This would not fall into my labeling a BP's action evil. Because his motive was good and selfless.

But what about the ones where they know it's wrong and they do it for the wrong motive to get their way at the expense of someone else and they KNOW it but choose to do it anyway, because, well... .  ? They just want something at any price?

[cfh]

pesim

When my son falls into the pit of wanting something at any price... .  it's when he wants drugs.  At that point all hope is gone.

He's a drug addict and when you mix that in with BPD it's a mess.

[MammaMia]

Yes, our BPDs have the emotional capacity of a child.  

My situation maybe somewhat unique.  I am the only person my ds will talk to:  the only person he is open with when it comes to his BPD and how it affects his life... .  the only person he trusts to ask for advice.  For that reason it is EXTREMELY important to me to keep the lines of communication functioning, even if it means relating to him from his perspective.  

That does not mean that BPDs should be allowed to do and say things that are cruel and irresponsible.  Like a child, they need to be reminded that others have feelings too.  Stay calm.   Say something like... "You know, it really hurts my feelings when you say that" and then drop the subject ... .  or  "You are right, I am not a perfect person, but I love you, and I am trying to do the best I can.  What can I do better---explain it to me."  Keep it very low key.  Try not to justify to much.  It is absolutely futile to get angry, argue, or yell.  It does not work.  

Yes, everything IS all about them.  It must be difficult with multiple children.  We need to be careful to not to exclude them from our time.

   

[Kate4queen]

I've just come to the conclusion that my son's reality is not my reality and that in his mind he is fighting some horrendous war that I can't understand or relate to and that within his mind we are responsible for everything that is wrong in his life, we are toxic and we simply want to control him.

That's his reality and that's what motivates everything he does because he has to fit our behavior into what suits him and protects what he has to believe in order to protect his fragile self.

He's willing to lie, cheat, manipulate and threaten just to protect his world view and to stop us 'controlling him'.

I'm not willing to drown alongside him anymore so even though I accept the above, I still believe I have a right to my own beliefs and own life where I'm not the criminal. Once I realized that I was just enabling him from my own fear, I stepped back and let him accept the responsibility for his choices. Not easy, but vital.

[MammaMia]

kate4queen

When my ds starts the Blame Game, it hurts.  It makes me feel like a total failure, and then it makes me mad.  We have all been there and we all have a breaking point.  It is like a broken record being played over and over until I could scream.  We did sit down one day and had a conversation about all his perceived issues growing up for which he blames me.  It was an opportunity for me to share with him for the first time what I have gone through over the years.  I was shocked when he actually listened.  It has reduced the Blame Game outbursts a lot.  I do not live with my ds.  It would never work.  I have the luxury of tuning it out and walking away, which I do.

I am sorry you are struggling... .  and yes, you absolutely have the right to a life of your own.  We cannot let their illness totally consume us.  We need to strike a balance to save our own sanity. 

We have been discussing whether or not pwBPD are consciously mean and/or evil and whether they have any sense of personal responsibility about anything.  The jury is still out.  We know about the warped reality and bizarre thought processes which are part of the disease... .  but wonder if they have ANY control over what they do and say? 

What do you think?

[qcarolr]

I can see that my DD26 does have the ability to manage herself as long as the stress level is low. This has certainly not always been the case - things have been better past couple years. Some is her growing up and getting tired of living homeless - we had evicted her out of sheer exhaustion and not knowing what else to do at theat time. Since then I have found this site and learned so much about how to manage MYSELF better - as I do better, she has done better. Validation, getting to know what my values are and putting self-protective boundaries in place (ie. giving up ALL my expectations that I have any power to change her behavior). It has been a slow process with many many bumps - things are good enough that she has been living in our home for 20 months.

When DD moves into her hopeless pit, then she either retreats away from us - to her room or away from home with her homeless friends -- or she begins to lash out and we ask her to take that time out -- in her room, the garage, or away from home. She knows if it reaches a point of our fear for our safety we will again call the police - and this time she is on probation and would go to jail.

kate4queen

When my ds starts the Blame Game, it hurts.  It makes me feel like a total failure, and then it makes me mad.  We have all been there and we all have a breaking point.  It is like a broken record being played over and over until I could scream.  We did sit down one day and had a conversation about all his perceived issues growing up for which he blames me.  It was an opportunity for me to share with him for the first time what I have gone through over the years.  I was shocked when he actually listened.  It has reduced the Blame Game outbursts a lot.  I do not live with my ds.  It would never work.  I have the luxury of tuning it out and walking away, which I do.

This really is so important - to keep our connection with our troubled kids in some way. And even more important than that is to first find ways to validate ourselves - to know that we are good people and have done the best possible parenting job in an extremely difficult situation. Then to learn to beleive this so we can go back to this good place when the gloomy times descend on us. date4queen - thanks for sharing this piece of your story. We need to hear of these moments of success.

qcr  

[MammaMia]

qcarolr -

You sound like you have found a way to deal with your dd.  It can be done.  It is never perfect and we all know the ups and downs of BPD.  There is no permanent solution.

I agree with you 100% about stress being a trigger.  Trying to keep things calm and the lines of communication open is

not easy.  When you look at the big picture, it is obvious pwBPD rarely if ever initiate either.  If we don't do it, who will?  Still, it is so very important to protect ourselves and other loved ones any way we can, and we DO have input into that process.  I believe our conversation about past grievances gave my BPD son AND me insight into what the other was dealing with.

Thank you.

[Kate4queen]

MammaMia, I've had those conversations with my son many times, remember I was the good parent' for many years At some level he does understand that what he's done has had terrible consequences for his siblings and for us and for himself, but to get to that realization takes a blow up of major proportions. We finally see how he really feels inside and it makes me so sad, but those rare moments of self-realization are followed very quickly by a patching up exercise and an attempt to either deny anything happened or simply move on. I don't think he can bear to be exposed like that for long. It's too much for him to cope with. In the past I would do anything to make that better for him, but recently I realized that I can't because even in those seconds of remorse and clarity he is frantically trying to shut that gap. it's sad but I think at the time of the rage he is prepared to say or do anything to protect himself, so I don't think he's evil just incapable of dealing with such pain.