Convincing BPDw to get therapy.

[maxsterling]

My W was diagnosed BPD as a teenager - 30+ years ago.  Considering this was not long after the DSM started including BPD, I assume her symptoms were obvious at that time.  She's been in hospitals and had some kind of therapy off and on since then, including DBT 20+ years ago.

Lately, all she has been doing is talk therapy, mostly virtual about every other week, and often cancels.  Instead, she tries managing her issues with medication, both prescribed and unprescribed.  I was unaware of how seldom she was meeting with her T until last's week's major crisis.  During the crisis she claimed she called a crisis line, but I found out later she lied about that.  And when I sent a crisis team to her location, she told them she was not in crisis and asked them to leave.  It's been a week, and she *still* has not met with her therapist other than call the T in front of me to prove a point.

She needs more intensive therapy.  For those of you who have successfully convinced your pwBPD to get therapy, how did you approach this?  I think having some kind of ultimatum (get therapy or XYZ) is just going to send her the other way.  Is it worth me talking with her T myself and explaining the situation?  Part of the reason she does not meet with her T very often is she feels her T pushes her too much.  My gut tells me eventually (probably sooner than later) a court will order her into it when she rages at someone who reports her to CPS (she's a teacher, and last school year several parents called the school with concerns - another incident is guaranteed).

Next week we are planning a vacation to visit some of her family.  I don't have enough vacation hours to be with her the whole trip.  The main reasons I am going are 1) minimize the time she is alone with the kids 2) to talk with her family members about what is going on.  Otherwise, I probably would not go.  I am hoping that other family members can help convince her that she needs a treatment plan.  Coming from me she won't listen.

Right now, rather than seek help, she is reorganizing the house again, buying things we don't need, ANYTHING that keeps her from addressing her problem. 

[Notwendy]

IMHO, I don't think an ultimatum is helpful.

Yes, your wife needs intensive therapy- but for any therapy to be affective, the person needs to be motivated to work at it, be able to have some insight into their own behavior. You may be able to get your wife to go to therapy by somehow forcing the issue- but even if she did- would she, herself, be motivated to work with it? She may go there- to because you gave convinced her to go, but would she actually do the work? How would you be able to assess that?

Why now? What has happened that you are wanting to try this now?

Your wife's family probably know your wife has these issues. Also her family has their own dynamics. Do you think her family would support your perspective if you speak to them?

[Anonymous22]

I tried for years to get my uBPDh to go to therapy. Like your W, he would agree, even schedule an appointment and he would still back out at the last minute...he was too tired, he had work he had to do, its been too long of a day, he doesn't feel like dealing with issues right now, I am the messed up one and he doesn't need therapy...you name the excuse, I heard it.  I tried every approach that I could think of, family therapy, he agreed but when the therapist wanted to meet with each member separately before meeting together, he bailed; couples therapy, he agreed to a session with a therapist whom he got to pick out, but stormed out the first session saying that I somehow knew the therapist so of course she would side with me (ahhh!), then we purchased a couple's therapy program for $1700 and he canceled when it was his turn to meet alone with the therapist losing our money.  I suggested therapist after therapist, got him on wait lists and when it was his turn, he would back out or he would go to one or two sessions and then never return.
 
It literally took him hitting rock bottom and being forced to see the legal consequences of his actions (and probably some persuasion from a lawyer) for him to realize that he does need help, and even then it took some time and finding the right therapist to help him. 

If it was me, I would not try talk to her therapist as that's not what I would want someone to do to me, I would not talk to her family as they will most likely back her and let her know what you said to them which will come back at you probably in the form of another breakdown, and I would not protect your wife at work, let her see the consequences of her actions, you can be there for her, but don't "fix" it or hide anything.  If CPS gets called on her, maybe it will help her to see that it is her and not everyone else.  I wouldn't try to "fix her", I would let her live and fall hard like you believe she probably will.  If she has another breakdown call 911 or drive to the ER if you are in the car, I wouldn't even tell her that you are doing so, so she doesn't have time to fake that all is ok with her.  It sounds harsh, but in reality there is absolutely nothing that someone can do to help someone else if they don't want the help, or think that they need the help.  Instead turn to working on yourself and learning how it is best to deal with each outburst from your wife. 

I am not going to lie, what my h and I have been through has been pure hell, but when I finally decided that I couldn't cover for him any longer or hide his actions he was forced to look himself and thankfully has turned in a positive direction, though we still have a never ending road ahead of us.  BUT...I have had to do a lot of work on myself as well, learning how to cope with these situations, how to not get sucked in to the crap but instead validate, not take anything personally and walk away; how to positively communicate to a brick wall when he is ignoring me; how to respond with love when what I really want to do is defend myself, scream and put it right back on him; and overall how to be ok sitting in my own emotions when his are ranting and raving...and I have to work on each of these every day.             

[maxsterling]

Why now? What has happened that you are wanting to try this now?

Your wife's family probably know your wife has these issues. Also her family has their own dynamics. Do you think her family would support your perspective if you speak to them?

In short, last week's event was the most serious in the 12 years I have known her in terms of safety for her and for those around her.  Without going into details, her behavior set forth a chain of events that led to an accident that could have killed my parents.  It's now gone beyond me and the kids to affect extended family in a way that that may be irreparable.  Until now, I trusted that she would voluntarily seek out resources if she knew things were bad.  Now I know that isn't true.

My wife's family knows all about her issues, but maybe not to the depth.  They are well aware of the issues when she was a teenager and early 20s, but maybe not that the issues continue to today.  They definitely would support my perspective, and I fully expect that when I visit them they will ask me privately what is going on. 

[maxsterling]

I wouldn't try to "fix her", I would let her live and fall hard like you believe she probably will.

This is inevitable.  And I often feel I may be preventing it.  Last week she ran off, and I fully let her so that she face consequences for her actions.  And she did for about 24 hours.  But then the police told me if I did not come and get her they would arrest her for trespassing implying that she was my responsibility - I went and got her.  Had she been arrested - I dunno - I think she would have blamed it on others' actions rather than look at her own.  Plus, she had our dog with her, and I was also concerned for the dog.

I was doing much better dealing with her by doing the things you mentioned, but last week was a real wakeup call that someone could seriously get hurt or killed.  My T reiterated to me that goal #1 is safety for the kids and for myself. 

[Notwendy]

It's now gone beyond me and the kids to affect extended family in a way that that may be irreparable. 

Is this because wasn't contained within the family? That is how it was in my FOO- people outside the family were not to be told what is going on with BPD mother. I imagine it would be akward and maybe impossible to get together as family after this.

This situation is similar to what I experienced with my parents. If the behaviors were mostly at home and not so escalated, then it wasn't a "crisis" situation. But at times, the behavior would escalate, to the point where others may notice or be affected. After the "crisis"- she'd generally go back to baseline and the usual family pattern.

Although DBT therapy wasn't known at the time, BPD mother had psychiatric and mental health therapy - but on her own terms.

I am glad you have a counselor who can be of support to you and keep you focused on your and the kids' safety. Perhaps the counselor can advise you on possible resources or ideas to get your wife to some sort of help, but whether or not that is possible, taking care of your own well being is important.

[PeteWitsend]

This is inevitable.  And I often feel I may be preventing it.  Last week she ran off, and I fully let her so that she face consequences for her actions.  And she did for about 24 hours.  But then the police told me if I did not come and get her they would arrest her for trespassing implying that she was my responsibility - I went and got her.  Had she been arrested - I dunno - I think she would have blamed it on others' actions rather than look at her own.  Plus, she had our dog with her, and I was also concerned for the dog.

I was doing much better dealing with her by doing the things you mentioned, but last week was a real wakeup call that someone could seriously get hurt or killed.  My T reiterated to me that goal #1 is safety for the kids and for myself. 

You need to perhaps take a step back and see your role in all this.  You're not helping her, you're enabling her behavior; you didn't allow her to see the consequences of her actions, you went and bailed her out. 

You're blaming the dog here (LOL), but could you have told the police you were picking up your dog but not your wife, and to go ahead and arrest her?  THAT would be allowing her to see the consequences of her actions.  I'm serious with this part of the question.

What was even she doing?  Trespassing means she had gone on someone's private property uninvited.  Did she break into a building?  Where was she? 

It may not be easy for your to stand up for yourself and stop the enabling; but that's something you may also need to get counseling for yourself for, so you can recognize these things better.  I am not defending your wife's actions here at all, to be clear, but in your posts, I get the sense you are not seeing the forest for the trees, and that's why you keep struggling to deal with her highly inappropriate and reckless behavior.   

[PeteWitsend]

Note that what Notwendy said is important here: she has to be motivated to go. 

If she's facing ultimatums from you or other family members, or otherwise feels cornered or forced into it, she might go, but then she's not doing it for her, she's just going to go to "check a box" to get you and anyone else off her back.  It's not going to result in any meaningful changes, and maybe not even any short term improvement.  She'll use therapy itself as an excuse to further justify her behavior. 

When pwBPD go to therapy because they're forced to, or feel like they need to in order to save a relationship, they're just looking at it as an opportunity to validate that they're not the problem.  It's highly unlikely they're going to be up front and candid with the therapist about their behavior and their role in conflict, and are going to use the sessions to avoid taking responsibility for their actions.  Expect what they say to the therapist to be highly embellished in their favor, or even completely untrue.  They may even admit their behavior was wrong in an instance, but only to the extent they can blame their reaction on you or someone else... which may seem like progress, but it's really not.  In the end, they're still going to act however they want, with the burden being on everyone else to walk on eggshells constantly lest they trigger another explosion from the BPD, which of course, was the problem you wanted them to get therapy for in the first place.

I've seen a lot of people share stories here consistent with this, and it was also my own experience.  BPDxw would only go to therapy to the extent she could control the sessions and use them to avoid accepting responsibility for her actions.  On the one occasion we had a therapist who tried to pin her down, and would not allow her to scream and deflect responsibility from herself, she stormed out and refused to go back.

[Notwendy]

I think the idea of "hitting bottom" /deciding enough is enough, goes for the non partner as well. When/if this happens is individual. I think it is possible to be at a sort of status quo for a while, even if it is challenging, with enabling. It's a challenge, but it's not so bad that the non is motivated to change their enabling behavior.

In my own family of origin, between my parents, the status quo was more maintainable when it mainly affected the immediate family. There were various crisis but if they involved other people- other family, police, then, then the status quo is challenged.

I wish there was a way to act on the person with BPD- to make them motivated to do the work to help their situation, to get therapy, but the reality remains that we can not change another person. Where we can change a dynamic between two people is to change our own enabling behavior- but this is also challeging and may risk a reaction from the person who is being enabled. The enabling works for them. They have no incentive to change, if change was possible.

For some people- they may not ever "hit bottom". The situation may be difficult but it may not be "bad enough" that they choose to change their behavior. What happened with your parents was scary, but perhaps not bad enough for you to say you've had enough of this.

I say this with understanding, not a criticism. This was the pattern between my parents. I understand your sister's perspective, seeing my father in this situation. I didn't want this for him and neither does she, but as an outsider- their relationship was more complex than any outsider could understand. She may see your wife as the problem, and you may see her need for help as the way to fix the situation, but the dynamics involve you both.