Husband has BPD - rock bottom

[winter_horse14]

Looking for validation and coping strategies for myself, both to care for myself and in interactions with my husband. I am critically examining the relationship and keeping "should I stay/go" conversations only with my therapist and close friends/family, so will not be discussing that online.

My husband has CPTSD and (VERY likely) BPD. The BPD piece has been brought up by his therapist in the past month and truly seems to fit. We have been on a rollercoaster for 6+ years and this seems like the worst place he has been yet.

For the last six weeks he has fallen into a very deep place of vacillating between extreme dissociation and rage. He left his job (I supported this at the time), feeling completely burned out and that he didn't have the mental space to work on himself. His job was objectively VERY stressful, but I am realizing that the burnout was truly more from his inner emotional landscape. He is looking for another job and seems to be doing so-so managing the job search. He is also deeply depressed. In December he seemed more centered and calm, no raging outbursts, then they started very quickly after realizing he wanted to leave his job. These outbursts are sparked when I ask him for something, hold him accountable, etc., and can include claiming I said or did hurtful things that I did not, blaming me, blaming others, swearing, rude comments, screaming. He will then often minimize what he did later. At other times he will acknowledge what he did and express that he is really scared and feels broken. He is really emotionally distant from the relationship at this point and though I have asked at great length he will not talk about physical intimacy and at times has blamed me for the lack of physical intimacy (I recognize this is not the most vital issue at this time, but this aspect has gotten really sad and lonely for me). He sees his friends once every 2-3 months and doesn't stay in touch with family, and has a couple hobbies but is struggling to even do those. He doesn't exercise and seems miserable most of the time (or will put on artificially happy face if he does see people, but has admitted that he's mostly dissociating at those times).

There are these "troughs" of dark times like this, and they come and go 2-4x a year, and can last months. Then he'll calm, his tone and facial expression and "self" will come back, but it seems like never long enough for us to really repair and reconnect. He'll vocalize using his DBT skills at these times, opening up more, taking breaks, being patient and calm, expressing empathy, etc. Then a crash will happen at some point again.

We both did DBT 1.5 years ago. I did it to help with emotion regulation and depression, and it was truly very helpful for me. He did it do help with these outbursts, dissociating, depression, anxiety, etc. We have done extensive therapy together and separately, including IFS (parts work).

His mother and father have always been extremely emotionally neglectful and abusive, and we became estranged from them in 2020. His sister also struggled extensively with mental health challenges.

He's on very little medication right now because his DBT therapist thought he was doing really well this summer. We are talking to a new prescriber on Friday who seems really good and actively looking into an intensive outpatient program/PHP/intensive DBT. He is highly educated (a doctor) and intelligent, yet right now is dissociating so badly that he is forgetting why he is calling these places, thinking he should cancel the appointments, etc. He has a really good therapist he's been seeing for years and she see EXACTLY what is happening. I attended his last meeting and she really validated me, validated him and also was tough love with him.

I am staying with my parents for right now, and taking space to calm myself and care for my own internal system. I have a strong support system and am also really leaning on the skills I've learned in therapy. I'm mostly letting him manage pursuing care, but am attending his meetings to hear what is going on, share my insight where appropriate and just kind of factually checking up at times "Did you call so-and-so?" "Remember, this is why you're going to this meeting." Validating his feelings but not agreeing/arguing. I am just struggling with how to handle this situation. I have never seen him so dissociated and often deeply confused, almost seeming like a psychosis at times, and I am extremely concerned and he truly seems to be in crisis to a point I've not seen before.

As I said above, I'm really critically looking at patterns, behaviors, etc. and considering how/if I want to move forward, so I am not looking for advice on that. More just how to navigate this unclear time--tips for caring for myself and for loving someone who is in crisis?

[RELATIONSHIP PROBLEM SOLVING]

RELATIONSHIP PROBLEM SOLVING This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members are welcomed to express frustration but must seek constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[kells76]

Hi winter_horse14 and a warm

This sounds like an exhausting chapter in your life, that you're still in the middle of -- kind of waiting to see how things shake out so you can make those "if A then B" decisions.

And it's not like you're new to treatment/support for challenging relationships. It's good to hear both of you did DBT and, in your different ways, retained some of those skills... yet that doesn't make today and your near future simple or easy.

Couple of thoughts, and you can see what seems to fit:

-this seems like a really undefined time right now, where symptoms/behaviors have intensified and you're waiting to see how things go with the new prescriber, and what doors might open with an IOP/PHP. Are there any "deadlines" or timelines associated with those interventions; something where you have definite dates for getting info back? I'm wondering if having some concrete dates may help you figure out how you want to navigate this nebulous time. Kind of like -- if you know that IOP Clinic A will tell you "yes or no" by February 21st, then instead of having to figure out the next 3 months, you can narrow your focus to: here's my plan for the next 7 days. Or, if those places aren't giving you concrete dates, maybe you can set some for yourself: "If I don't hear back from PHP X by February 27th, my next step is to call PHP Y on the 28th". Finding areas in this cloudiness that are under your control to make clear, could help.

-again with the idea of "narrowing the focus" during this chapter -- I'm curious if there are areas in your life you would feel okay with jettisoning right now or letting lapse, to pivot that energy to other areas? Can you hire a housecleaner, have a friend do meal prep for you, ask a neighbor to walk your dog...? Not suggesting ditching "self care" areas (unless cleaning the house is self care for you!), more peripheral things just for now, to make it through.

...

Am I tracking with you that your H is on board with stepping up to a PHP/IOP?

And do the two of you have any kids?

...

We're looking forward to walking with you on your journey, no matter where it goes;

kells76

[winter_horse14]

@kells76 - Thank you so much for your response and support. It's hard to throw something like this into the void of the internet, but I want to hopefully find some support and constructive ideas from people who have been through some similar things.

I think your suggestion of narrowing the focus (for timing and otherwise) is really helpful. I keep mentally going out years and speculating, but really I think coping right now is getting through smaller periods of time as I get new pieces of information. I'm going to practice this perspective and I appreciate you sharing it.

Correct, my husband is on board with IOP/PHP. My actual concern is wondering if he's really ready to get better and start to heal--he will promise the moon to not disappoint me or his therapist but then does not follow through well historically for either of us. I'm guessing because the stakes are high in those relationships--when it comes to friends or workplace he's very reliable, but he keeps his "happy face" on with those people.

No kids, just two cats and a dog.