Pathological Dissociation

[How to communicate after a contentious divorce...]

My wife w/BPD was brought by ambulance to the ER because she "passed out" at work due to what is called dissociation.  This is about the 10th time this has happened in the last year.  Several of her co-workers told her she did not look good/was pale.  She did not respond to coworkers and was brought by ambulance.  I think stress is probably the main factor in these episodes.

My therapist thinks that much of her behavior is intentional, attention seeking behavior.  She knows that she will be cared for in a hospital and get some time off of her dreaded work.  She does many things to focus on mindfulness and staying grounded at work, but either they aren't working or her episodes are intentional.  She tries to say that she was not aware in anyway of her dissociation and thinks she should not be held accountable for it.  I have essentially mentioned at this point it doesn't matter whether this behavior is pathological or not because the emotional and financial costs occur regardless.

I already have got a legal separation of finances.  We do have a 4 year old child.  I have made it clear that another psychiatric inpatient hospitalization would lead to us living separately.  I also have made it clear that dissociation is not an acceptable coping mechanism.

Should I just realize that she either refuses to or cannot control her behavior?  I personally believe the behavior is intentional and impulsive.  I have a boundary that I will not pick her up from a hospital, work, or ER if it is caused by her behavior.  She was understanding of this.  I'm not sure if she was trying to test that boundary or what.

I want to make taking care of myself and my daughter a priority.

[Michael43]

My wife w/BPD was brought by ambulance to the ER because she "passed out" at work due to what is called dissociation.  This is about the 10th time this has happened in the last year.  Several of her co-workers told her she did not look good/was pale.  She did not respond to coworkers and was brought by ambulance.  I think stress is probably the main factor in these episodes.

My therapist thinks that much of her behavior is intentional, attention seeking behavior.  She knows that she will be cared for in a hospital and get some time off of her dreaded work.  She does many things to focus on mindfulness and staying grounded at work, but either they aren't working or her episodes are intentional.  She tries to say that she was not aware in anyway of her dissociation and thinks she should not be held accountable for it.  I have essentially mentioned at this point it doesn't matter whether this behavior is pathological or not because the emotional and financial costs occur regardless.

I already have got a legal separation of finances.  We do have a 4 year old child.  I have made it clear that another psychiatric inpatient hospitalization would lead to us living separately.  I also have made it clear that dissociation is not an acceptable coping mechanism.

Should I just realize that she either refuses to or cannot control her behavior?  I personally believe the behavior is intentional and impulsive.  I have a boundary that I will not pick her up from a hospital, work, or ER if it is caused by her behavior.  She was understanding of this.  I'm not sure if she was trying to test that boundary or what.

I want to make taking care of myself and my daughter a priority.

[JohnLove]

Sorry to hear of your struggles. I have witnessed pathological dissociation... .but it didn't look  (or feel) anything like this. This sounds so much more serious that I suspect it's actually something more complex... .

[formflier]

What does your partners medical team think is going on?  Have they given a  diagnosis and plan of treatment?

At first blush, this seems complex (I agree with JohnLove) and I'm concerned that the situation is not fully understood.

Frankly, I see    when a persons apparently reasonable actions to seek help and stay safe (going to a psychiatric facility) are used to determine living and/or custody arrangements.

      I can imagine how tough this is.  Can we all slow down and get a care plan from the medical professionals.

Please... .if you have questions about how to best care for your partner... .submit them in writing to your partners medical team.

FF

[teapay]

Having gone through similar with my W, I have a similar boundary of separating with her if hospitalizations continued.  My W’s hospitalizations were costly and threatened the family finances.  The instability of finding and affording child care for our five kids while I was at work was also threatening my job and our finances.  In my case, the knowledge that I would separate or divorce her as a result of continued hospitalizations was enough to stop them and force my W to cope differently or lose her family.  I haven’t had to deal with that for a few years now.  I might tolerate one now, but not repeated ones.  I look at mental illness the same way I view alcoholism or addiction.  If these conditions veer into situations where the family is threatened the sufferer needs to resolve their issue or lose the benefits of being in the family unit.  It’s unfortunate for them, but those are the wages of mental illness.

[asiyah93]

Wow. I didn't know pathological disassociation was a thing. I witnessed it when my exBPD person a few months ago after I discovered he stole money from me. When he couldn't intimidate me as he normally would because I was on the phone with my nonBPD SO, he all of a sudden started hallucinating and saying he was having a heart attack, couldn't feel his body, was sick, etc. I didn't know that was him disassociating, but I knew it was an act, I knew it was intentional to distract me and get me to rush to his aid, and it didn't work. I simply said, "ok then go to the hospital." Minutes later, he's suddenly "ok."

[Michael43]

***Update********

I did meet with my wife's therapist today.  In her opinion her behaviors do not warrant a diagnosis of dissociative identity or dissociative amnesia.  This is likely just a complex form of PTSD or BPD.  My wife does have a history of sexual abuse in her past.  Her therapist feels that this behavior is an automatic response learned from her childhood that is not an appropriate coping strategy and is being targeted for extinction.

However, this does not mean that my wife doesn't do things for attention.  When my wife has a friend or co-worker drive her to the ER for minor headache or back pain, then that is definitely pathological, intentional, and likely attention-seeking.

This visit gave me a better understanding of her episodes.  Our boundaries we have are still in place.  I'm glad that I was able to get more information about her dissociation.

[Sunfl0wer]

She tries to say that she was not aware in anyway of her dissociation and thinks she should not be held accountable for it.

Just felt like chiming in and saying... .
Speaking as a person, who last year I was diagnosed with OSDD (basically a light version of DID) I am absolutely accountable for anything I do, all of my Parts, Fragments and Pieces or whatever you want to call them.  Sure, I may not always be aware of what other Parts of me do or think and such, but bottom line, I am always accountable for my actions no matter what aspect of me did them.  Most persons in treatment for DID or OSDD or other forms will be taught by their therapist that yes, we are accountable for all of our Parts.  

I often cannot control my dissociation, however, I can control and use my coping strategies and such of course.  I am responsible for that much.  

Anyway, glad your wife is not that severe with her dissociation, however, imo, the BPD stuff is really hard stuff on its own none the less.  Sounds like the talk you had with her therapist went well and helped you to understand some things.

[empath]

To piggyback on Sunfl0wer, I had PTSD with flashbacks for many years in my childhood - dissociation from reality into a different time and space. I was aware of those times and quite troubled by them because they were times of extreme emotion without higher level processing. I was still me, and they had an effect on those around me. I just couldn't really control it for a while.

There are good treatment options now for that, though.

[formflier]

  I simply said, "ok then go to the hospital." Minutes later, he's suddenly "ok."

   

Nice response


FF