Spouse with BPD need advice

[D880]

My Spouse of 30 plus years was recently hospitalized and diagnosed with BPD along with Mood disorder.  She wont really acknowledge it, so its difficult to get a foot towards improvement in the behaviors.  She talks openly about being Bi-Polar and med management being off track, but I am trusting that her therapist is walking her through the Borderline part - which is by far the most troubling for our family. 

Any thoughts on whether/how to confront someone in apparent denial ?

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PLEASE - NO RUN MESSAGES This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members may appear frustrated but they are here for constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[ArleighBurke]

You don't.

She lives with an immense amount of shame already. Having to accept that she "has BPD" can be too much. She will deny it forwever. But whether she accepts it or not doesn't matter. Therapy can be done without labelling.

She will probably always have BPD - and may never "get better". But there are things that YOU can do to make life better. Learning how to talk with her with Validation, and learning how to set and hold Boundaries, will both make life much better. This is a skill that YOU and your family need to learn.

Are you ready to learn?

[livednlearned]

Hi D880,

I wanted to join ArleighBurke in welcoming you to the site. And I'm sorry for what brings you here -- people here know the toll that a 30-year marriage to someone who struggles with BPD is like, and the effects it can have. How are you doing?

Do you feel comfortable talking about what happened that led to her hospitalization?

My BPD loved one has a bipolar II diagnosis (with psychotic depression) and often blames her behavior on medication mismanagement. She will probably never admit to BPD simply because of the stigma associated with it. Fortunately, there are many relationship and communication skills that can make small differences, though admittedly these skills take practice and patience.

Is your wife still hospitalized? Are there any kids affected?

[D880]

Thank You, LivedandLearned

BiPolar II is present here as well, along with eating and anxiety disorders. My wife is not currently hospitalized, but did attend Intensive Outpatient for several weeks after being admitted to the hospital which actually seemed to make things "worse" in that the group therapy provided a forum for her to talk about her perception of events and family dynamics which reinforced the thoughts that we (the family) were all out to get her.

She has been trying to get off of many of the medications she has been on for Bi-Polar (with a doctors help) which I think is perhaps the real reason for the hospital visit.  It has been a roller coaster of medication change which eventually led to a screaming match with younger daughter that was enough to make her want to self admit.  After discharge, the diagnosis of Borderline Personality Disorder was listed along with elevated stress in context of relationship with older daughter and mood disorder.

Reading the first things on the internet and in books about BPD was like having a thousand bells and buzzers and bright lights go off all at once for the family.  Suddenly all the behavior that really didn't make much sense in the context of the Mood Disorder was perfectly described in the descriptions of BPD.

She does have a Therapist (thank the stars above) whom I believe knows about BPD and that my wife has been diagnosed with it.  Its about the only silver lining.  At this point (and I know it is likely to change) she insists on seeing the Therapist although psychiatrists for her are a function of how willing they are to supply her with the Klonopin she has become so dependent on.  She actually went back to the hospital she went to for IOP intending to stay in the Partial Inpatient program long enough to see another doctor that would adjust the medications.

The current state of things is this: 
Older daughter recently had our first grandchild.  We moved a bout a mile away from her to be close enough to help take care of her. 

Although their relationship has been rocky over the years (they are like two peas in a pod - sometimes not good), it has been generally good. 

Since the hospitalization and subsequent outpatient experience, they not only don't talk but the animosity both have displayed towards one another is astounding.  They both claim years of abuse at the hands of the other, and I am pretty stuck in the middle.

I am not able to take a phone a call from the daughter without having another "split" occur for my wife - I think that's the right term for it.  Her face even changes and its like there is another person that takes over who has all the "Never and Always" words and repeated refrain of "she is keeping the baby from me- how can you even talk to her".
Sometimes this happens within ten minutes of actually having the baby physically in her lap.

This is too long a post - I apologize.  I do thank you for responding.  I am halfway through Stop walking on eggshells and got rather frustrated as it seemed to be describing life with someone who has BPD and I am actually rather familiar with that now.  What I do want to know is how one can make sure they "Validate" feelings when the emotional response to certain things is so extreme.

[ArleighBurke]

What I do want to know is how one can make sure they "Validate" feelings when the emotional response to certain things is so extreme.

That's BPD!

I guess the key is that she doesn't CHOOSE her emotions. For a non - we can control our emotions (to a point). We can use logic to examine what we feel, put it in perspective, and calm down. A BPD cannot. They feel eveything 100x times more intense then us, and they CAN'T control it.

So when she's annoyed at some little thing, we get that she shouldn't be, but the fact is she *IS* annoyed. THAT'S what we are validating - the fact that she's annoyed (NOT the why). And we can "help" her come down from that using Validation and SET. We need to ignore the "cause". eg You have lipstick on your shirt (from your daughter). Wife assumes you are having an affair and gets annoyed. Her "logic path" of lipstick=affair is wrong - but ignore that part. The cause of her anger is not that you had lipstick, it is that she FEELS like you are having an affair. Validate that part. "It must be so painful thinking that your hubby is having an affair. That must feel gut wrenching". Using SET helps. The SE allows her to feel heard. After a few rounds of SE (depending on how worked up she is), then throw in some T to help ground her again.

[D880]

I'm sorry, I was so with you right up to the end of that.  In your example, how in the world does validating her feelings that I would be having an affair help her conclude that I am not ?

For a real life example, My wife is obsessed with the notion that our oldest daughter is completely evil, is totally responsible for sending my wife to the hospital four times, and is keeping the grandchild from her. 

The older daughter knows how my wife feels and is at a point where she has de-friended her on facebook and blocked her phone calls in an effort to protect herself from being made to feel responsible for moms dilemma.  Children in particular are prone to believing what a parent puts forth no matter how skewed.

When my wife comes out with the "I can't believe you even talk to her, you need to choose between the two of us and the wife should always be the first priority" - can you give me examples of how to Validate the wife's feelings without turning my back on my child ?

I actually believe heart and soul in the dialectic nature of the world.  By definition, there is no grey area her to work with, the wife wants it all in or all out, there is no in between.  I want desperately to find a way to show my wife the beauty of understanding that, and accepting that sometimes people make mistakes and should just be accepted for that.

I have not mastered the art of validating the feelings but not condoning the actions since one leads to the other.  In other words, "It must be gut wrenching to believe our daughter and the rest of us are all out to get you" doesn't yet seem like a way to do anything except exacerbate the situation.

Is there another way to try and soothe someone into understanding that we are in fact not colluding to destroy her ?

[ArleighBurke]

In your example, how in the world does validating her feelings that I would be having an affair help her conclude that I am not ?

OK. SET is Sympathy Empathy Truth. They are the 3 sides of how to talk to a BPD. If you only provide Sympathy and Empathy, then they continue to live in their fantasy". If you try to provide "Truth" - they get frustrated because you aren't hearing them, and they won't hear the truth. You need all 3 in the conversation to get somewhere. S&E allow them to feel heard. Then T is when you can "set them straight".

In my example, I did not provide any Truth. This was probably a mistake. But we male nons use too much Truth and not enough S&E. She can't hear your Truth until she feels heard first. If she is quite enraged, this may take a number of rounds of S&E before she calms down enough to be able to hear and process Truth. But yes, at the end you say "I think that lipstick is from my daughter".

I don't have much science to back this up, but I actually have the opinion that the BPD does NOT actually logically believe what they feel. My BPD wife is high functioning, and in her better times she can actually spell that out to me. She'll say "I know this doesn't make sense, but I feel so... ." and off she goes and gets disregulated. So I think that you actually don't have to "prove" you aren't having an affair, because deep down in her logic she knows that. What you have to do is help her to soothe her emotions. I guess it's like startling an animal - perhaps it thinks there's a snake in the bushes. You don't have to prove to the animal that there is no snake - it's already been triggered - it already feels panicked - you can't take that away. You need to now deal with the panic - the emotion.

[ArleighBurke]

"I can't believe you even talk to her, you need to choose between the two of us and the wife should always be the first priority"

Explore her feelings:
You: I agree - my wife should and is my first priority. Does me talking to my daughter make you feel not so?
Her: Yes because blah

Agree where you can. This is part of the S&E. Then, add some T.
You: I'm sorry me talking to her makes you feel that way. My daughter is also a priority to me. I believe I can have both. How can I help you feel OK about that?
(You are putting HER problem back onto HER to solve)

She'll probably say "don't talk to her". This is where you can state a Boundary.
You: You and her are both priorities.
Simple statement. Not asking anything of her - just stating what YOU value.

[D880]

Bless You,

Good example dialogue, and I agree about Not actually believing what they feel. My wife will do the same thing when calm and "un-triggered"

I am unfortunately an engineer as well as being male and although  I'm not quite Spock, I have had a lifetime of training in logic and rules, etc. Its difficult for me to extract pure emotion from a sentence of words that often contradict the essence of the communication if ya know what I mean.

Thank You very much, I'll keep SET in mind and practice it.  I feel hopeful for the first time in a while quite honestly, its been getting brutal lately !

[ArleighBurke]

I'm also a male engineer. It's been fun learning and I STILL get it wrong a lot.  But I am getting better at applying SET, and I use it with my kids and get good results too. Often people (mostly females) don't want a solution, they just need to "get it out".

[livednlearned]

There's a really good section in I Hate You, Don't Leave Me that talks about difficult double bind scenarios, and how to use SET in different ways depending on the degree of emotional dysregulation and the importance of the Truth statement. If you are conflict avoidant (many of us are!) you may feel averse to the truth statement and standing by it.

If she is very emotionally out of control over a topic that triggers her over and over again, you may at times need to apply seT, with an emphasis on Truth, like if she is a danger to you, to herself, or to someone else.

Is your daughter putting down a boundary (limiting time with grandchild) because your wife was hospitalized?

You may also want to read about Karpmann drama triangles -- being in the middle of a drama triangle is awful. The key is to learn how to step outside the rescuer-persecutor-triangle dynamic and figure out how to be a coach, without taking sides (where everyone loses).