So Conflicted about what to do

[Depression = 72% of members]

My husband and I have been married for several years, and have two young children together. After we were married, he became very erratic, unlike the man I thought I knew while we were dating. After tons and tons of research, it became apparent to me that he very much fit the criteria of BPD, and that he had a history of abuse and trauma. I told my husband that I could not live with his out of control behaviours - yelling to himself, dissociating, and email/texting rants, where he goes off into another world that is completely irrational and impulsive. Given that I felt unsafe around him, and we both desperately wanted our marriage to work, he agreed to seek therapy. He has been in individual therapy now for close to 2 years, and completed two rounds of DBT. I can see that his awareness and understanding of himself has improved, but his behaviours are still a huge problem - to the point that I and my children have moved out of the house. We have put in so much work into this marriage, even when living separately. The most confusing part to me is that it seems that the more insight he has about himself, the more erratic he becomes. It's like he needs to up the ante in order to get the "release" that he had before. I am so embarrassed by some of the things he has done publicly at this point, that I don't know if I can ever get past it. Does anyone have any explanation as to why someone in treatment who seems to have greater insight would look worse instead of better? How long does it typically take for a person with BPD in treatment to become relatively stable?

[Horselover]

My husband and I have been married for several years, and have two young children together. After we were married, he became very erratic, unlike the man I thought I knew while we were dating. After tons and tons of research, it became apparent to me that he very much fit the criteria of BPD, and that he had a history of abuse and trauma. I told my husband that I could not live with his out of control behaviours - yelling to himself, dissociating, and email/texting rants, where he goes off into another world that is completely irrational and impulsive. Given that I felt unsafe around him, and we both desperately wanted our marriage to work, he agreed to seek therapy. He has been in individual therapy now for close to 2 years, and completed two rounds of DBT. I can see that his awareness and understanding of himself has improved, but his behaviours are still a huge problem - to the point that I and my children have moved out of the house. We have put in so much work into this marriage, even when living separately. The most confusing part to me is that it seems that the more insight he has about himself, the more erratic he becomes. It's like he needs to up the ante in order to get the "release" that he had before. I am so embarrassed by some of the things he has done publicly at this point, that I don't know if I can ever get past it. Does anyone have any explanation as to why someone in treatment who seems to have greater insight would look worse instead of better? How long does it typically take for a person with BPD in treatment to become relatively stable?

[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.

[Lauters]

Well, I'm not an expert, but I can only give you my view on the situation you're in (which must be very hard and confronting).

Is the therapist aware that your husband has BPD? A lot will depend if he has the lower functional conventional form or the higher functional invisible one (or a mix of both is also possible). My wife has the invisible form, so she behaves perfectly normal in the 'outside' world, with as a result that therapy makes things initially worse. She tells them that she only has problems at home, so they believe that it is all about family dynamics. To a certain extend, this is true: a lot can be solved/avoided with a better and emphatic communication. But, they advice her to stand on her limits, which ends in even more raging and verbal aggression at home.
Problem is that most therapists do not know a lot about BPD, as is mentioned in one of Randy Kreger's books. Indeed, only 3 pages (out of the 1200) are dedicated to BPD in the DSM-4, and a few more in the DSM-5 (according to ChatGPT). That is a half % for an illness that occurs for nearly 5 to 6% in the population. So, I would not expect too much from therapists. My wife has a stable and contineous carreer, she doesn't do drugs, she never did a suicide attempt, she doesn't show risky behaviour; so from their view point she cannot have BPD (if one is not aware of the invisible form, which is not or hardely mentioned/described in the DSM).
So indeed, in some cases therapy makes the situation worse. But therapy will not solve the problem anyway. It takes just one person to change a relationship: and that will be you. Don't expect this from you partner.

I hope that I didn't discourage you too much with my reply. There is hope, but most of the times it is a long way with a lot of obstacles. But you're not alone!

[CC43]

Hi there,

I think it's great that your husband is getting therapy and sticking with it.  Alas, treatment for BPD takes a lot of effort on his part, as well as a willingness to change, in order to start to feel better.  Change is hard for most people, especially if it's changing learned behaviors and ways of thinking.

Does your husband have a victim attitude and blame others, especially you, for all his problems?  I think this is perhaps the worst part of BPD, because it basically renders him helpless.  If he's not responsible for causing his problems, he thinks that others should change, not him.  On top of that, he feels powerless much of the time, a victim of his circumstance.  With powerlessness, he feels shame, too, like he's not good enough.  His self-confidence is in the pits.

I can't help but wonder, after he learned of a BPD diagnosis, if he felt even more shameful about having a personality disorder.  There's still a stigma about this.  Rather than frame it by thinking, he has some challenges in dealing with his powerful emotions, and he needs extra support right now to get a better handle over them, as well as to recover from the trauma of a high-conflict/high-stress period in his life, he might see the diagnosis as a condemnation.  Or he might see it as an excuse.  Since BPD often is associated with a weak sense of identity, he might struggle to know who he really is and what he really wants.  A healthy person might think, I have to focus on treatment right now to get better, and get my family back, because that's the most important thing.  A healthy person can find the inner resources to make things happen.  But someone with BPD really struggles.  Sure, one moment they could have clarity of thought and purpose, but they easily get derailed by a minor setback or emotional outburst, and quickly get into a negative, hopeless mindset.  Sound familiar?

Look, I have an adult BPD stepdaughter who got intensive treatment for BPD after her life fell apart.  Granted, she was younger than your husband, and that might have helped her, as did having the support of a loving father who became a partner in her recovery.  The good news is that after hard work, she fought her way back.  Her life looks much healthier now.  The frequency, intensity and duration of her emotional outbursts have much diminished, and suicidal talk/attempts are off the table.  She doesn't indulge in rages like she used to.  Though she's still extremely emotional and gets distracted by minor setbacks, she's not flying off the handle or totally losing touch with reality like she used to.  I bet she wouldn't qualify for a BPD diagnosis anymore, though her emotionality, impulsiveness and weak sense of identity are still strong.  With ongoing therapeutic and family support, she is working on creating an adult's life for herself.  That gives me reason for hope.

But I'll be honest, there's no quick fix for BPD, and progress doesn't happen in a straight line.  There have been setbacks.  The pattern seems to be that, as she reaches another adult milestone, such as going to a job interview or searching for an apartment by herself, she will rapidly "regress" whenever something doesn't go her way--like not getting the first job she applies for or being rejected for the apartment because she has no income.  Her expectations tend to be too high and verging on delusional (i.e. getting things she wants on the very first try, or thinking a landlord will sign a lease for someone with zero income), and at the same time, I bet she fears that when she gets a job or apartment, she'll be alone, or that the parental support will be withdrawn, and she's terrified about that.  I think her underlying issues are fear and uncertainty--about herself and about the future.  It's as if her ability to tolerate distress and uncertainty is minimal.  She's plagued by anxiety over every little thing.  To cope, she tends to retreat in avoidance (napping, escaping, watching TV), which means she's a terrible procrastinator, and then the days will fly buy, and she'll be mad at herself for not doing the things she had planned to do.  She's full of intentions, but she's mercurial and can't really act on them.  Worse, she feels deep shame, because she thinks she's a failure.  But she's not a failure because she's intrinsically dumb or incompetent--she's a failure at some things because she's too scared to try, as her expectations are unrealistic.  Her outlook is so negative sometimes, I can hardly stand it myself!

I guess my assessment of someone who is trying to recover from BPD has a slightly different set of issues that might not get as much airtime on these boards.  This is what I see:

Behaviors that got the pwBPD into treatment:
*Persistent angry rages/violence
*Suicidal gestures/attempts
*Ruptured relationships
*Dysfunctional life (addiction/long-term unemployment/loss of housing/run-ins with police)
*Temporary bouts of disassociation/loss of touch with reality
*Constant blaming of others/wildly distorted perception of events

Behaviors that persist after getting intensive treatment/during recovery:
*Difficulties with prioritization/focus
*Unrealistic expectations
*Impatience
*Ongoing shame and self-doubt
*Heightened anxiety
*Glimmers of past BPD behaviors (rages/blaming), but less frequent/severe

What has helped me is to think in terms of baby steps.  Change is hard, so I try to look for small changes, one at a time.  The first change for my stepdaughter was merely to attend therapy sessions.  That became her sole focus for a time.  Then there were small changes in daily habits, like following regular sleep times, eating meals (not snacking/grazing on junk) and getting outside and getting some exercise.  Then a small change was taking an online class.  Only once she showed that she could handle all this did she progress to two or three classes.  Then she added a part-time job.  Even after all these changes, she wasn't ready to repair some ruptured familial relationships.  I think she needs to build up her identity first, before she'll be on enough of an "equal footing" to repair relationships with family.

Just my two cents.  All my best to you.

[Horselover]

Thanks so much for these in-depth replies. They are both very insightful and relatable.

In response to Lauters, the therapist informally said that my husband has "BPD traits", so he didn't receive a formal diagnosis, but I think this is because the therapist is more focused on treatment/therapy than assessment. I am quite sure that my husband qualifies for the full diagnosis, and in his 20s, he had several psychotic episodes following great periods of stress. As well, he struggled with drug related issues and suicidality in the distant past, none of which he disclosed to me before we were married. Currently, he would probably mainly be classified as the "higher functioning" type, as he does not struggle with the latter issues anymore. I wouldn't call it invisible like your wife, as it does affect him in the outside world, but he appears much more high functioning there than he does at home. He is well educated, has a lot of experience in his field, and can hold a high powered job for a period of time, but inevitably he will have a fight with someone at work and abruptly quit or get fired. Also, although he is seen as a generally functional and well-liked person in the community, he behaves very erratically with my extended family, and will send ranting emails to my siblings etc., in an attempt to get close to them  (he doesn't seem to know how to form healthy, functional relationships). So his behaviours extend beyond the immediate family unit, although that is the main area where they appear and affect him.

Back to the therapist, I chose him (my husband asked me to select one for him) because this particular psychologist did an extended internship with the BPD population and was very familiar with DBT. So he does have that background and experience . However, it is not his current focus, and he has an "emotion focused" slant in addition to being "DBT informed" (a term used by the therapist). In addition, my husband was simultaneously attending actual DBT groups for pwBPD while attending individual therapy, but after about a year and a half he decided to just stick with the individual therapist, whom he likes very much. I agree that therapy does not completely solve the problem, unfortunately, and I have had similar issues that you described about the therapist not really challenging my husband on his "boundaries" and then these limitations wreaking havoc in our relationship.

About the concept of only needing one person to change the relationship, and that person being me, that is what I have been focusing on for the past year or so. One of the reasons I moved out of the house with our kids is because, while I would prefer not to get divorced, I needed to feel grounded and happy with my own life while my husband tries to work through his issues. And I could not feel stable and grounded knowing that he could suddenly start screaming or slamming doors or lock himself in a room while I and the children are around him (clearly my tolerance for erratic behaviours is not too high . I've also been establishing concrete boundaries about what I can and can't handle. I don't text or email him anymore, as he tends to become delusional in these domains, and go on rants where he does not stop for hours and hours or sometimes days. So he knows I will not engage with this at all. In our phone conversations, I tell him that if he starts screaming I will need to regulate myself and will have to stop the call. In person, I leave the room or area if the same thing happens. Obviously, this would all be a lot harder if not impossible if we lived together. At the same times, I try to offer encouragement, warmth and support when I can.
I've been watching a lot of videos on a YouTube channel about called "Put the shovel down" that offers guidance to family members of loved ones with an addiction, and although the problem here is not an addiction, I find a lot of the ideas very helpful.

The problem is that I would like for us to be moving towards living together as a family!!! What I find is that we are in this constant cycle of seeming to take steps towards spending more time together, or he will come up with a plan for moving forwards, but this only lasts for a week or a few weeks and inevitably he "loses it" and we are back to square one. Sometimes, it almost seems like he is doing it intentionally on a subconscious level, as though he both wants to have a family, but is too scared to live as a family, so needs to sabotage it. So do you have any advice on how I can shift things in this area and actually help us to move forward? Or is it my job to just accept that I can't do anything about this? As I said, there is also this strange paradox that, as he has attended more therapy and become more and more aware of his feelings and where they are stemming from, he becomes more and more triggered. It's like he is totally exposed and naked, and has no more defence mechanisms, so he just wants to scream and hide (he has literally locked the door to our house and said he can't handle seeing me and the kids), and while he used to implement DBT techniques at times, it's almost like he is so overwhelmed, he doesn't even try anymore.

CC43, you described so many aspects of my husband's difficulties so perfectly, it sounds like you've met him! He definitely has a victim mentality and blames me all the time! His self-confidence is so low, despite being such a capable person, and I figure some of that is related to the abuse he experienced as a young child. Everything you are saying about him having clarity of thought one moment followed by delusional thinking is spot on. I think that before he got married, he was doing ok in the little bubble he created for himself, but being a husband and father was just too much for him. I can relate very much to what you are saying about stress and setbacks. How do you deal with delusional thinking and the victim mindset? How do you deal with goals that are completely unreasonable? He does this all the time! I try to explain that he can accomplish a lot more if we come up with small objectives and do them consistently, but his plans are almost always completely grandiose and beyond his abilities. Do you point out when your stepdaughter makes no sense, or just let her figure it out?

Is there anything anyone can think of that I could be doing that I am not doing? I wish we could move towards living together in some form (even some idea like having adjacent apartments where we go back and forth and he has his own space), and am willing to give him time to heal himself even if it takes some years. I just don't want to live in this limbo forever, and I am not working with someone who is capable of coming up with a sensible plan and following through with it. Sigh.

[Lauters]

You're doing well and you're very brave. It must take a lot of courage to go and live apart taking care of the children. Maybe I should have done the same some 20 years ago. But I underestimated the situation and the effect on the children (at least on my younger son). So, somehow I feel that you should give me some advice instead of the way around  .

I think that we are not capable to really imagine how it feels to be in their Splitting-Shame-Fear spiral. It must be devastaging for them. So, your husband going to a therapist is already a giant step. And if the therapist has knowledge of the illness, that is really a good thing. In my case, the therapists blame me for thinking that my wife has a disorder (whatever the label). My feelings about this are that, or they are not really aware of what BPD exactly is, how complex it is (except for the lower funtional form), or that they are extremely clever: telling the person that she/he has BPD just makes things worse (I know this because I made the mistake). But in the latter case, I feel that they should at least tell me.

My next step is to try to find some litterature about the Karpman Triangle. The right communication skills can help a lot in avoiding or decreasing moments of crisis. My wife also gasps for more connectedness and a family. But she doesn't understand that it is partly her behaviour that counteracts her longings. And an inadequate reaction from our side to her feelings: we're only human, so we also make mistakes! So, I'm going to work more on these skills: try to better listen empathically, get out of the  negative interactions described by Karpman.

I wish you (and myself) a lot of strenght. Kind regards.

[Lauters]

Aso the book by Kreger 'The essential Family Guide to BPD' helped me a lot: I even made an 8 pages long synthesis of it. The second half of this book provides you with 5 'Power Tools' in order to enhance your relationship.

[Horselover]

Thanks again for your support and encouragement. It was definitely a big step to live separately with our children, so it feels good to hear that hopefully I made the right decision. I will check out the resources/books that you recommended.

I'm sure you're right that we really cannot comprehend what our spouses with BPD are going through and how they experience life. Even with therapy, it seems to be a very, very slow process of change for my husband, and it is so hard because the demands upon him outweigh his capacities. It might be easier for him to heal if he was younger, and did not have the responsibilities of a relationship and children, as he can barely understand himself and take care of his own needs, leave alone others. I have removed pretty much all responsibilities from him in terms of raising our children, and I try to do whatever makes me happy and not rely on him for things in general, but even the few needs I have or want him to accommodate are very stressful for him.

So this is a huge challenge, and I don't really know how we can ever be able to live together!

[Horselover]

And I wish you strength too in navigating your situation