Mom with history of severe hypochondria

[etown]

Hey all,
So a few days ago, my bpd mom emailed to say she had a heart attack.
I've been practising very low (almost no) contact with her for a few years and for the most part, it's been going well. She lashed out at first, but then sort of faded away when that didn't work. I know she's been relentlessly attacking me on social media for it, but because I've blocked her, I don't have to deal with it.
But her best tool for controlling the people in her life has always been her health. She's had some real problems over the years, but she's also manufactured or imagined many others. She's talked doctors into performing treatment on those manufactured illnesses and then had new medical emergencies related to the side effects of the treatments. It's hard to know what's real with her because in her mind, everything she experiences is real.
And so along comes the heart attack. It was weird because just a few weeks ago, she sent a long update on her health in the guise of a birthday message to me. The e-mail went: one sentence about my birthday, thirty sentences about her health, one sentence vaguely apologizing for some toxicity in my childhood, love mom. I thanked her for her wishes and left it at that.
In that long middle paragraph about her health, she wrote with great pride about how strong and healthy her heart was according to a cardiologist she'd been seeing, so it seemed unlikely she'd be having a heart attack a few weeks later. But I felt awful just not saying anything while she sat in the hospital, so I sent a couple of sentences telling her to keep me up to date.
Of course it was not a heart attack. There were some other issues but they've done a massive battery of tests and she's mostly fine. I suspect it was probably something real mixed with a panic attack (which is a common issue for her). I suspect--because this is how she thinks--she believed her birthday message had solved our relationship and then freaked out when I didn't send her a Christmas or New Year greeting. This last suspicion makes me feel like maybe this was all my fault, which I know is not healthy.
But I'm left, once again, with this terrible feeling of dislocation. She is at an age where her health is a real issue, but she's been doing this to me since I was a small child. Her (perceived or real) illnesses were always her excuse for not performing her basic role as a mom, and I just had to accept that. I had to be another parent to my sibling and parent myself. I had to figure out how to move through the world without help from a very young age. She actually left me homeless at one point when I'd just turned 19 years old. 
It's taken me decades to understand and begin to unravel the effect all this has had on me. I know she'll never understand that because she simply doesn't experience empathy in that way. Her only interest has always been herself--her pain, her disappointment, her fear, her comfort. Again and again she demonstrates this. I've grieved the loss of this ideal form of a mom over and over. I know this is the illness, which was born from her own trauma. I do feel for her, but I have responsibilities that require my attention, ones that aren't just a gaping unfillable wound of need like she is.
So here I am again in the aftermath of one of her freak-outs, trying to figure out how to focus on the work ahead of me. Trying to get my head back in the present and in my own life. I'd love your thoughts on this. Do you have a bpd family member who has used their health issues to control the people in their life? How did you deal with the guilt?
Thank you!

[Swimmy55]

I understand all too well about parental guilt.  I still have problems with it and I am 62 years old.  Here is some posts  on guilt from this forum https://bpdfamily.com/message_board/index.php?topic=354127.0
You have established appropriate boundaries  here.  My Dad has used guilt on me in other ways especially when I dare to travel without his permission,  not taking any money from him so he can control what I do with it..etc. It is hard, but each yes you have for yourself is a no to her dysfunction.  I say this for me as well.  Our bpd parents know our buttons and push them automatically.   You are on the right road, and not alone in this
 

[Notwendy]

But her best tool for controlling the people in her life has always been her health. She's had some real problems over the years, but she's also manufactured or imagined many others.

It's hard to know what's real with her because in her mind, everything she experiences is real.


But I'm left, once again, with this terrible feeling of dislocation. She is at an age where her health is a real issue, but she's been doing this to me since I was a small child. Her (perceived or real) illnesses were always her excuse for not performing her basic role as a mom, and I just had to accept that.

I know she'll never understand that because she simply doesn't experience empathy in that way. Her only interest has always been herself--her pain, her disappointment, her fear, her comfort. Again and again she demonstrates this. I've grieved the loss of this ideal form of a mom over and over. I know this is the illness, which was born from her own trauma. I do feel for her, but I have responsibilities that require my attention, ones that aren't just a gaping unfillable wound of need like she is.

So here I am again in the aftermath of one of her freak-outs, trying to figure out how to focus on the work ahead of me. Trying to get my head back in the present and in my own life. I'd love your thoughts on this. Do you have a bpd family member who has used their health issues to control the people in their life? How did you deal with the guilt?
Thank you!

I could have written this. For as long as I can recall, my BPD mother has had some kind of medical issue that to her is the "reason" for whatever behavior or neglect she does.

She has also self harmed to gain medical attention. I also can't tell what is "real" or not.

She's elderly and in assisted living now and still does it. I have just had to back away- not from being empathetic but because, she has sabotaged my attempts to help her and then blamed me for when they don't work out. So, any effort I make to help her isn't effective, so I just don't get as involved.

She mismanaged her money, and then when it is gone, badmouthed me to other people over it.

I have attended many meetings, by phone, by zoom, over care plans for her.

At one point she needed skilled nursing. The social worker got me involved about the decision. There was a staff and family meeting about it. In the middle of it my mother anounced that "her family was trying to dump her in a nursing home". She wasn't admitted there.

During one hospitalization, she got so sick, she was placed on Hospice care. I had spoken to her providers at the time and agreed it was the best option for what she was willing to do ( she's not compliant with her care and was refusing treatment at the time). She actually did better on Hospice and she was discharged.

During this time, I did begin to grieve, to feel sorry for her, to be attentive to her. (from a distance, I don't live near her) I was involved in speaking to her nurses, and keeping up with how she was doing.

Then all of a sudden, silence. No nurse calls. Nobody called me. I asked why and found out she told the nurses to not call me.

Somehow, after that, I had to back away and not have as much involvement with her care team or her.

I do things that are helpful to her- like help her with keeping up with her necessary bills for her to pay and speaking to her medical team when necessary but  but I have accepted that efforts on my part don't seem to make a difference for how she feels and so don't feel a lot of guilt. I do feel sad that things aren't more "normal" between us but I have tried for normal. It just doesn't work.

[CC43]

Hi there,

The short answer is yes, the pwBPD in my life uses health as a means to manipulate and get out of doing things she doesn't want to do.

The longer answer is that she doesn't currently use her health issues to the extremes that your mother uses, but there was definitely some manipulation involved.  And now that she's gotten treatment for BPD, using her health issues to manipulate has toned down, thankfully.

Nevertheless, when my stepdaughter was untreated and her negative BPD behaviors were at their worst, she had multiple health issues.  I think some were self-inflicted and self-reinforcing.  For example, daily marijuana use sapped her motivation, and she'd eat a lot of junk food.  She gained some weight, had acne and surely felt sluggish.  (My personal view is that if you eat crap, you feel like crap, and that is what was happening with her.)  She'd lie in bed or in front of the TV around 23 hours per day, which probably led to some muscle soreness.  Since she had no daily routine, she claimed she had insomnia, and yet she'd sleep 12 hours per day or more, and she'd often nap.  Napping was a standard way to avoid interacting with the family (she'd typically nap through mealtimes).

Anyway, she'd claim she was suffering from all sorts of aliments--from colds to flu to insomnia to aches to stomach issues to PMS.  Surely she had health issues from time to time, but it seemed like she was afflicted year-round, and it definitely wasn't normal for her, as she was historically a healthy and active kid.  I felt that she feigned sickness to get attention and "service," as well as to get out of doing things she didn't want to do.  One example was when her dad offered to go with her to the DMV to help her sort out a car title or license issue.  He arranged for an appointment (which is possible in our state), at 9:30 am on a workday, and he took the morning off work to help his daughter.  Well I just knew in advance that she wouldn't want to wake up that early.  Sure enough, when the time came, she was "too sick" to leave the house.  She had her dad run to the pharmacy to get her some cold capsules, because she didn't like the cough syrup we had in the house.  Then she wants to dictate what was for dinner, even if she didn't show up to eat the chicken soup or whatever.  Yet miraculously, when she wanted to go out that evening, she had recovered.  This sort of shenanigans happened frequently.  I could reliably predict her reaction:  if she were asked to do something she didn't want to do, she'd pretend to be sick to get out of it.  When taken to an extreme, she'd attempt suicide.  I'm not certain how many "real" suicide attempts there were--I'm sure there were at least three and probably four "real" attempts, but there are a couple of others where I'm not certain if she truly tried to harm herself, or if she just thought about it, or if she just claimed she made an attempt; maybe she really did swallow some pills, but not enough to land her in the hospital, because she clearly didn't want to go to the hospital.  In summary, there was probably a combination of reality mixed with fiction, and a heavy dose of manipulation, too.  Teasing out reality from fiction is fraught.  With BPD, the distorted thinking patterns can twist facts beyond recognition, ending up with "her truth."  What does "her truth" look like?  She's always a victim, and that includes being a victim of health issues.

In addition, I wonder if the distortion in BPD thinking can actually bring on the physical ailments.  Let's say she's filled with anger or anxiety.  It may be that her anger or anxiety are so intense that they make her feel tired, wired or weird.  It may be that her thinking is so distorted, she can't really pinpoint where her distress is coming from.  Is it her angry thoughts?  Or is her heart racing?  Is she so tense that her muscles hurt?  She doesn't know how to self-soothe, and so anything she feels is probably ten times worse than how you or I would experience it.  When untreated, her tolerance for discomfort is really low.  So maybe what would be a little, annoying ache or pain to me, to her is a major illness blown out of proportion.  I suspect this tendency for intensity of feeling, intolerance of distress and general confusion about feelings might be at play, too.

[Methuen]

But her best tool for controlling the people in her life has always been her health. She's had some real problems over the years, but she's also manufactured or imagined many others. She's talked doctors into performing treatment on those manufactured illnesses and then had new medical emergencies related to the side effects of the treatments. It's hard to know what's real with her because in her mind, everything she experiences is real.

It's like you are writing about my mother.

etown, there is so much in your post that resonated deeply with me.

Yes, my mother uses health issues to use people, get attention, manipulate, control others to have her needs met.

I wish you could see my mom.  I think you would instantly "get" why your post resonated with me.

I get what you mean when you say you are left with a feeling of "dislocation".  My mom lives about 5 min from me and I kind of feel permanently "dislocated".

And you ask about how others have dealt with the guilt.

For me, the guilt has been kind of crippling. I returned to work out of retirement, to avoid the chaos around my mom's expectations of me to "take care of her needs".  People who see her would see physical needs.  But we all know those are on the surface, and the bigger needs are below the surface, inside of them, and no one can ever meet those needs.  Returning to work set a boundary because suddenly I wasn’t available to meet those needs.  The act of returning to work brought an epic rage from her.  Those words cut me to shreds. I felt (and 4 years later still feel) guilt for that.  I feel guilty that I can't help this person I still care about.  I feel guilty that I can't be the daughter I desire to be.  But being around her makes me feel unsafe, anxious, stressed, and "acutely out of sorts", so I keep working instead of doing things on my retirement bucket list.  I have a therapist.  Both my T and my H would support me to retire.  They say to "just do it".  But I haven't been able to.  I am stuck.  I guess I have more work to do to get myself unstuck.

Yes, my mom uses her health issues to get attention from other people.  Yes, she sometimes manufactures them.  One example was to stop taking her heart medication the day before we were to leave on a big holiday.  Then she called us to tell us she felt like she was dying because her pulse/heart rate/ blood pressure numbers were off the charts, and told us to call her an ambulance.  At the hospital, a smart doctor figured out she had stopped taking her medication, and everything immediately went back to normal after they gave her the meds.  She did this to manufacture a crisis so we wouldn't go on our trip.  Back in 2015 we cancelled a big trip after she pulled a similar stunt.  We didn't know better.  But we learned.  So yes, I totally understand when you suspect some of her health complaints might be manufactured.

Years ago she talked a surgeon into doing two hip and one knee surgery within about 3 months of each other.  He of course said no.  But mom was a trained nurse, and sweet talked her rationale, and was relentless.  He did the surgeries.  She never did physio.  Now she can't walk - is crippled up.  Has had falls.  Uses a walker.  Is a shut in.  You would have to see it to believe it.  A good question is why was she so determined to have 3 surgeries so close to each other?

She had an endophthalmitis infection after a shot for macular degeneration.  This can cause blindness.  Because she lives alone, and has Parkinson's disease, and she needed drops in her eyes 4 times a day, I arranged home care.  She eventually cancelled it.  Now she is nearly blind in that eye.  Why do they sabotage themselves like this?  Who wouldn't accept the help to retain their vision?

Everything somehow lands as being my fault.  I don't take good enough care of her.  I'm not there for her.  I'm a terrible daughter.

Aach.  So yeah, I struggle with guilt.  I totally understand why you stayed quiet while she was in the hospital.  But the guilt got to you, so you sent her a couple of messages telling her to keep you up to date.  I understand that guilt too.

I can only speak for myself, but for me I think it comes (at least in part) from "enmeshment".  For much of my life (child, teen, young adult, new mother) I was very close to my mom.  I see now that it was pathological.  She raised me to be her caretaker, her best friend, her parent, her counsellor, her everything.  I tried to be the perfect daughter - get good grades, awards etc to be seen by her.  But I did everything she wanted me to do, instead of doing what I wanted to do. For me I thought she was a normal mother.  She wasn't.  Despite being and doing all that, I am now somehow a "terrible daughter" because I put up a boundary by returning to work and not taking care of her needs.  Her plan for her elder care, was me. But I was never consulted. And she could yell and scream all her projections at me, and I was still supposed to want to take care of her.

Years ago when I joined this forum, a wise person suggested I needed to work on "emotional detachment". 

I am no longer enmeshed with my mom.  It has helped with the guilt.  I see things much more clearly now. 

But these are the mothers who raised us.  They raised us to feel certain things.  Guilt is their tool.  They built the buttons for feeling guilt into us.  They know how to push them.  Are brains have been wired to feel that guilt.  Unlearning that - is hard.

I still feel bad.  Mostly it's grief.  But I still struggle with guilt.  It's not as intense as it was, but it's still there.  And I resent it.

I love the thread you've started here.  It's such a great topic, and one that I believe touches so many. 

Like you, I would love to hear how others have come out the other end of the "guilt tunnel".

It's taken me decades to understand and begin to unravel the effect all this has had on me. I know she'll never understand that because she simply doesn't experience empathy in that way. Her only interest has always been herself--her pain, her disappointment, her fear, her comfort. Again and again she demonstrates this. I've grieved the loss of this ideal form of a mom over and over. I know this is the illness, which was born from her own trauma. I do feel for her, but I have responsibilities that require my attention, ones that aren't just a gaping unfillable wound of need like she is.

This.

So here I am again in the aftermath of one of her freak-outs, trying to figure out how to focus on the work ahead of me. Trying to get my head back in the present and in my own life. 

   When my mind is whirling/ruminating, I've plunged my face into a sink of cold water for a few seconds.  It does re-integrate mind and body and bring one back to the present.

Walks in nature, pursuing a hobby that immerses my mind, an epsom salt bath, grounding exercises...

Sigh.  I hope you start to feel better soon.  You've got this!  We're here for you.

Welcome to our forum. 

[Notwendy]

This tendency to have medical issues got complicated when my father got ill from serious medical issues and eventually passed away.

The attention that BPD mother gets from her "medical" issues shifted to my father. In addition, Dad's function as emotional caretaker for her diminished.

BPD mother's behaviors escalated. Her abusive behavior increased. Dad, being enmeshed and her rescuer, also got angry.

I did feel guilt that I didn't do more for them. They were angry that I didn't. I wanted to but the abusive behavior was overwhelming. I had children at home and a family. They needed me too. They needed me to also be emotionally intact. I had to have boundaries.

I went to see my parents and stayed with them for a while to help. As soon as I returned home, BPD mother called me insinuating that Dad was seriously sick. Even though I had just returned home, I jumped in the car and went back.

When I got there, the home health nurse was on her way. She assessed Dad, had him readmitted for an infection but he was OK for the moment. Dad was being taken care of. I didn't need to be there.

What I realized though is that BPD mother now had a way of getting me to be at her beck and call. "Dad needs you" was another "medical reason" whether this actually was true or not.

I don't post much about the emotional effects of this time period. I was genuinely grieving the loss of my father. BPD mother's emotional and verbal abuse escalated. Dad died, both parents were angry at me. BPD mother "disowned" me (temporarily apparently).

Yes, I do feel some remorse at not doing what I feel is an important obligation, caring for my elderly parents. I sincerely wanted to help with Dad but how much abusive behavior is one expected to tolerate? I couldn't sleep, was anxious. Got myself into therapy.

Even recently. BPD mother is in assisted living. She's a strain on the staff with her behaviors. She recently got sent to ER and admitted to hospital for urinary infection and being unsteady on her feet. She's now in skilled nursing for physical therapy. She leaves a sad message on my phone about how nobody has seen her all day and she feels bad. I spoke to the nurse- she's fine, she's been seen by nursing, social work, PT, and has hired her own private aide to tend to her. ( she does if she has any extra money but she doesn't have a lot).

Much of what she tells me on the phone isn't true. It may be her own feelings. "Nobody" coming to see her means she's alone now but the nurse may have been in there 5 minutes ago.

Yes, she's a sad situation, and I feel sorry for her but it's not possible to know what is real and what isn't, and not possible to meet her emotional needs and expectations. I do what I am willing to do for her. Whatever I do isn't going to be "enough" as far as she sees it.