Therapeutic Separation with a pwBPD

[Cole]

BPDw packed up and moved out today. States she knows she has not been a good wife and mom because she is MI and needs distance to heal. She has moved out of state right down the road from her parents and already has appointments with a T there. She will continue phone sessions with current T up here and allow them to share information. 

She says she does not want a divorce, and wants to look at this as temporary. In fact, she cried and begged me to please see this as temporary. I told her that would only work if we have a plan in place, starting with a marriage counselor who can guide us properly down the road of a "therapeutic separation" with the end goal of rebuilding the marriage.

What I told her I need is:

1. She needs EXTENSIVE therapy and I have to see progress. (She agreed and is actively seeking it. Med compliant, too.)

2. MC as often as the counselor sees fit. (She stated she will come here every weekend for MC if he says so.)

3. A time line and markers to be determined by MC counselor. (She says she will agree to anything he lays out)

4. Neither of us will see anyone else. (She agreed to that, too.)

5. Set up a time to see each other. (She wants all weekend, every weekend, I said let's talk to MC Counselor about it.) 

She is agreeing to everything I asked for. All she wants in return is for me to look at this as temporary and to still see her. 

So, as we travel down this road of "therapeutic separation", I will post and share what I learn along the way. I have learned so much from all of you, hope I can return the favor.

PS. Rereading Stop Walking on Eggshells. If you have not read it yet, go buy it right now. 

[Skip]

I think you are right, concerning oversight on the Therapeutic Separation.

You may want to add this to your library:

https://bpdfamily.com/book-reviews/loving-someone-borderline-personality-disorder

Unlike a lot of books that use anecdotal references, this is a very "nuts and bolts"  book which provides solid tools and very detailed explanations of how to use them. We all know for example, that it is pretty easy to validate someone who is not upset and much harder validating a person who is emotionally aroused. Below are Manning's six aspects of validating someone who is upset.  And while the process appears complex in its description - it's effective and with a little practice it can easily become second nature.  According to Manning, there are really good reasons for changing your responses. The reason for validation is to dampen emotional arousal.

[Cole]

I think you are right, concerning oversight on the Therapeutic Separation.

W has called me 4 times since leaving just to say she loves and misses me and has asked if I will come down to stay with her next weekend. I think I will decline, pending some guidance from a professional.

SIL called and said she loves me and the kids and we are still family. Let me know MIL and FIL are remarkably unhappy with wife's actions, as is she.

W only managed to make it to Tuesday last week before having a breakdown and ending up in the  hospital. I really do not expect this to last long, especially as I am following the advice you gave previously concerning the stick, the carrot, and letting her come to me. Should she change her mind and want to come back, I will force the partial hospitalization or in-patient as part of the deal.

Yes, I will get that book, next!  

 

[enlighten me]

One thing that concerns me with therapeutic separations and BPD is object constancy.

I think if communication is cut off either completely or cut right down then object constancy could cause the pwBPD to pull further away.

I also think that the unstable sense of self can also come into play as a pwBPD latches onto their partners identity and without influence then I feel the SO could drift further apart.

If communications are good and you meet regularly and there are no other outside influences then it could work well.

[Cole]

One thing that concerns me with therapeutic separations and BPD is object constancy.

I think if communication is cut off either completely or cut right down then object constancy could cause the pwBPD to pull further away.

I also think that the unstable sense of self can also come into play as a pwBPD latches onto their partners identity and without influence then I feel the SO could drift further apart.

If communications are good and you meet regularly and there are no other outside influences then it could work well.

Agreed. My original thought was NC. A variety of others on the board, including Skip, helped me see that is counterproductive. I have to walk a balance between removing the object consistency and letting her dictate the terms, which are constant contact and visits. She is a state away and I have two kids (one autistic spectrum) who are heavily into scouting and our Church/school activites. Their needs must not be overlooked in deference to mom's schedule.

[pallavirajsinghani]

Cole:  Two points :  1)  Therapeutic separation implies that you only meet each other and under the circumstances that the therapist guides you both to.  2) Please read the posts of "Steph" on this board.  She is a success story.  Her husband become a well-managed BPD sufferer. (I mean to say self-managed, self-controlled.  BPD, cannot be "cured" like a physical ailment.  Like other mental disorders, it is a generally held belief that it can be "managed" to an optimum point where the sufferer can lead a fully functional and satisfying life.)  Last I heard, Steph and her husband were in a good place together.  The marriage survived.  Here posts may offer you some key insights.

All through out this, please do understand that the children take precedence.  Given the very hard choice of taking care of children who are children or an adult who is childlike (no criticism intended), your emphasis on the welfare of children and your personal good care as a steward of their future, should not waver. 

God bless... .I am sending a lot of good thoughts your way this morning.

[Cole]

Cole:  Two points :  1)  Therapeutic separation implies that you only meet each other and under the circumstances that the therapist guides you both to.  2) Please read the posts of "Steph" on this board.  She is a success story.  Her husband become a well-managed BPD sufferer. (I mean to say self-managed, self-controlled.  BPD, cannot be "cured" like a physical ailment.  Like other mental disorders, it is a generally held belief that it can be "managed" to an optimum point where the sufferer can lead a fully functional and satisfying life.)  Last I heard, Steph and her husband were in a good place together.  The marriage survived.  Here posts may offer you some key insights.

All through out this, please do understand that the children take precedence.  Given the very hard choice of taking care of children who are children or an adult who is childlike (no criticism intended), your emphasis on the welfare of children and your personal good care as a steward of their future, should not waver. 

God bless... .I am sending a lot of good thoughts your way this morning.

Thank you for your good thoughts. I can use them right now.

Point #1, 100% agree this has to be done with the help of an expert. Fortunately, BPDw agrees. We have a marriage counselor we were seeing and will reschedule with him. He is in the same practice as her T and she has signed off to allow them to share information.

Point #2, I will look up the posts. Than you!

Yes, Kids are precedence. No need to worry about "childlike". She, like most BPD's, fits the bill.

Still not sure how long this will last. She has been calling and texting all morning with "I love you and miss you" and "What have I done?" But I stand firm on the medical help all her doctors have said she needs as a condition of returning, should she ask.

[pallavirajsinghani]

When she leaves and yet continues to say things like she misses you and is not sure why she did it and perhaps she made a mistake etc.  She is actually asking you to comfort her, to soothe her.  This defeats the purpose... .the purpose and objective being to teach her self-management, self-regulation and personal responsibility.  So there is a delicate balance between being rude (and invalidating) and between enabling/soothing.  Being a caregiver can burn one out... .as you know... .heck... .being a primary caregivers of children can burn one out too.

So, all the more reason, you continue to talk to counselor regarding your own emotional welfare as well as hers and your's together.

You are the lynch pin here... .the nail that the survival of the kingdom rests upon.  It is a daunting responsibility... .be kind and good and forgiving of yourself.  Have compassion for yourself.  Care for yourself to replenish your spirit. 

Good night.

[KateCat]

The posts of board member "Steph" came quickly to my mind too when reading of your dilemma. If you can in any way find the time to plunge into them, it will be well worth it. They can give you a much better handle on whether therapeutic separation may be something you and your wife can attempt at this time.

[formflier]

   Couple of comments on the therapeutic separation.  I agree that you are the lynch pin, you have your fingers in a lot of pies to make sure they are all cooking right!  However, I would resist the mindset of "standing firm" (I go there way too much.  It is very close to "fight"  If you want to "stand firm", think about what it will look like (from her point of view) if you were assertive about your position.  You are not the "heavy" or the "enforcer".  A T should take on that role of giving her the bad news that she has not complied with (insert condition).   This will happen and hopefully you can take on the role of empathizing with her about how hard this is, while encouraging her to put out effort, and being assertive that the rules are the rules.  In my case, my wife and I were required to "comply with our counselors".  She routinely tried to "buck" what they were saying and get away with things.  There is an invitation to fight in this behavior, try to ignore it unless what she is "bucking" is critical.    In other words, focus on the 90% she is doing rather than the 10% she is thumbing her nose at, unless the 10% could undo everything.  Do the kids have counselors?  Is there a family T in the mix?                      

FF 

[KateCat]

Cole, I'm wondering if any of the professionals you've been speaking with lately have felt that your wife was a good candidate for "therapeutic separation" at this time? If so, would that suggest they feel that she's strong enough just now to limit contact with you and concentrate on her own recovery?

I read Steph's account of the therapeutic separation process a long, long time ago, so my memory may not be very accurate. But I had the impression that both parties would need to be in a fairly stable emotional state to embark on this type of project. I think Steph's husband was a high functioning professional, and yet he had to do what must have been enormously difficult work on himself in his personal therapy sessions. (For instance, the "group" part frequently consisted of him as the only male, with other participants being more typical "borderline" females.) He had to tough this out mostly without Steph. They were actually separated, I believe, and met infrequently, either at the marriage counselor's office or on occasional dates. This went on for months.

It would be sad to see your wife agree to this and then experience failure.

[formflier]

  I would show all the professionals involved the links and articles to therapeutic separation, so everyone is on the same page as well.  KateCat is right on point, we seem to have a willing candidate, lets get this right and not experience any confusion.  One major plus is that a couple of the Ts are in same practice.      This is good for them to work together.  Do the kids have their own?  Any chance that is in same practice?                      

FF

[Cole]

Cole, I'm wondering if any of the professionals you've been speaking with lately have felt that your wife was a good candidate for "therapeutic separation" at this time? If so, would that suggest they feel that she's strong enough just now to limit contact with you and concentrate on her own recovery?

I should clarify I have not had a chance to talk with the MC, so it is not a therapeutic separation, yet. It is more an issue of her running away, thinking that will solve everything. Typical decision making for her:

1. Do something without thinking.

2. Think, "Oh crap, why did I do that?"

3. Find something on which to blame the failure of the decision so as to save face.

4. Reverse course.    

This is how it may play out, but if not, I need to guide this with the help of professionals. As was suggested in a previous thread, give her a few weeks to let what she has done sink in and see if she changes her mind. Either way, extensive T and MC are involved.

the purpose and objective being to teach her self-management, self-regulation and personal responsibility.  So there is a delicate balance between being rude (and invalidating) and between enabling/soothing.  

 

However, I would resist the mindset of "standing firm" (I go there way too much.  It is very close to "fight"  If you want to "stand firm", think about what it will look like (from her point of view) if you were assertive about your position.  You are not the "heavy" or the "enforcer".  

Both speaking of balance and how to drive this track. Yes, I want to teach her self management and have told her several times I am sorry she feels so sad, but this was her decision and she owns it. However, I do not want to come off as the "enforcer". That was my first reaction- going NC to prove a point- and I was talked out of that by many of you wise folks. (Thank you.)    

Right now I am facing that dilemma. She wants to come home Friday after she gets off work, spend the weekend with me and the kids, and have a thanksgiving meal Saturday. Asked if she could sleep with me in my room. So, do I decline this, because she made this decision and should learn to face the consequences? Or do I say yes and show her what she is missing in hopes it will be a carrot I can dangle to get her into the T she needs so she can return? I suppose the object constancy brought up by enlighten me plays into this decision, as well.

   

[formflier]

  Wow!  So she is basically asking if she can sleep with (sex) you while home.  If you look at this from push/pull, I think you would say yes, but let her do the "chasing" and not go over the top with your reactions and pronouncements of love and all that.  There is obviously a personal decision for you here.  (Shouldn't all be about what is best for your wife)    So, let me confirm the situation.  Her stuff is all gone but she wants to come back for a nice visit. (do I have this correct?)  My gut says go for it, but keep your side low key, steer conversations towards next steps towards healing and "real" TS.                    

FF  

[pallavirajsinghani]

I think that this dilemma should be resolved not on "moral" issues, as to what is good for her, or even what is good for you both,  Whether to let her sleep with you is good for her or not and whether it is good for the relationship or not.

I think at this time, resolution of the dilemma should be based on whether YOU want it or not.  So the steps would be 1) Explore your emotions regarding this issue without any guilt.  If you want it to happen, let it.  If you don't do not.  2) Once you have explored your own emotions then a) further exploration as to how to communicate that to her can be done and b) mental preparation to face either of the possibilities that she may yet change her mind or blame you for using her for sex can result.   

And some preparation that if you do not want to sleep with her... .you may be considered uncaring, unloving... .etc.

This is the time when you need to develop inner strength to go through this -- it is a marathon.  There is no immorality in evaluating whether such a decision is good for you or not good for you.  For right now, what is good for you is also good for the children.

I am not advocating abandonment or neglect.  I am advocating self-care.

I'd welcome others to chime in and critique my recommendation... .

[KateCat]

This is the time when you need to develop inner strength to go through this -- it is a marathon.  There is no immorality in evaluating whether such a decision is good for you or not good for you.  For right now, what is good for you is also good for the children.

I am not advocating abandonment or neglect.  I am advocating self-care.

I agree with all you have said on this thread, pallavira.

You're at such a difficult point, Cole, that I'll just go ahead and throw my thoughts into the ring, though I have not read all your posts: I think your wife has been quite unstable for about a year's time. I think perhaps every single one of her doctors and therapists has suggested she needs to enter a formally structured program (like partial hospitalization) at this time. I think anything that can help her accept that imposed structure is a good thing.

I suspect she would say "yes" to therapeutic separation more readily, as it certainly sounds less scary, but fear she would not understand what she was saying "yes" to, really. Success sounds unlikely from what you have described of her recent patterns. I think she needs the really big help.

[Cole]

So, let me confirm the situation.  Her stuff is all gone but she wants to come back for a nice visit. (do I have this correct?)

FF, you have it right. Tend to think you are on track on how to handle it, too.

And some preparation that if you do not want to sleep with her... .you may be considered uncaring, unloving... .etc.

She does have severe abandonment issues. I have to take into consideration that she may react exactly that way if I say her coming is a bad idea right now. 

I think your wife has been quite unstable for about a year's time. I think perhaps every single one of her doctors and therapists has suggested she needs to enter a formally structured program (like partial hospitalization) at this time. I think anything that can help her accept that imposed structure is a good thing.

Yes, she has been very unstable for about a year.

Yesterday she explained she feels overwhelming guilt over how she has treated me. I think this move is about trying to run away from that guilt and core shame issues.

She said she has been angry at me for years because I did not fill her needs. She now realizes that was an unrealistic expectation, that no person can fill the void inside her. She has to do it herself. 

In my extensive research over the last year, I have read many times that pwBPD tend to have very low self esteem (she definitely does) and try to fill that void with the love of others. But no one can fill that void except the pwBPD, who has to learn to love and respect themselves. When that love from another is not enough, they feel abandoned and get angry at that person.

She has come to this realization on her own, which I think is a big step and shows remarkable clarity of thought. 

[formflier]

  She has come to this realization on her own, which I think is a big step and shows remarkable clarity of thought.   

                      When she says these things to you, how do you react/act?    Somehow it seems that being supportive, while she does the fixing is the way to go                    

FF

[Cole]

She has come to this realization on her own, which I think is a big step and shows remarkable clarity of thought. 

When she says these things to you, how do you react/act? 

Somehow it seems that being supportive, while she does the fixing is the way to go

FF

Yes. Supportive, but not beyond that. This is like high level business transactions. Let the other party come to their own awareness of what they need then help facilitate.

Last night she posted pictures of us together all over her FB account. She sent me a pic of her at her desk a few minutes ago wearing her wedding ring, which she has not worn since she had an affair in 2007. If push/pull was an Olympic sport she would definitely have the gold!

[formflier]

 Has she ever been this self aware before or otherwise like "this".  Where she is admitting to being MI and wanting to get help/fixed (however she puts it).                    

FF

[KateCat]

Has she ever been this self aware before or otherwise like "this".  Where she is admitting to being MI and wanting to get help/fixed (however she puts it).

FF

What an important question.

[formflier]

  Perhaps I am overthinking, but I'm also concerned that this is just "part" of a regular pattern.  It sounds new to me (which is hopeful), just trying to confirm and make sure this is "legit".                    

FF

[Cole]

She has had times where she was aware her feeling and actions were out of control but could not understand the cause.

This is the first time she has put it all together into an understanding of why she feels and acts the way she does. It is interesting that her explanation is so like those of other people with BPD which I have read about.

[KateCat]

Cole, what happened with the recent attempt at something like a partial hospitalization program? Did you say she left against doctors' advice? Did she say why? Would she be willing to return to such a program if it were more firmly proposed?

I'm having trouble seeing how any other course of action will produce good results for your family, but maybe I'm just missing something.

[Cole]

Cole, what happened with the recent attempt at something like a partial hospitalization program? Did you say she left against doctors' advice? Did she say why? Would she be willing to return to such a program if it were more firmly proposed?

I'm having trouble seeing how any other course of action will produce good results for your family, but maybe I'm just missing something.

That is the general idea. She is agreeable to extensive therapy for herself and MC for us. She made a nice first step here, but is far from healthy.

[KateCat]

Is there a specific "deal" on the table?

[Cole]

Should she change her mind and want to move back home, extensive therapy (weekly or more), visits with her P for meds, and MC will be required.

I don't think this will be an issue. She has already committed to seeing a T where she is. She is med compliant. She has asked me to see if our MC can see us Fridays after 6pm or Saturdays and has committed to coming up every weekend for MC.

I am not going to force the partial hospitalization unless her P and T say it is an absolute necessity. She is scared to death they will lock her up or that someone she knows will see her in the program (she has worked/studied at all our hospitals in the area). Our GP told me he would consult with her P and T to find another option because if she is that apprehensive she will not get anything out of the program.

Should she stay where she is, I will have to wait until I can get hold of our MC for further advice.

[KateCat]

Oh, that's terrific.  You are on the case.

I hope your family has a happy Thanksgiving.