How to be sympathetic without being enabling

[Cat Familiar]

My husband and I are getting along well on a regular basis, thanks to what I've learned here. When things start going south, I've been able to halt the progression and get us back to a reasonably comfortable baseline. He's high-functioning and very intelligent and much easier to deal with than my previous husband, who was BPD on steroids.

That said, health issues have been impacting him and his black and white thinking leads him into despair. Last summer we both had stem cell therapy: mine for a 15 year old shoulder injury and his for a bad hip which started troubling him a few months earlier. I'm well acquainted with chronic pain and I've been able to have an active life nonetheless. I did many years of physical therapy which helped me but never got me to being totally functional with that shoulder, though the pain was lessened.

I was told by an orthopedic surgeon that my only hope was to have a shoulder replacement, which was a concept that I rejected. So when I had the opportunity to do stem cells, I gladly took the plunge. My husband was less hopeful for a good outcome, but he decided to try it too. His surgeon had told him that he should wait a few years before getting a hip replacement, so I interpreted that as a positive thing in that he didn't need it yet.

Now, I'm a "success story" for stem cells and though I still am doing physical therapy to regain strength and range of motion, I occasionally have quite a bit of pain if I overdo it. Generally I'm relatively pain-free, but I have to work out on a regular basis to sustain this state.

My husband, on the other hand, had a much greater stem cell count than I did and I suspected he'd have a great outcome based on this. However, he has continued his couch potato lifestyle and has done very little physical therapy--both counter indicative of a good outcome. In followup visits to his stem cell doc and also an osteopath, he's been told that he's doing really well. And to an outside observer, this is indicated in his gait, which is much better than before the procedure.

However, he's having pain lately, which could be caused by a couple of factors. Recently he quit using painkillers, which he'd used for years because of a back injury. Also he's started to do physical therapy and home exercising on a more regular basis.

OK, after that set-up, here's my dilemma. When in my presence, he loudly yells "Ouch!" and limps dramatically from time to time. I don't doubt that he's in pain, but when I observe him when he's not aware of me watching, he walks a lot freer and doesn't vocalize. So, I feel that I'm being treated to a "performance" and that he wants my sympathy.

Also he frequently tells me how I get to go horseback riding with my friends and that he "can't do anything" although he just left minutes ago to drive many hours to the city to go to a symphony. (And driving was what he suspected caused his injury in the first place.)

I try to be supportive and I know how painful it is to start working out after an injury has laid you low. So, I'm not able to know whether he's really hurting severely or whether he's being overly dramatic. I have seen him being very dramatic about things like a paper cut in the past, so I'm not exactly an unbiased observer. And he's actually said that he wants sympathy.

Also he's had an unrealistic expectation about having a hip replacement. As intelligent as he is, he expects that he can have surgery and be immediately walking afterwards, as though he'd gotten a new replacement part for his car. We share the same physical therapist and she has told me that his expectation is very unrealistic. So there's that black and white thinking again.

All in all, it's his body and up to him whatever he chooses, but at the same time, I'm feeling some blame because he chose the stem cells, based on my observation that it would be better to try a conservative measure first before doing surgery. I'm doing well at not internalizing any blame, since he made the choice he did, but I do wonder if he's not giving the stem cell procedure a fair shot to work.

Any feedback is welcome.

[formflier]

I suspect you are about 50/50 on the performance thing.  

I would suggest a bit of a "broken record" approach, that is more friendly that sympathetic.  

Perhaps biased here... .but if you asked me if I wanted "friendly" or "sympathy" from my wife... .I'd pick friendly.  To me... sympathy is a bit of  "head pat" with an "awww... .poor thing" to it where has "friendly" is a bit of a "sh$t dude... .that has to hurt... "

Here is my broken record suggestion.

"Ohhh... .goodness... .that has to hurt. (pivot immediately to solution)... .I'm going for a massage/therapy/acupuncture later today... .I'd love some company... " (perhaps a swat on the butt... )

I would really stay away from mothering "you should xyz... ." (even though he should).  

Maybe you could tack on "perhaps my massage person can loosen that up some... .what do you think?"

At some point, after  month or so of consistently doing this and him saying no.  I'd be frank with him.

"Your moaning and groaning concerns me.  What scares me more is your inaction on your health.  I wish you would do more for yourself."

or something like that.

I dunno... .you know him best.  How do you think he would react to this?


FF

[Cat Familiar]

Thanks, FF. You've parsed that out in a very helpful way.

Lately he has been doing something--some massages and actually going to physical therapy (when it's convenient for him). It's funny--he was on the waiting list since he cancelled his PT appointment earlier in the week. They called him this morning with an opening. He could have gone and delayed his trip to the city by an hour, but no... .

If it were me and I was in as much pain as he wants me to think he is, I would have hightailed it to the PT office immediately.

I like how you describe "friendly" vs. "sympathy" and yes, it's a challenge not to "mother". I can't imagine wanting sympathy when I could have friendly, but that's me. Sympathy plays into the victimhood stance and I sure don't want to find myself in that place--it feels totally disempowered. But again, that's me. Perhaps it's comfortable for him. 

It's funny, but I gave him a gift certificate to my massage person who does deep tissue work and is really good; she's helped me a ton over the years. After several months, he finally went to see her and all I heard was how extremely painful it was and how sore he was afterwards. (You're welcome.)

Then I gave him a gift certificate for a place that does floating, infrared sauna and massage. It took him nearly a year to use that gift certificate and then he complained that floating later hurt his back and the water got into his ears and now he's probably got an ear infection. (Again, you're welcome.)

Oddly enough he forgot about all that after a couple of days and went back and did the same thing and now he's found a massage person he likes there. Good. Baby steps... .

[formflier]

Then I gave him a gift certificate for a place that does floating, infrared sauna and massage. It took him nearly a year to use that gift certificate and then he complained that floating later hurt his back and the water got into his ears and now he's probably got an ear infection. (Again, you're welcome.)
 

Sorry to chuckle at your expense... but... .that's just classic BPD.  "Rescuing defeat from the jaws of victory... "

I wonder... I really wonder if the "unease" in his mind would be helped by massage with rock music playing... or other "non-relaxing" things.

Generally nons enjoy solitude, quiet, relfecting... a warm cup of coffee and quiet wind blowing in the morning.

Know any pwBPD that want to be "quiet" with themselves?   

So, imagine how uncomfortable the "comfort" was in that floating spa thing (which i have NOT tried by the way... but it's on my list).

FF

[Cat Familiar]

Generally nons enjoy solitude, quiet, relfecting... a warm cup of coffee and quiet wind blowing in the morning.

Know any pwBPD that want to be "quiet" with themselves?   

So, imagine how uncomfortable the "comfort" was in that floating spa thing (which i have NOT tried by the way... but it's on my list).

FF

Good point, FF. I’m often enjoying the quiet sounds of nature while having my morning cup of coffee and he bursts in and turns on the radio and makes an inordinate racket, slamming cupboard doors and drawers and cursing to himself.

And in his studio, he will have the TV AND stereo on and be playing on the computer. I've never known anyone who needs so much distraction (from whatever is going on in his head).

The funny thing is that he used to meditate, but his form of meditation and mine are vastly different. He follows a type of Tibetan Buddhism which practices a very complicated ritual, with little dishes of multicolored peoples, bells, beads and other stuff. And there’s a complicated pattern of history and lineages to recite. I don’t know anything about it, but it seems like it’s a lot of work. I’ve met some other followers and they seem very proud of all the knowledge they’ve accumulated and very dismissive of heathens, such as me. (I find it very amusing and my husband is embarrassed by these people, so he doesn’t invite them to our home anymore.)

I appreciate your chuckle and I find laughter is one of my best friends in dealing with personality disorders, which seem very common, now that I know what I’m looking for. I enjoy laughing heartily within, while wearing my poker face externally.

[AskingWhy]

Dear Cat Familiar, first of all, let me say how happy I am that you are taking charge of your health.

My uBPD/uNPD H is unrealistic about his health.  At middle age, he is trying to cope with new medical problems (we all get them at some point) and is having trouble accepting the fact he is aging.

One time, a cat had surgery and had to be crated after, and the vet said after two weeks keep her confined to one room. Did H do that?  No!  He let her run all over the house, jumping on furniture and the cat tree.  The next day she was lame and crying.  I was furious, to say the least.  I was so embarrassed to report this to our vet.   He said to place her back in the crate for another week.  I found it hard to admit I had a stupid husband.

I know BPDs can be like children.  In addition to lack of empathy, they don't understand the concept of patience, and that things take time. 

 

[Cat Familiar]

I know BPDs can be like children.  In addition to lack of empathy, they don't understand the concept of patience, and that things take time. 

So true, AskingWhy, so true.   

A friend gave me a new strategy for the inevitable future when my husband is again discussing getting a hip replacement. She does this with her husband, who also has bouts of "magical thinking". "So, what's the plan?" she asks, and in the process, gets him to detail explicitly what he's thinking, asking questions about the parts she doesn't understand.

I know my husband thinks that after a hip replacement, he will be walking up the stairs to his studio bedroom. Our physical therapist told me that the only way he'll be getting up stairs is by scooting on his bottom, one step at a time. Then there's the how does he get to the bathroom issue and how he gets into the shower.

He outweighs me by 80 pounds and no way am I going to trash my healing shoulder to lug him around. So it may be that he will need to stay in a skilled nursing facility until he's able to be more mobile on his own.

We have other bedrooms where he could sleep where he wouldn't have to navigate stairs, but I know he wants to be in his studio with all his electronic toys. And the bathroom is upstairs.

So the other strategy my friend suggested is to accompany him on a visit to his concierge physician and pose all those questions about his recovery and what limitations he'll face.

Yesterday I dug a 3 foot by 3 foot hole in the horse pasture and planted an apple tree! Yay for getting stronger!

[formflier]

Check my thinking to make sure I have the concept correct.

Your hubby seems haphazard with his PT and self care. (as in he does it, but kinda oddly)

I'm assuming there is a fairly regimented PT course after a hip replacement.

I'm assuming that his PT habits (up to this point) are nowhere near what it will be like after surgery.

I'm assuming that people in better shape are quicker to recover from hip replacement.

Therefore

I would assume that a reasonable next step would be for him to commit a PT course that EXCEEDS what he will experience after surgery.

With the result of...

Hey... I feel better, let's talk to the surgeon in a year.

or

I feel confident that I can recover from surgery as prescribed.

Perhaps an argument along those lines might match up with his "lawyer thinking".

FF

Of course he may respond that you obviously don't care about him and his wellbeing... .

[Cat Familiar]

You are 100% correct, FF.

I had to laugh (to myself) the other day when my husband was momentarily inspired seeing Lindsay Vonn talk about how hard she had to train to recover from serious injuries and surgeries. "If Lindsay can do it, I can do it." You can guess how long that motivation lasted.

I've brought up the concept of "pre-hab" to him, treading very carefully. His response was that he should have had surgery last year before he was so "bad off".

Today he's walking around doing fine. (I try to frequently mention the phrase "inflammation cycle" so that he gets it in his mind that yes, sometimes it can be uncomfortable now but that doesn't mean it's not getting better. Gosh--he just drove 7 hours yesterday. He believes driving is what caused his injury in the first place. Hello?)

I have a great physical therapist who I see privately. I get an hour of her time and I pay her out of pocket, then send in receipts to my insurance company for reimbursement. They only pay about 1/3 of it, but for me, it's well worth the money spent because I get her focus completely for one hour, she's not busy taking notes for the insurance company, and because she's not an employee of someone else's practice, she can do alternative treatments that might not be otherwise available.

My husband sees her at the practice where she works, but she's so overbooked there that he doesn't get to see her regularly; they often substitute a PT assistant. I'm hoping that he will switch and do what I'm doing, which he certainly can afford and it's really not that much of a hassle to send in receipts now and then.

During my time with her, I've been able to give her an overview of him and his black and white thinking. She's told me the lowdown on hip surgery and what can be expected. You're absolutely right, FF, that someone who has committed themselves to getting in great shape prior to surgery will have a much better outcome and faster recovery. And she told me that the pain he currently feels will be dwarfed by what he will experience post surgery.

Of course I've tried to tell him these things months ago, but since I'm no medical professional, he completely discounted everything I had to say. He was truly shocked when he saw an osteopath for an unrelated condition and the guy told him that no way would he be bounding up stairs the day after surgery.

As smart as he is, I'm continually amazed by the magical thinking. And yes, if I get too much into his business, then you're right: I "obviously don't care about him and his wellbeing."   

I'm seeing all this before I step into the sh!tstorm and I keep my waders handy. 

[formflier]

So... .we both share a common thing that we have to consider.  When to open our mouths and when not to.

At the moment I'm taking antibiotics for strep.  

The only time when I've failed to finished all the antibiotics are when a culture came back and a doc said stop taking them and switch to this kind, which is more targeted.

So... .I put my medicine in the "up high" cabinet and happen to see the bottles in there for my wife and for D12.  With pills left in them.  They both had said they were done with their meds weeks ago.

My wife can ruin her health... .all she wants.  :)12 is kinda a shared thing... .but I still need to be smart about how I say things.

Next time either one of them has to take meds... .I will require a log for my daughter and suggest one for my wife... .(as a parenting example of course... .)

But... seriously... .taking all your antibiotics is kinda health care 101.

Sigh... .

Someone get a ladder to get me off my high horse...

FF

[Cat Familiar]

Aaaargh... .antibiotic abuse. My mother wrecked my immune system by giving me antibiotics for every sniffle and cough, then abruptly stopping them when I was better. It took a long time away from her for me to get my beneficial bacteria to rebound.

It amazes me that pwBPD can be so smart, so well educated, but have no concept (at least for themselves) of cause and effect or consequences. And beware the non who tries to point that out!   

[Red5]

 

It amazes me that pwBPD can be so smart, so well educated, but have no concept (at least for themselves) of cause and effect or consequences. And beware the non who tries to point that out!  

Ain't that the TRUTH!

... .and beware the non who tries to point that out ! 

To channel Captain Queeg: "woe betide the sailor";... .

Red5

[Cat Familiar]

I guess at this point, I could count my relationship as a "success story" of dealing with BPD. However, it's definitely a mixed blessing. Keeping the peace without fully disclosing oneself seems a very one dimensional relationship at times. But at the same time, I realize how programmed we are in this culture to believe in the fairy tale of "happily every after" and how few people actually live that out, BPD or not.

There's a lot to be learned in a relationship with a partner who has a personality disorder, and much of that learnings can be applicable to all relationships with people. It's unfortunate that in the process of understanding who one's partner is, it puts us on a different playing field. We thought we came into this partnership on equal standing, but we learn that's not the case.

[pearlsw]

Keeping the peace without fully disclosing oneself seems a very one dimensional relationship at times. But at the same time, I realize how programmed we are in this culture to believe in the fairy tale of "happily every after" and how few people actually live that out, BPD or not.

There's a lot to be learned in a relationship with a partner who has a personality disorder, and much of that learnings can be applicable to all relationships with people. It's unfortunate that in the process of understanding who one's partner is, it puts us on a different playing field. We thought we came into this partnership on equal standing, but we learn that's not the case.

oh yes. i can so relate to this!   i had such high hopes about who he was, what things could be... .i manage to be grateful for what i have learned and am learning though... .

[BasementDweller]

Hi, Cat -

I have a good friend like this - she has bipolar/depression, and a lot of psychosomatic complaints that she tends to play up for sympathy and attention. (Some is genuine, some is overdramatized for effect... .)

She would frequently play up her pain and disability when even recovering from a very mild routine surgery or minor illness like a cold.

After a while, when she would do the "OUCH! and overly dramatic limp or weakness, I learned to say "It hurts, huh? Progress is painful isn't it! I'm really proud of you for getting through this!" It seemed to have a weird double edged effect of both calming her, and having her equate pain with progress... .which meant to her: progress = less sympathy. So the complaining stopped. 

Not sure how it worked, but it did. She got attention, but not coddling. After a while she lost interest in over dramatized complaints.

[Cat Familiar]

oh yes. i can so relate to this!   i had such high hopes about who he was, what things could be... .i manage to be grateful for what i have learned and am learning though... .

Pearl, you have a very upbeat attitude in the midst of trying circumstances. I've been there too. What I would caution you about is to be your own advocate. You are obviously a very loving and caring person. I'll state what a therapist told me many years ago: "Nice girls are targets for abusers."

Don't you owe yourself as much support as you're willing to give others?

    Cat

[Cat Familiar]

I have a good friend like this - she has bipolar/depression, and a lot of psychosomatic complaints that she tends to play up for sympathy and attention. (Some is genuine, some is overdramatized for effect... .)

She would frequently play up her pain and disability when even recovering from a very mild routine surgery or minor illness like a cold.

After a while, when she would do the "OUCH! and overly dramatic limp or weakness, I learned to say "It hurts, huh? Progress is painful isn't it! I'm really proud of you for getting through this!" It seemed to have a weird double edged effect of both calming her, and having her equate pain with progress... .which meant to her: progress = less sympathy. So the complaining stopped. 

Not sure how it worked, but it did. She got attention, but not coddling. After a while she lost interest in over dramatized complaints.

Very clever and useful strategy, BD. Thank you. Always good to have lots of tools in the toolbox. 

[BasementDweller]

  You can always give it a try! Sometimes you have to get veeeeeerrrry creative about finding that balance between being too enabling and being too dismissive, and those boundaries are a bit tricky when you throw in a PD. I think I'll forever be in trial and error/learning mode there. ;-)

[formflier]

What I liked was the way there was "validation" of an issue and very quickly there was a pivot to  expressing confidence they can handle their stuff.

Big picture imagery.  We often talk about "not picking up the gauntlet" when "they" want to fight with us, to let the gauntlet land on the floor if they toss it at us.

This is kinda the reverse... .this is tossing the gauntlet of responsibility at them. 

The follow up to this is what to do if they don't pick it up or try to toss it back at you.  Remember, we don't "make" them be responsible.  We move on with our lives and let them struggle with their stuff.

If a response is needed... .perhaps sort of a shrug while we muse... "why wouldn't you be able to handle it?"

FF

[Red5]

  You can always give it a try! Sometimes you have to get veeeeeerrrry creative about finding that balance between being too enabling and being too dismissive, and those boundaries are a bit tricky when you throw in a PD. I think I'll forever be in trial and error/learning mode there. ;-)

I think I'll forever be in trial and error/learning mode!

Oh Boy !... .that's me2 !