Help to use DEARMAN to try and communicate what I want to change...

[sweetheart]

Hi all,

I think DEARMAN is the tool of choice for my dilemma and would like some clear examples of how you all might go about using it for my particular issue.

The background is my dBPDh is prescribed a whole heap of psychotropic medications that really do keep him on a more even-keel. One medication in particular is an antipsychotic he has been on for all the time we have been together. My first experience with him not taking it was 5 years ago when he made a conscious decision to reduce himself to a lower dose. He chose not to discuss this with his P. Over the next 8-10 weeks he became increasingly more paranoid, he was more irritable quickly increasing to angry outbursts. He was agitated and would obsessively ruminate about the end of the world. All the symptoms of BPD were much more readily under the surface. His P eventually suspected something was wrong when he a had a major dysregulation. He agreed to increase dose back, couple of weeks all back to reasonably ok.

Fast forward four years he stopped taking it for four months earlier this year, chaos ensued and he was hospitalised in July. Has been taking all his meds regularly until I suspect perhaps the last 4 weeks. His presentation has again been one of increasing paranoia, irritability feelings of persecution, being controlled and abused. Lots of passive-aggressive behaviour with frequent episodes of blaming and projection.

Today I was doing some before Christmas cleaning and I found loads of his antipsychotic meds all stuffed in a box on top of a kitchen cupboard. We don't have spare meds in the house he is prescribed exactly what he needs and whilst he was in hospital I cleared the house of any and all surplus boxes of tablets.

So I now know he is not taking his medication properly. For me my h taking his meds as prescribed and taking responsibility for good mental health is the same as him being in therapy, this keeps him well and ensures our family life is as stable as possible.

I want to talk to him about what is happening and I want to let him know that it is important for our marriage that he takes responsibility for taking this medication because this keeps him mentally well. I just don't know how to say it to him.

1. I want to say I know he's not taking his medication as required.

2. It's important for his mental health that he takes the right amount.

3. He is vastly more stable when he takes the right dose.

4. This has happened before and has led to him becoming v unwell.

5. He can choose to not take this medication but I see this as a boundary issue for me in that I won't stay with him.

I haven't said anything at all as of yet. Any advice, help would be much appreciated. He does know that for us to be a family together he has to stick to his psychiatric program and not return to OTC codeine use. These are deal breakers for me along with infidelity. I am not afraid to ask him to leave if the situation remains the same. We have a s6 and any ongoing instability will upset him, although my h has no direct responsibility for our sons care anymore, having a parent who is withdrawn and paranoid is not healthy.

It's frustrating because when he is compliant with his medication our lives have been ok and liveable. He is more available as a husband and father so I know it is possible.

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[Rapt Reader]

I'm so sorry, sweetheart, that your Husband is slacking on taking his meds. My adult (37) son, who was diagnosed with BPD in April 2013, is on lots of meds himself, and when he "forgets" and is off for more than a week or so, you can really see a difference in him. As of now, he's been very good with them, but he seems to be in remission of his BPD because of his many Therapies and Treatments, and he is more cognizant of his need to take his meds regularly.

I do remember several years (prior to his diagnosis, these Therapies and his remission) of him not taking his meds regularly, and I also tried to figure out how to get him to do it. In fact, for a bit of time after his BPD diagnosis and my finding this site and learning about S.E.T. and validation, he went through a spell where he thought he was "cured" and didn't need his meds. I knew not to harangue him about it (as you do, too   ), but really struggled with trying to figure out how to help him get to the place where he would agree that he should start taking them again.

I admit that I've never really mastered DEARMAN (I've been lucky; learning S.E.T. and validation has done the trick for me with both my son and Husband, and other loved ones). But what I did was just casually mention to my son that I noticed that his weekly pill container was filled up, and I was wondering if he thought that might be contributing to what I thought appeared to be his persistent depression? I made sure that I wasn't being accusatory, but concerned, loving and curious. I made sure my face wasn't angry or frustrated, but sympathetic and caring. A good trick, since I had been fuming for weeks about this   , but once I figured out the angle I would take to approach him about it, I was able to calm down.

It turned out that we ended up having a great conversation about how he was feeling, the depression he couldn't shake, and thoughts that he'd had that the other Therapies he was undergoing (Out-Patient, Psychiatric, Neurofeedback Therapy) would be able to keep him emotionally stable. I just let him talk, validating everything he told me, and he actually came to conclusion on his own that he should start the meds up again, which he did. That very day!

It seemed like as long as it was his idea to do it, he would do it... .I just led him to that decision by chatting non-judgmentally with him about how he was feeling, not telling him he had to make that decision. In fact, I made sure to let him know that I was just wondering if there was a correlation between his depression and anxiety, and the fact that the meds were sitting in his pill container (he'd missed weeks of them, at that time). I know your situation is different than mine, but this is how I handled it... .

[sweetheart]

Thank you so much Rapt Reader for your response. I wasn't even looking for my post because I thought DEARMAN in the title would scare everyone off so I gave up on any replies. I was going to reword it.

My h is noticeably better when he takes his medication regularly, I knew he was off it just by his general demeanour. He can cope with the vagaries of the world so much better with it and we function better as a family as well rather than me and s6 and then h isolative and suspicious.

I have been writing a little script against the DEARMAN letters and practising it in the car  - this is an area it is very easy for h to feel invalidated, so I'm going to take my time with this.

He hates his diagnosis he feels 'defective' and the medication makes it hard for him to think and it blocks creativity, so I can really understand why, but further down the line without it he will end up back in hospital. I would like to try and avoid this if possible.

Thanks again.

[Rapt Reader]

I have been writing a little script against the DEARMAN letters and practising it in the car   - this is an area it is very easy for h to feel invalidated, so I'm going to take my time with this.

That sounds like a very good idea. You could even post some of it/all of it on this thread for some group feedback if you felt you needed it  

He hates his diagnosis he feels 'defective' and the medication makes it hard for him to think and it blocks creativity, so I can really understand why, but further down the line without it he will end up back in hospital. I would like to try and avoid this if possible.

Thanks again.

Yeah... .That sounds exactly like my own son's complaints about his old meds, in the past. He's an artist, and had been abusing drugs for so long--and living with undiagnosed ADD, Depression, Anxiety & BPD for so long--that he thought the meds were changing who he was, and it would take away his talents if he stopped the opiates or "lost" who he was, disorders and all  

What helped him so much is that after his BPD diagnosis and all his Treatments, Therapies and new/adjusted meds, he is now much more artistically productive than ever before! He is working on a graphic novel, and animating it as he goes along, and is thrilled to learn that the talents that made him a phenom of sorts when he was very young (from age 2 to teen years, prior to his BPD kicking in and his drug abuse starting), are part of him, and not drug- or disorder-induced  

It's truly been wonderful to watch him gain and capitalize on this discovery... .

[sweetheart]

Rapt Reader that's so great about your son, I have read your posts with interests over the last year as there are some similarities with my h. He has a diagnosis of Paranoid Schizophrenia as well and his teenage years are littered with drug abuse and some serious violence, he was a very unwell young man. He nearly returned to that past through a relapse of his illness last summer and seriously messed up with OTC codeine which created more problems than he thought it would solve. With lots of continuity of boundaries from me and validation of how bad he was feeling( it took me soo long to take responsibility for my part in his deterioration) he was hospitalised just when it really mattered. If it hadn't been for this forum our marriage would not have survived my believing I knew best because I wasn't ill - I didn't even realise I was invalidating and undermining him.

I will post my script if I am brave enough I notice people do it all the time. I am quite closed as a person and I find I struggle to express myself in writing but I might just try. 

[Rapt Reader]

If it hadn't been for this forum our marriage would not have survived my believing I knew best because I wasn't ill - I didn't even realise I was invalidating and undermining him.

That's the most amazing thing that I've learned by participating on this site; I'm humbled to realize how much I'd contributed to the dysfunction in my relationships with the BPD/BPD traits loved ones in my life. And I'm shocked at how much better those relationships all are now, after I've changed my attitude and communication tactics. I regret my "old days" of unintended escalation of my loved ones' dysregulations due to either love, confusion, or my natural inclination to "be understood" by using J.A.D.E. 

I will post my script if I am brave enough I notice people do it all the time. I am quite closed as a person and I find I struggle to express myself in writing but I might just try. 

I promise to give you time to get to that place where you will be comfortable with doing that, sweetheart