Question about partners with constant medical issues

[Family Court Strategies: When Your Partner Has BPD OR NPD Traits.]

So I've become convinced my SO isn't BPD, but instead is chronically depressed in a major way.  This came about after a T session and T said a few things that resonated with me regarding the link between clinical depression, irritability, angry outbursts, etc.  I did a bit more research on my own, and viola.  SO has never really fit the BPD pattern (unlike my uPDxw and uBPDxgf), so yeah for missing BPD this time at least.  However, I found a website that really described it well, and after discussing with T at next session, I'm convinced SO has a textbook case of clinical depression, and might even be sliding in and out of Bipolar II. 

Took me 3 years to figure this out.  Now I'm kicking myself because, duh, it's pretty obvious.  How thick have I got to be for taking this long?  Anyway... .

SO has a history of injuries going back to childhood.  Car accidents, getting hit in the head with bottle while in marching band at a football game, and a bunch of beatdowns from her XH.  I've seen some of the medical reports and paperwork, but it's not complete.  There's no documentation as to the on-going severity of her on-going issues that encompass back, neck, hand, and foot/ankle issues.  At the same time, I've seen all kinds of situations where it felt like  she was trying to manipulate me via the sympathy route for how bad off she is.

She's making statements like things are just going to get worse, will never get better, I shouldn't expect improvement because she doesn't, etc.  And this is all in response to me saying something along the lines of "it will get figured out and treated, it will get better".  Part of me thinks she is sinking into victimhood mode, and she's at times not exactly pleasant towards me because I'm not bowing down at the alter of her victimhood, but at instead pushing a more positive "you'll get through this and get better" optimism.  I can't tell if she's getting angry because she feels I'm invalidating her concerns or because she's not able to manipulate me.

How has everyone else handled this?  Myself, I'm trying to be compassionate but also not do anything for her that she can do herself.  Also still making sure I take care of me, spend plenty of time with my son, friends, etc.  I'm not letting this issue interfere with my own happiness.

She has no insurance.  She has her 4 kids covered on medicaid, but they won't cover her.  She also has no money to get insurance for herself, and she really won't go to regular doctors much anyway as she favors alternative medicine approaches.  So there's a convenient roadblock money wise for getting a full workup. 

I also don't think she's completely forthcoming with me about it all.  I get to see bits and pieces and hear about more, but I'm losing my faith that she's not purposely giving me half-truths and exaggerating symptoms.  At the same time, I don't want to say to her something like "you need to get a work up and prove it all to me!"  I don't see consistency in her symptoms.  In fact the only consistency I do see are when she doesn't want to do something, the symptoms get worse!

So my question comes down to this - what are options for uninsured to get the medical work ups they need when they can't pay out of pocket?  I can't make her do it, but I'm interested in finding out on my own for some subtle coaching.  The constant nebulous health complaints with no attempt at real solution are wearing on me.  I'm trying to tease out whether she's being genuine, or she's trying to manipulate me with sympathy and exaggerating things.  I'd like to be prepared that the next time the subject comes up, I'd like to potentially be able to say something informed.

[Waddams]

So I've become convinced my SO isn't BPD, but instead is chronically depressed in a major way.  This came about after a T session and T said a few things that resonated with me regarding the link between clinical depression, irritability, angry outbursts, etc.  I did a bit more research on my own, and viola.  SO has never really fit the BPD pattern (unlike my uPDxw and uBPDxgf), so yeah for missing BPD this time at least.  However, I found a website that really described it well, and after discussing with T at next session, I'm convinced SO has a textbook case of clinical depression, and might even be sliding in and out of Bipolar II. 

Took me 3 years to figure this out.  Now I'm kicking myself because, duh, it's pretty obvious.  How thick have I got to be for taking this long?  Anyway... .

SO has a history of injuries going back to childhood.  Car accidents, getting hit in the head with bottle while in marching band at a football game, and a bunch of beatdowns from her XH.  I've seen some of the medical reports and paperwork, but it's not complete.  There's no documentation as to the on-going severity of her on-going issues that encompass back, neck, hand, and foot/ankle issues.  At the same time, I've seen all kinds of situations where it felt like  she was trying to manipulate me via the sympathy route for how bad off she is.

She's making statements like things are just going to get worse, will never get better, I shouldn't expect improvement because she doesn't, etc.  And this is all in response to me saying something along the lines of "it will get figured out and treated, it will get better".  Part of me thinks she is sinking into victimhood mode, and she's at times not exactly pleasant towards me because I'm not bowing down at the alter of her victimhood, but at instead pushing a more positive "you'll get through this and get better" optimism.  I can't tell if she's getting angry because she feels I'm invalidating her concerns or because she's not able to manipulate me.

How has everyone else handled this?  Myself, I'm trying to be compassionate but also not do anything for her that she can do herself.  Also still making sure I take care of me, spend plenty of time with my son, friends, etc.  I'm not letting this issue interfere with my own happiness.

She has no insurance.  She has her 4 kids covered on medicaid, but they won't cover her.  She also has no money to get insurance for herself, and she really won't go to regular doctors much anyway as she favors alternative medicine approaches.  So there's a convenient roadblock money wise for getting a full workup. 

I also don't think she's completely forthcoming with me about it all.  I get to see bits and pieces and hear about more, but I'm losing my faith that she's not purposely giving me half-truths and exaggerating symptoms.  At the same time, I don't want to say to her something like "you need to get a work up and prove it all to me!"  I don't see consistency in her symptoms.  In fact the only consistency I do see are when she doesn't want to do something, the symptoms get worse!

So my question comes down to this - what are options for uninsured to get the medical work ups they need when they can't pay out of pocket?  I can't make her do it, but I'm interested in finding out on my own for some subtle coaching.  The constant nebulous health complaints with no attempt at real solution are wearing on me.  I'm trying to tease out whether she's being genuine, or she's trying to manipulate me with sympathy and exaggerating things.  I'd like to be prepared that the next time the subject comes up, I'd like to potentially be able to say something informed.

[Mutt]

I don't see consistency in her symptoms.  In fact the only consistency I do see are when she doesn't want to do something, the symptoms get worse!

I'm sorry I can't help you with insurance information. I'm Canadian. That being said, does this not sound waifish?

[Waddams]

I'm sorry I can't help you with insurance information. I'm Canadian. That being said, does this not sound waifish?

Very much so. I'm actually quite tired of observing the self-defeating behavior and attitudes followed up by the complaining about the results of it later.

[Mutt]

I'm sorry I can't help you with insurance information. I'm Canadian. That being said, does this not sound waifish?

Very much so. I'm actually quite tired of observing the self-defeating behavior and attitudes followed up by the complaining about the results of it later.

I'm sorry it's hard to watch. A criteria for BPD is lack of impulse control, learning from past behaviors and the consequences of ones actions?

That being said. What my wife thought me is that people have personality quirks. What I learned is to depersonalize the behaviors. This, I learned to apply in everyday life.

For example, negativity and complainers in the work place irked me. I see this as a part of someone's personality and I depersonalize this quirk. It's not personal to me? It's less stressful, communication is easier.

[Waddams]

That being said. What my wife thought me is that people have personality quirks. What I learned is to depersonalize the behaviors. This, I learned to apply in everyday life.

For example, negativity and complainers in the work place irked me. I see this as a part of someone's personality and I depersonalize this quirk. It's not personal to me? It's less stressful, communication is easier.

Oh absolutely.  I'd phrase it alternatively as not personalizing negative behaviors of others that don't really affect us or otherwise aren't our problem to worry about.

Where an issue comes up that I'm having trouble figuring out is how to not personalize a negative behavior when it is affecting me.  For example, SO's youngest daughter got a report card last week that showed she was failing two different core subjects.  SO went on one of her rather loud reactions, but beyond that there hasn't been any consequence.  The kid is still not doing work, staying up 'til 11 pm on school nights watching TV, missing the bus in the morning, the school hasn't even pulled her from her extracurriculars, etc.  SO has in the past made it clear I'm not part of disciplining her kids, so I just stay out of it.  If even the school won't enact a consequence, what good would it do for me to try to stick my neck out and say something?  Her oldest daughter has also had similar shenanigans, and it also includes no consequences enacted by the school - she's still in the chorus stuff, going to extracurricular singing things, etc. 

But the impact on me is here's this kid being allowed to run wild in the house I live in.  With all 4 of her kids, there's no discipline enforced.  They're all just doing whatever, no structure, etc.  It's complete chaos all the time.  I don't like the environment, and even my S10 is making comments to me in private about it.  There's no consistency.  Just SO occasionally blows her temper and rages and rants at the kids for not doing their chores or following rules, then back to the same thing.  She refuses to establish regular rules and consequences.  I've talked to her about it, and I get a long song and dance about how awful their biodad was.  What does that have to do with healthy structure for them now?  That question ends up with one of us on the couch for the night.

I guess the biggest thing I'm struggling with is depersonalizing the behaviors is also resulting in detaching in a bigger sense.  The lease on our house is up May 1st.  We really need a place with a bit more space, and we'd like a place with a better yard, so we've been looking around at what's out there, but I've also found myself browsing Zillow for smaller rentals for just me and my son.  The home environment is just not acceptable to me.  I don't want to live in a place where the kids are allowed to run everything, there's constant fighting and hostility between them all and their mother, and there's really no where to go to get away from it except to leave the house.  And since I solely pay for rent and house bills right now, I look at the situation and say "should I really have to put up with this crap in my own home?"

On the insurance front, I found out from a real estate broker my company partners with that a realtor's association (NAR) offers great insurance options to members.  SO has been trying to avoid joining NAR though.  Doesn't see the benefit.  Next time the subject comes up, I might drop it in there that NAR membership provides access to affordable insurance to her.

[Mutt]

SO has in the past made it clear I'm not part of disciplining her kids, so I just stay out of it

This may be something to revisit? She has a mental illness?

The kid is still not doing work, staying up 'til 11 pm on school nights watching TV, missing the bus in the morning, the school hasn't even pulled her from her extracurriculars, etc.

Her oldest daughter has also had similar shenanigans, and it also includes no consequences enacted by the school - she's still in the chorus stuff, going to extracurricular singing things, etc.

But the impact on me is here's this kid being allowed to run wild in the house I live in.  With all 4 of her kids, there's no discipline enforced.  They're all just doing whatever, no structure, etc.  It's complete chaos all the time.  I don't like the environment, and even my S10 is making comments to me in private about it.  There's no consistency.  Just SO occasionally blows her temper and rages and rants at the kids for not doing their chores or following rules, then back to the same thing. She refuses to establish regular rules and consequences.

Is this because she's asked you to stay out of disciplining and she disciplines the kids or lack thereof) and the result is they are struggling in school and the home is chaotic? It sounds like there may some work to do with boundaries. She deals with anxiety and stress differently and has undefined boundaries and this is the result of a chaotic home:

Just SO occasionally blows her temper and rages and rants

Lesser traits for BPD is undefined boundaries and the result is chaos and she's emotionally dysregulating.

I don't want to live in a place where the kids are allowed to run everything, there's constant fighting and hostility between them all and their mother, and there's really no where to go to get away from it except to leave the house.  And since I solely pay for rent and house bills right now, I look at the situation and say "should I really have to put up with this crap in my own home?"

Your S10 is telling you what the issue is:

my S10 is making comments to me in private about it.  There's no consistency. boundaries.

I think the root of this problem is boundaries and your SO lacks personal boundaries and understanding personal boundaries of others. If you stay in this home or move and you stay out of disciplining the issue moves with you. If you stay, you may want to step it up and put boundaries in place and find a way to discipline?

[Waddams]

This may be something to revisit? She has a mental illness?

Yeah, but I think it's just plain old severe depression as opposed to BPD.  It might swerve into Bipolar II territory.  I'm basing that on prior experience with BPD types (ex-wife and a prior ex-girlfriend) and discussions with my T.  I found this website which had a bunch of articles that really hit the nail on the head for this current situaiton (same as bpdfamily did for dealing with my ex-wife and the prior ex-girlfriend):

Link is to one of the articles but there are a bunch that are really good:  www.storiedmind.com/relationship/11-relationship-traps-of-depression/

There's other advice for how to deal with it on there, and between that and talking it out with T, there actually has been progress beginning to happen recently.  It's the forays into extreme reactions of Bipolar II that keep me coming back here to discuss and ask questions.

Your S10 is telling you what the issue is:

my S10 is making comments to me in private about it.  There's no consistency. boundaries.

I think the root of this problem is boundaries and your SO lacks personal boundaries and understanding personal boundaries of others. If you stay in this home or move and you stay out of disciplining the issue moves with you. If you stay, you may want to step it up and put boundaries in place and find a way to discipline?

Oh definitely she doesn't have a healthy understanding of personal boundaries or how to enforce them.  And yeah, if I stay, there has to be boundaries put in place and some home discipline established.  My next few months are going to spent at home trying to do just that.  But if she just plain refuses, I know where that leaves me.  My last rent check goes in April 1st.  After that I'm free to move if I decide I need to.

[Mutt]

This may be something to revisit? She has a mental illness?

Yeah, but I think it's just plain old severe depression as opposed to BPD.  It might swerve into Bipolar II territory.  I'm basing that on prior experience with BPD types (ex-wife and a prior ex-girlfriend) and discussions with my T.

Depression is short term mental illness. Has she gone to a MD for depression BiPD, BPD.

Is she being treated?

Oh definitely she doesn't have a healthy understanding of personal boundaries or how to enforce them.  And yeah, if I stay, there has to be boundaries put in place and some home discipline established.  My next few months are going to spent at home trying to do just that.  But if she just plain refuses, I know where that leaves me.  My last rent check goes in April 1st.  After that I'm free to move if I decide I need to.

I think Waddams you have a good handle on things.

[Waddams]

Depression is short term mental illness. Has she gone to a MD for depression BiPD, BPD.

Is she being treated?

No.  She has no insurance, and won't go explore any free counseling programs.  When I mentioned I was concerned she might be suffering from clinical depression recently, she did not take that comment well.  She has said she knows she needs counseling but won't act to go get it.  The excuse is she can't afford it, find time for it, etc.

My opinions about depression vs. BPD vs. BiP are based on extended discussions with my T (a Ph.D level clinical psychologist - the man is very very good) along with prior experiences and my own reading.  Now, I still might turn out to be wrong, and that's fine.  

I think Waddams you have a good handle on things.

Thanks.  

I actually made out a table of basic house rules and consequences.  I consider it a draft.  My thought is to tell SO that I think the house needs more structure and consistent boundaries with the kids, as an adult in the house, I feel I should be part of establishing and enforcing it, and I'd like to work with her to improve it.  If she responds well, maybe show her the draft.  If she doesn't respond well, then keep it in back pocket and not show it yet.  

[Mutt]

I actually made out a table of basic house rules and consequences.  I consider it a draft.  My thought is to tell SO that I think the house needs more structure and consistent boundaries with the kids, as an adult in the house, I feel I should be part of establishing and enforcing it, and I'd like to work with her to improve it.  If she responds well, maybe show her the draft.  If she doesn't respond well, then keep it in back pocket and not show it yet.  

I think the type of mental illness is secondary. She has a mental illness of some sort. The primary issue is she telegraphs "I don't have issues and I'm not going into therapy" and someone else can't make this choice for her that she needs to get into therapy.

Change comes from you. Change doesn't come from someone else.

She's unwanting - unwilling.

What you have on the table with house rules and consequences ( boundaries ) is sound. You can also put it in your back-pocket and there's an option of moving out April 1st with S10?

[Waddams]

I think the mental illness is secondary. She telegraphs "I don't have issues and I'm not going into therapy" and someone else can't make this choice for her that she needs to get into therapy.

What you have on the table with house rules and consequences ( boundaries ) is sound. You can also put it in your back-pocket and there's an option of moving out April 1st with S10?

I agree the mental illness is secondary for my decision making.  And yeah, the option of moving to live on my own is there sometime after April 1st.  Probably not on April 1st.  Her mental issues are her issues, not mine.  My issues are the living situation and conditions in my home, and that's what I need to take on.  I can express other concerns and tell her what I think, but it's not up to me to take on her issues for her.

[Grey Kitty]

If you and your son move out of the house with her and her kids, would that be a breakup, or a change of the shape of your relationship?

[Waddams]

If you and your son move out of the house with her and her kids, would that be a breakup, or a change of the shape of your relationship?

It would probably lead to complete breakup, but I don't know that for certain. 

[Grey Kitty]

You are obviously posting on undecided, so you probably don't know what you want there.

What changes you would need to feel that living with her and her kids is healthy for you and S10?

[Waddams]

What changes you would need to feel that living with her and her kids is healthy for you and S10?

In my mind, there are two tracks to this.  The first has more to do with me than her.  It's that in all my relationships, I've been guilty of not really living true to my own values, interests, desires, etc.  I compromise them to try to make women happy with me.  I need to change that myself.  I need to change my own behavior so I don't compromise my own beliefs, needs, and wants.  There are specifics that I won't get into immediately, as I could turn this post into a novel on the subject with the way I like to write and expound on things.  

The second track has to do with her reactions.  Can she agree to certain things that will change as I change?  She doesn't have to obviously, but if she doesn't it creates an inherent problem in the relationship foundation.  One has to do with marriage.  We're cohabitating.  I agreed to it as opposed to marriage originally because we were both in agreement we'd be married very quickly after she moved in.  It never happened, and she's found reason after reason to follow through.  It's in my values that I don't want to cohabitate long term anymore.  I want to be married if I'm going to live with a woman.  I need to stand up for that value.  If she won't marry, then in order to live that value, that means I have to live in a separate residence.

There are a myriad of issues regarding marriage though.  I've posted before about her kids not having birth certs, SSN's, etc.  She's working on getting them, and actually has a court date in a few days to get delayed birth certs ordered to be issued.  After that is done, she should be able to get the SSN's finalized and approved.  But not being married has allowed her to qualify for various forms of state aid as she's had major problems maintaining an income due to medical issues.  Without that aid, things would be much tougher.  When she gets the SSN's, she can then also turn around and qualify for all kinds of tax breaks, do amendments, etc. and get a big chunk of cash.  So there are materialistic benefits to not being legally married.

At the same time, she's played rather loose, and probably on the wrong side of tax laws and regulations. As in not filed taxes, etc.  She's getting letters from the IRS wanting her to explain why she's not filing.  Well, it's because she doesn't want to file w/out the kids claimed, otehrwise it looks like she has to pay, etc.  But she's still digging a hole with the IRS until she gets all this straightened out.  And not being married insulates me from all that.

So with all these issues, that she didn't reveal completely until we were cohabitating and citing as reasons why we couldn't get married, I feel like she should have revealed them because they are show stoppers.  And I wouldn't have cohabitated if I'd known about them.  These prevent me from being able to move forward in a relationship with her in a way that is consistent w/ my values.  I think I had a right to know exactly what I was getting into before I let her move in.  She knew it all, and didn't come clean.  She instead says she didn't lie, she just didn't tell me it all.  It's called exclusionary detailing and it's recognized as a form of lying by every reputable therapist, lawyer, and cop I've ever dealt with.  

There are also other values differences where if I move forward with living my values in certain ways, she gets angry and starts pulling the silent treatment/withdrawal of affection/disregarding/ignoring routine.  It's a control thing.  If I don't live according her wishes, she withdraws as a way to try to get me back in line.  To me, if I'm not hurting her or anyone else, and am otherwise being responsible in our life together, she's out of line with what she's doing.  And that behavior is recognizes as abusive by every source I've ever seen.  Why do I want to live with that kind of thing?  I don't.

There are other issues regarding the kid's discipline in the house, etc.  Currently she has no limits or boundaries on her kid's behavior.  She lets things get out of control with them, then gets mad, looses her mind and has these screaming rage incidents with them, but never really enacts consistent boundaries, consequences, etc.  The kids are allowed to run the show instead of the adults.  And she excludes me from doing anything discipline wise regarding her kids as well.  My thought is I'm an adult in the house, I pay for the place and bills solo, I should get a say.  I don't want to make it all up on my own, I've even gone as far as to create charts of suggested house rules, consequences, presented it to her in private with the intent of talking about how to get us both on the same page, asked her what she thinks, can we put this together, change things and agree on it, and then post it up for the kids, and got b*tched out because she isn't gonna be told what to do or controlled.  After the meltdowns she'll acknowledge she needs to change something, but then refuses to do it.  It's just a catch-22 that happens because, deep down, she just plain doesn't want to do the work to rein in her kids behavior because it's hard work.  She just plain doesn't want to face it.

And again, I've got a big values conflict with all this because I believe kids need some strict rules to live by, and consistent consequences to keep them in line.  I believe the adults are in charge, not the kids.  I believe the kids will grow up without the ability to discipline themselves and will end up having a lot of problems they way things are going.  I can't live my values regarding raising kids with her because she's just not open to even listen to my concerns, much less trying to get on the same page.  

Everything turns into some kind of control issue.  If I ask for something, it's an instant "I won't be controlled" reaction.  I won't try to control her, but I do have a right to ask for things.  There's no working anything out unless she can open herself up to at least be willing to listen first.

Honestly, I don't think she's got much affection or caring towards me anymore in her.  I don't know exactly how it changed, but it has.  I don't think I even begin to wiggle her love meter anymore.  It seems to me that between all the issues with the kids documentation, her medical issues, her struggles to find some kind of career option that will work for her and not aggravate her medical issues, the chaos with the kids, and her own attitude to basically cut me out or she feels like she's being controlled that she's become so self focused and has developed a massive case of narcissism.  There isn't much in her mind and feelings anymore except for herself.  

We've got multiple friends that have all independently approached me and asked where the big change and escalating selfishness in her has come from because she wasn't like that in the past.  I think she's gotten herself into a significant depression.  I'm at a loss of what to do besides get myself and my S10 out if she can't get herself out of this mindset.

[OnceConfused]

waddam:

I think you have answered most of your issues (aside from hers), by the one key statement that "you need to establish your key values, moral compass".

without these, you will not know your boundaries, what are wrongs and what are rights.

Ask those questions of introspection to yourself, and define what they are and what you need to do to defend them.

My philosophy of life now is quite simple - Lead a simple life, stay on the path and let NO ONE pull you off that path. I don't attempt to change others and but I also don't let others change me and make me into a door mat.  Circumstances do not make you, they only reveal who you really are. So you must clearly define who you are . That is how you find peace and stability in your life.

About your SO's kids living in your world (where you pay for rent/mortgage) then they have to conform to your rules. But if your SO defies your rules then I don't see how you will be happy in this relationship. Your SO can bring up her kids the way she wants bec that is her rights but once they are living in your castle they have to abide by some of your rules (I don't mean all of them but the most important ones to YOU).

[Grey Kitty]

Go for broke!

Live according to your values! OK, hold off on the marriage one--you sure don't sound ready to marry her today, so just drop that one.

Give yourself an April 1st deadline: You will be living in accordance with YOUR values in this shared residence with her by April 1st, or you will move out and live in your own residence with S10 according to your values.

I wouldn't recommend announcing the deadline to her, although talking to her about living in accordance with your values sure is worth doing.

Please note: Your values probably don't include treating her like a doormat on these issues, any more than they include acting like a doormat for her.

If you like the idea, start working out what it will look like. And then start doing it.

[Waddams]

Go for broke!

Live according to your values! OK, hold off on the marriage one--you sure don't sound ready to marry her today, so just drop that one.

As for living my values - I am.  Some of them, SO doesn't like.  The distance she's creating is a result of me not conceding my values.

As for marriage - it's weird.  On one hand, I do have a complaint that the cohabitation has drug out this long.  On the other hand, I recognize that I benefit from it in multiple ways.  That's why I go back to thinking now that if she wasn't positioned in life to get married, she should have been honest about it instead of surprising me later.  She working on resolving her issues, and it's looking like she'll have them resolved in the next few months.  So I'm thinking right now, I need to focus on other issues short term and at least see if a concrete plan can be laid in place that leads to a wedding or not once she's got her ducks in a row. As in set a date and start making arrangements.  If she won't agree to that at some point, then it is what it is and need to make a decision.

Give yourself an April 1st deadline: You will be living in accordance with YOUR values in this shared residence with her by April 1st, or you will move out and live in your own residence with S10 according to your values.

That's what I've already been thinking.

I wouldn't recommend announcing the deadline to her, although talking to her about living in accordance with your values sure is worth doing.

Most definitely.  A deadline is something I keep to myself for the moment at least. 

Please note: Your values probably don't include treating her like a doormat on these issues, any more than they include acting like a doormat for her.

Define doormat treatment, though.  To me, it is really more about taking advantage of someone to their detriment.  Expecting them to be giving to you, while not being willing to reciprocate.  Making it all about you, and never about them, or about you both together.  It's not necessarily an issue regarding value differences between people.

[Grey Kitty]

As for living my values - I am.  Some of them, SO doesn't like.  The distance she's creating is a result of me not conceding my values.

You can fail the test--you can fail to live up to your values. (For example, in how her kids are running her instead of the other way 'round)

Or she can fail the test--she can find living with your values unacceptable.

Either one is showing that the test isn't working out very well.

Define doormat treatment

I mean keeping conflicts with ehr over value differences productive... .not harshly imposing things on her... .or simply giving in based on the desire to end the conflict.

Instead, use all the tools at your disposal--don't be invalidating, do validate her, and try to be interested in her motivations and intentions--She isn't trying to be difficult or evil, or anything. She's just muddling along through life the best way she knows how, and perhaps you can help her find some better ways.