Dealing with fertility issues

[maxsterling]

A main reason my wife and I got together was because we both realized we were in our late 30s, and wanted a chance to have children.  It was one of the things we talked about when we were first meeting.  Both my wife and I just turned 40.  Yes, there have been tons of BPD issues that have made me hesitant to have a child with my wife.  But after weighing the issues, I had to decide that if I even want the chance to have a child, I either have to try with her or break up, because biological time is running out.  I made the decision to at least give it a shot.  I know many will disagree with my decision, but this post is not about that.

I had some issues with prostatitis earlier this year.  A few months later, when I was still dealing with other health issues, I decided to get a semen analysis just to see where I was at, and if it could point to the cause of the other health issues.  I went to a fertility specialist to get the test, and results showed I had poor sperm morphology.  Causes for that are unknown, but environmental factors, age, and stress could all be culprits.  They basically told me to eat better and reduce stress, and then said if I was really trying to have a child I needed to bring my wife in so that we could see what our chances were.

After running various tests on my wife, they said her internal organs looked fine, but hormones needed for healthy ovulation and pregnancy were low, and that is common for 40 year old women.  The doctor said that our chances of conceiving naturally at this point were low, around 1%, but taking hormones and artificial insemination would increase the chances, or we could try in-vitro fertilization and increase the chances to around 20%.  I look at it this way - it's like gambling $10,000 on a 1 in 5 chance. 

After researching the results of the tests the doctor gave us on my own, I don't think we are being fed a line - our chances are low.  But I do feel like we are being sold to the idea that IVF is our only logical option.  We haven't gotten a second opinion, but I would assume to hear the same thing - we are 40, we don't have much time, and that our best chance is with IVF. 

So here is the issue - I'm okay at this point if I never have a child.  I think I can emotionally handle it if we try and fail.  But I think my wife would completely fall apart.  I'm also frustrated that my wife seems to want to focus only upon me that is the problem here.  She hasn't even read the pamphlet of the things she can do to help the chances - such as exercise and eat better.  I've read that at this age, being healthy and reducing stress can be the best we can do, yet the process seems to stress W out even more.  She OBSESSES over this, and wants to talk about it 24/7.  I've been setting boundaries here, and things have gotten better. 

The reality is, from what I have read, the chance of a woman having a child in her 40s is already much lower than when she was in her 20s and early 30s.  I've also read that smoking, drug use, and unhealthy lifestyles all contribute to poor egg quality, and a woman who leads such a lifestyle will hasten the time when she loses her fertility.  My wife smoked for 20 years, was a heroin addict, and generally lead an unhealthy lifestyle.  IVF cannot compensate for poor egg quality. 

With the latest visit to the fertility clinic this week, it seems W has now painted them black.  W now wants to get a second opinion.  My feeling is that another doctor will tell us about the same.  I think W's issue is that this doctor is telling her what she doesn't want to hear - that our chances are low.  That's why she is painting this clinic black.  The doctor also told her that she needs to exercise regularly and eat better, and W doesn't want to hear that, either.  And I have a feeling that her negative attitude may cause doctors to not want to work with us, and it will be just like our wedding where vendors bailed on us because they got tired of my wife's badgering.

I'm not sure how to handle this, because this is a major issue that I can see turning really ugly.  How do I validate and not invalidate, yet be realistic?  What I want to communicate is that our chances are low, and I need her to understand that the odds don't favor us having a child, and we need to emotionally prepare ourselves for that.  How do I say it is worth talking to doctors, but not get her hopes up?  Every time another woman tries to give her advice on this topic W gets extremely mad.  A few people have expressed to her that at 40 it is difficult, and that adoption is another option.  W gets LIVID when she hears that.

I think shame is part of this - deep down W feels she abused her body, made poor choices, and as a result will not be able to have a child.  Of course she projects that onto me, doctors, and others, but I think the real problem here is shame.  I don't see any way for me to approach that. 

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[Cat Familiar]

You're kinda in a no-win situation, no matter what you say. Yes, core shame is likely the big issue with your wife.

"I've also read that smoking, drug use, and unhealthy lifestyles all contribute to poor egg quality, and a woman who leads such a lifestyle will hasten the time when she loses her fertility.  My wife smoked for 20 years, was a heroin addict, and generally lead an unhealthy lifestyle.  IVF cannot compensate for poor egg quality." 



I think your wife needs to be made aware (if not already) that poor egg quality could mean, even with a successful pregnancy, a child born with chromosomal abnormalities, developmental disabilities, autism, down's syndrome. Added to this, as I'm sure you know, is the greater likelihood of miscarriage with advanced age. So there's a lot at risk here. On the other hand, you certainly could have a healthy baby.

Let her paint the doctors black. She really needs to know what is at stake here. BPD magical thinking is not gonna work. Reality is reality.

[sweetheart]

Max is your w currently on any psychiatric meds, like tranquilizers, mood stabilisers, antidepressants ?

[maxsterling]

She's on antidepressants.

[maxsterling]

Yes, Reality is Reality.  We could go to anther doctor and be told different chances, be given more hope, but that does not change reality.  Reality says that our chance of having a healthy baby are low.  IVF increases the chances, but they are still low.  And it may not make much of a difference which clinic performs the IVF.  Biology is what it is.  If eggs are of poor quality, they are of poor quality, and nothing can change that.

It does feel like no-win, and it has me feeling quite down and a little fearful of what this may bring.  We can try IVF, spend lots of money, and have it fail, and I deal with that.  Or I can say that IVF for such low chances is not worth the money, and I deal with that.  She could get pregnant and have a miscarriage, and I deal with that.  I just don't see anything that I can do or say or a doctor can do or say that will avoid the inevitable emotional breakdown that is looming. 

[Cat Familiar]

Max, you cannot protect her from the consequences of her bad choices. She chose heroin and ciggies over her peak fertility. What's done is done.

I'm sorry that you sense  that you'll feel the brunt of her coming dysregulation, and you're probably right.

My question for you is what do you want? I hear you spend so much time trying to cater to her needs and moods. Are you a gambler? Do you want to spend the money to give it a try? Are you OK with being childless?

I sense that you'll be fine no matter what the outcome, but truly, what does Max want?

[maxsterling]

I sense that you'll be fine no matter what the outcome, but truly, what does Max want?

Good question.  If I could control the outcome, I would want to have a child.  Yet, I would also want my wife to be cured of BPD .  The reality is that I cannot control the outcome, and I have come to a place where I can put it in the universe's hands whether we have a child or not.  It won't make or break my life, either way. 

As far as IVF - I'm still wrestling with what I want there.  If it would guarantee a child or at least have odds greater than 50%, then it would be a different story.  But if 20% is realistic - suppose we spend a bunch of money and nothing.  Do we call it quits?  If we call it quits then, then why even try the first time?  The logical and ethical side of me says to not go with IVF.  The emotional side isn't quite in the same place. 

[Cat Familiar]

I think you'd make a great dad. Your wife would certainly be challenged by being a mother--that's another topic.

What I wonder, and I know this is sensitive territory, is: if you did have a child with disability, do you think your wife could deal with it? I'm sorry if this is a painful question.

[maxsterling]

What I wonder, and I know this is sensitive territory, is: if you did have a child with disability, do you think your wife could deal with it? I'm sorry if this is a painful question.

I think if we had a normal child she would search and search and claim he/she was disabled    I think that having a healthy child would be hard enough for my wife to deal with that a disabled child wouldn't be much worse.  Her stress level is what she makes it, and not based on reality. 

[Scarlet Phoenix]

Hi Maxterling, I'm sorry to hear that. It's hard  

This is extremely difficult for someone even relatively stable. I've been there, I'm 40 now but got the same message from my doctor/specialist when I was in my early 30's. I had terrible grief and shame around it even though I had not let a lifestyle that would lead to infertility. If you want any input from a woman who's lived, and is still living with this, don't hesitate to ask.

I just don't see anything that I can do or say or a doctor can do or say that will avoid the inevitable emotional breakdown that is looming.

I'm afraid that's true.  

Maybe in advance think of some ways for you to resource when the bomb goes off?

[Notwendy]

Infertility is stressful and heartbreaking for couples - and difficult for couples who do not have issues like BPD. It is understandable that your W is upset, and also understandable- that with her condition- she will project it- and paint the doctors black, be livid at anyone who suggests something like adoption. It is understandable that she can not look at herself- it is far too painful to face it. So she will look outside of herself- at you.

I think you will need to draw the line according to what is acceptable/affordable to you. If you wish to try IVF, then that is your decision, but agreeing to IVF if you don't want to do it to appease her will likely be like all the other times you appeased her, it is a temporary reprieve.

She wants another opinion. If that is OK with you, then do it. However, you need to know how many opinions you wish, as if she doesn't like the second, then she may want a third.

[sweetheart]

I was on an SSRI when I was trying to get pregnant and was referred to a P for a consultation about my medication. The P told me and provided me with studies ( they are easily accessible online ) that were I to continue trying for a baby it would be against his advice.

He advised me to reduce off the antidepressants, because SSRI's are known to cause congenital heart defects.Then leave a six month gap, then try for a child.

I took his advice because I knew that as I was in my forties all known risks increase and fertility reduces.

Was I concerned about the risk of my depression returning, yes I was, but I wanted a baby and a healthy one way more. However I made an informed choice around all these issues effecting me and a baby. Do you believe that your w is capable of making this kind of informed decision?

I was 42 when I fell pregnant, I had two miscarriages prior to my pregnancy. The risk of miscarriage also increases as the woman ages.

Have you thought about the impact of a miscarriage on your wife's mental state, and on you?

Has your w discussed the issues of medication with her P?

I also recall max that you are on medication, have you checked this out with you physician in relation to any effects on the foetus, or on fertility ?

It's a vicious circle because in dealing with the issues I've raised above, it potentially creates more stress for you both, thus impacting further on fertility.

[maxsterling]

Sweetheart - all of what you mentioned has been discussed.  The meds she is on are considered completely safe.  We tried the no meds route long enough, and she simply could not cope with life - led to a suicide attempt. 

The fertility doctor did spend a considerable time talking with W about her mental health issues, and the challenges fertility treatments would play.  She also discusses this with her T because her T went through the same issues. 

I think a miscarriage would be devastating for her.  We've discussed this, and I have expressed that a miscarriage is a real and likely possibility, and that we need to be prepared and accept that possible outcome. 

[sweetheart]

Sweetheart - all of what you mentioned has been discussed.  The meds she is on are considered completely safe.  We tried the no meds route long enough, and she simply could not cope with life - led to a suicide attempt. 

The fertility doctor did spend a considerable time talking with W about her mental health issues, and the challenges fertility treatments would play.  She also discusses this with her T because her T went through the same issues. 

I think a miscarriage would be devastating for her.  We've discussed this, and I have expressed that a miscarriage is a real and likely possibility, and that we need to be prepared and accept that possible outcome. 

It's really positive that everyone is looking at both fertility and mental health together, because they are interlinked.

I didn't imagine that it would be possible for your w to be medication free, so that's great about the antidepressants.

[maxsterling]

I think if they could, W's doctors would advise her against having a child.  Yet, they know if they say that, W will paint black and leave.  I don't see how a responsible doctor can not have serious reservations about helping someone get pregnant when they know W attempted suicide earlier this year.  When we met with the fertility doctor, she was very upfront with W in seeing how she was handling all of this emotionally.  I felt like W made things sound better than they were, because what I witnessed was serious depression.  Her Psychiatrist also seems concerned, and tends to steer W towards reasons to wait, such as the need to get her meds stabilized first.  It has to be a tricky situation for doctors.  I don't know what kind of liability they could face should something go wrong.  There are tons of consent forms to sign, so maybe there is language in one of them that protects them.

I also wonder about adoption - if my wife's history of mental illness would be investigated there. 

[flourdust]

Although I can't in good conscience recommend bringing a child into a BPD household, I would suggest adoption might be your best bet. Besides avoiding the medical risks, there's the possibility that BPD-related tendencies can be inherited. My daughter has had significant issues with emotional control and explosiveness that led to six years of rotating therapists, medications, and even a psychiatric hospitalization. All before she was 10. Besides what that means for her own life, the stress of raising a child with unusual challenges also impacted the stability of my BPD wife.

[sweetheart]

I think if they could, W's doctors would advise her against having a child.  Yet, they know if they say that, W will paint black and leave.  I don't see how a responsible doctor can not have serious reservations about helping someone get pregnant when they know W attempted suicide earlier this year.  When we met with the fertility doctor, she was very upfront with W in seeing how she was handling all of this emotionally.  I felt like W made things sound better than they were, because what I witnessed was serious depression.  Her Psychiatrist also seems concerned, and tends to steer W towards reasons to wait, such as the need to get her meds stabilized first.  It has to be a tricky situation for doctors.  I don't know what kind of liability they could face should something go wrong.  There are tons of consent forms to sign, so maybe there is language in one of them that protects them.

I also wonder about adoption - if my wife's history of mental illness would be investigated there. 

Max you have good reason to wonder. Maybe it's different here in the UK, I have a close friend who has unstable BiPolar and cannot b off her meds. She was advised in no uncertain terms by her P that it would not be in hers or the child's best interests if she got pregnant. She decided her mental health was more important than her desire to have a child. The actual process of coming to this decision caused her to be hospitalised.

I am surprised that your w's P has not expressed more concern.


In answer to your question about adoption, here in the UK you would not be able to adopt a child. I suspect if you make enquiries the same will be so where you are. Were you to be suitable for adoption every aspect of both your lives would be under investigation, particularly your w's mental health. Without wishing to sound obtuse why wouldn't it be ?

[Sunfl0wer]

I learn so much from reading around here...

What I hear in this thread... .

It sounds like good advice to think about what you want Max, then just work within that.

We cannot run around anticipating and preventing and buffering every possibility of our partner dysregulating. Yet, we may be in this automatic thought process as a type of self preservation.

We cannot protect our pwPD from themselves or the consequences of their actions.  (Or at least we are limited in this... .to an extent)

I imagine it would be easiest for you to have another person set some boundaries on what is acceptable for your W having a child.  I also can imagine professionals are reluctant to be involved and reluctant to help her in the same manner had your W not had many of the psychological issues she does.  I can only imagine, she may be keen on their 'thoughts' _{against her} and she may take offense to this greatly, which will be painful among the many other painful realizations this will bring forth.

So it sounds like you are willing to look into IVF, but only so far.

While I do not generally promote 'dishonesty,' is there a way to decide for yourself the dollar amount and energy you are willing to put into this, and only make that amount easily available for this cause?  Maybe shift the rest of your money in a retirement account that does not permit withdrawals or something?  Then proceed on being as supportive as you can within the parameters that you in your head have already defined that you will stick to.

I also wonder if there is benefit from initially appearing that you may be willing to spend say $3,000 when in reality you may actually go to $10,000 so you still appear negotiable and influenceable vs appearing as if you made a unilateral decision.

I apologize if my thoughts appear manipulative, and I normally would want my partner and I to have complete honesty and not think in these terms, (such has having a secret high number) but I also believe that circumstances do matter and that my suggestion may actually be a kinder method of negotiating in your relationship than the whole truth.  ... .If that makes sense.

[maxsterling]

The problem with trying IVF is being able to have limits.  In the relationship as it stands, I see IVF causing more stress than it will solve.  If we can't set a limit beforehand, it is probably better in the long run to not even try.  I know what will happen.  We spend tons of money and it fails.  W's depression and obsession gets worse, and things fall apart.  The doctor we went to gave us 20% odds of success on any given cycle, but that means 80% chance of failure.  If I felt that W emotionally understood the chance of success is small, and could live with trying just once, then it would be easier.  But knowing my wife, she could agree to that, but if it fails, she will emotionally adopt the "try until it works" approach.  And if I stand in the way, I am the source of her displeasure. 

Interestingly, we actually had a fairly constructive conversation about this topic yesterday afternoon.  I think we agreed that a second opinion is definitely wise considering the expense.  And we also discussed that our odds are low no matter what doctor we talk to.  We just feel that we would be able to make a better decision after talking with another doctor.  We both decided we really want is a doctor to be straight up with us about our chances and not afraid to tell us the chance is low.  The current doctor told us our chance was low, but at the same time immediately pushed IVF on us.  Both W and I feel a bit uncomfortable with a doctor giving us low odds, then trying to push us into a procedure with such a low chance of success. Of course, W dysregulated on me this morning, so even though this conversation was constructive at the time, I think she was still emotionally dissatisfied. 

I am hoping W can come to terms on her own (or with the help of a doctor or T) that the chances are low, and there is nothing wrong with focusing her life elsewhere.

[Sunfl0wer]

Ok, I think I understand better

How about an approach that makes her think she is the one that made the decision to not go through with it? 

Maybe use the second opinion to ask some clever questions to the doctor that will help steer her decision?

Such as... .

What percent of couples with similar odds do you actually have that go through with IVF? AND successfully conceive and give birth to a HEALTHY baby?  A special needs baby?  Couples with our odds typically need to spend how much before successful pregnancy occurs?  How many miscarriages are typical?  What about the extra eggs/fetuses (if going this route)?

What stresses should we be prepared for?  On our bodies?  On our relationship? 

Is there extra counseling and therapy services offered/available for dealing with the issues unique to fertilization issues?  Do you recommend this?  (Maybe the idea of counseling will be a turn off to her)

Obviously, you wouldn't want to appear to be steering things... .rather appear objective... .or like you are looking out for your wife, on her side, from possible scam doctors... .is she is open to joining you in this type of mindset.

Idk... .just thoughts... .in case something in it rings helpful for your situation.

[Sunfl0wer]

Oh... .or maybe see if someone could recommend some infertility group grief counseling where a group of people can help her feel negative about the process and she will better experience some of the real stress through the hearing of others experiences?  (Like a reality scared straight program type thing... .but really just group counseling) Better if this is recommended by one of the doctors as a prerequisite to her participation... .if there was a way to ensure that.  Maybe the second opinion doctor WOULD recommend this at your guidance if he knew ahead of time, privately, some of your wife's emotional issues that are at play?

[Wrongturn1]

Max,

First let me say that I think that knowingly bringing a child into a situation where a parent has BPD is a bad idea for the child.  Aside from the psychological damage your wife could do to your child, you're also unsure whether your wife will still be alive one year from now, or 5 years, etc.  It's best for the child if both parents are in the picture over the long term.  Read up on the rates of substance abuse and suicide among children who have had a parent commit suicide (it's not pretty). 

Notwithstanding the above, if you insist on bringing a child into your lives, I would suggest adopting a newborn baby if possible.  This would reduce the probability that your child would inherit BPD due to genetic factors (the research is not clear, but it does suggest that BPD can have a genetic component and be passed along to offspring).  Not to say that no BPD mothers are giving children up for adoption, but I think adopting would still improve your odds of having a BPD-free child.

In general, I think the IVF methods are not a good deal: costly, low success rate per attempt, emotionally traumatic for the parents.

Finally, my apologies to you for offering such a contrarian post.  I care deeply about children and prefer to see them in the best circumstances possible. 

[KateCat]

This problem is a doozy, max, even if it's been coming for a long time. 

Sweetheart mentions that in the UK you would not be able to adopt a child. I believe that will be true in the U.S. as well. People I've known who have been successful in the adoption process (including same-sex and opposite-sex partners) have been vetted up and down, left and right, from all angles. Maybe one way they proved their stability to the agencies involved was by enduring the process itself.

[maxsterling]

I appreciate all the feedback, folks.  

Today I found another fertility clinic that offers a much cheaper IVF rate for people who work where I work - half the cost.  I told W about it, suggested we go there at least for a second opinion.  I'm okay with this, and much more okay with taking the IVF gamble at this reduced cost.  

The website of this new place has lots of info on it.  I hope W reads through some of it.  The success/failure rate they quote is consistent with the first clinic.  It looks like the odds given to us by the first doctor are pretty much standard odds for any couple 40 years old = 2-5% chance of conceiving naturally, 40% miscarriage rate, and success for IVF between 20 and 50%, depending on other factors (age being the biggest one).  So my feeling is the new clinic won't tell us anything different, but may be cheaper.  

But what is really telling is that this new clinic also offers a 3 cycle package guarantee for around $25,000.  If you don't have a baby after 3 cycles, you get your money back.  But, there are stipulations to the package - only available for women under 40, who have no history of smoking or drug use, and whose BMI is in an acceptable range.  That basically hints on what they truly feel the odds are for people in our situation - not high enough to put their money on it.  

[Notwendy]

For something like BPD- with unknown genetics and a spectrum disorder, I think it is drastic to consider not having a child on the basis of genetics alone, unless that is a choice of the couple. None of us can fully know our genetic makeup. Having a baby is taking that risk as well as a commitment to love and care for the child that arrives- as she or he is. Fortunately, the majority of children are born without serious genetic conditions.

However, a strong consideration is the mental health of the mother and her ability to parent. This has been the topic of other threads with Max.

Another thing that is not possible to predict is the resilience of the child and the child's role in the family. I am the child of a BPD mother who is very affected.  I do not have BPD. I am glad to be here.

My family life was stressful in many ways, however there were family friends and relatives who were role models for me, and their influence has made a big impact on me.  As wrongturn said- I am also protective of children, as are many posters here. Many of the nons are doing all they can to help their children. It may be that a parent with BPD has a higher chance of having a child with BPD, but it isn't 100%.

Max, is it possible that your W fears you will not be happy with her if the two of you don't have children? I don't think you need to pretend that this isn't painful for you too. You have the right to grieve. However, this may trigger her fears of abandonment, reinforce her shame for the things she regrets. Have you reassured her that you will love her and be happy with her no matter what?

[HurtinNW]

Re: the adoption question.

I adopted several kids prior to meeting my current boyfriend. I'd like to gently offer a few thoughts. One is many adopted kids today come with special needs. All mine are drug and alcohol effected. That means a LOT of work! I love my kids so much, but their behaviors can try the patience of a saint. Also, most adopted kids today have open adoptions. My kids have birth families members in their lives. I even host them all for Christmas! Can you imagine your wife dealing with an open adoption with a birth mom who might be prettier and younger than her? Having that mom over for a birthday? Watching the birth mom give you a BIG hug? None of that bothers me at all but I bet dollars to donuts it would bother some women with BPD.

I have been so, so happy with my kids but modern adoption takes a lot of strength and courage. It shouldn't be something you do just because you are infertile. Adoption brings a huge set of challenges. For me it has been the most rewarding challenges of my life... .but for many it would not be at all. My warm wishes and luck to you!

[Notwendy]

Becoming a parent doesn't come with any guarantees. The choice to have a child is in part, emotionally based, not entirely rational. This has been a topic for Max on several threads and has come to the point of considering IVF.

This is an emotional decision for even the most emotionally intact couples. It is what it is, and will go the way these things go with someone with BPD. One can not predict the future, but understanding how someone with BPD responds to stress may help not taking it personally.

Max, you can not protect your wife from her feelings, nor from any outcomes of this decision- good or bad. If you get a baby, then, that is a baby- with all the joys, changes, and challenges of a baby. One can not predict or control any more than that.

[Sunfl0wer]

I want to add some personal observations regarding the pwBPD that have been in my life, in case it may be similar for your situation and help you empathize and support with what your W may be dealing with.

The pwBPD that I have known did not want children for the same reasons that other people may want children.

They appear to have wanted children to fill the voids of... .

Lack of identity

Abandonment

Once you have a child, you will forever have a sense of identity tied into that.  You will always be somebody's mom which can lead to a more permanent sense of filling that abandonment feeling.  Many mom's wear the "mommy badge" with great pride.  Heck, all anyone has to say is that they are a mom and they can immediately get accolades from strangers congratulating them and treating them like a hero just for their biology. 

The issue with this thinking is that the motivations that drives having a baby are counterintuitive to actually raising a healthy well adjusted child.  As a child needs some autonomy and independency and attention, all of this threatens the pwBPD and the pwBPD competes with baby or uses baby to get their emotional needs met, to the detriment of baby.  Some pwBPD can provide for baby's basic physical needs, but fall short on the emotional ones. (And obviously there are also ones who physically neglect and abuse baby either directly or indirectly) Children I have observed with parents with BPD, if they did thrive/survive, did not do so because of their parent, but rather in spite of them.  Actually, the ones I know barely survived... .and lead very self destructive lives for many years.  For example: My nieces were so exposed to suicide threats, suicide became such a norm, I am grateful they were not successful killing themselves. 

Anyway, onto how this may be helpful for you to support your W... .

Your wife has two roles that I am aware of and both she feels insecure in at times.  She is a wife, she is a teacher. 

I wonder how things evolve with her work, or devolve, will she get more invested in this idea of a child with more desperation as she looks for another 'stable' role in life to cling to?  Do you think her concept of identity could be strongly motivating her desire to have a baby?

If so, I think this may be a very good time to identify all the roles in your wife's life that are important to her and make her feel valuable.  She may also be a sister, aunt?  Or maybe she volunteers at an annual event or such? 

It seems like she is currently feeling strength in her role as wife, yet not so much as teacher. I think you should continue to emphasis and build her up in ALL role identities that she has, maybe focus on ones that are less obvious and give her credit for these too as this could be the key to her getting through the loss of the concept of the"mom" role.

I am making this all up, but do you think strengthening and focusing on strengthening her "identity" could be a good way to support her in this?  (Without ever making that connection outright at all)

[Notwendy]

I don't know what went into my parents decision to have children, perhaps it was much like all parents. I know that my father enjoyed being a dad and that we kids were a source of joy to him. I have no idea what my BPD  mother's experience is of it. I think much like women in her era, the norm was to get married and have children, and that is what she did. She both took care of us, and did not.

It is hard to differentiate between things that she did that benefited her and us, because they overlap.

Growing up as a reflection of mom meant that I felt my parents didn't know me as an individual. It was a symbiosis. They were good parents in that they provided good things for me, but also, I serve a purpose for them. I tried for decades to get them to "see" the real me, but I don't think that is completely possible.

I will echo Sunflower in that, I did as well as possible emotionally in spite of my mother, not because of her. However, I also have to acknowledge that my parents did a lot of good for me, whether that motivation was for them, for me, or all of us.  

I don't think my mother had another source of identity or validation other than through us kids and my father. If we were good, then she was good, and if we weren't then she would fly into a rage. Makes sense if this was her source of identity. It fit her era well- the good mother and housewife. Our family rule was that mother is normal, and so we were not allowed to mention her dysfunction to anyone. Most people didn't have a clue what went on at our house.