Question about getting help for a BPD

[Zakade]

My wife has not been diagnosed with BPD but the first time I read the symptoms of the illness and how other people's accounts with living with someone with BPD, I thought that they were reading my mind or watching my life's story.  They all seem to be direct accounts of the things I was experiencing in my life with my wife. 

Right before we went to therapy, I was at the end of my rope.  I thought that I was crazy.  Nothing made sense anymore.  But during this time is when I read this.  I was convinced that this was what I was experiencing with my wife.  When we asked about it from the therapist, she dismissed the idea and said that my wife just had a terrible childhood. 

Fastfoward 2 years.  I have continued reading and I've seen the light that it's extremely difficult to show/convince someone with BPD to accept that they have an issue.  Exactly what I was experiencing.  I am really contemplating the leave but yesterday something happened that never happened before.  I talked with her about how I think that her childhood has affected her more than she actually tells me and that I'm still convinced about BPD.  She initially defended it saying that the counselor had told her that it wasn't it. That almost sealed my decision on what I had to do.

The next day, I walked into the  bedroom and she was crying.  I carefully and cautiously asked her why she was crying and she said that she was thinking about what I had said about her childhood and how right I was.  This has never happened before.  We talked some more and I asked if she was interested in listening to a book that I was listening to, chapter 2 of stop walking on eggshells. She agreed.

When we were finished, she was very emotional but not in the same way that she usually is. It felt different.  She said that she felt ashamed and broken.  She said that she didn't know what to do to make it better but she could really relate to the accounts of people with BPD.  She said that she wants to find treatment and get help.

Here is my question after this long post.  I know that I'm too close to the situation and I've convinced myself 1000 times that it will be better but this feels different.  Is this really the turning point for her?  Or is this like an alcoholic that will say that yes I have a problem but doesn't do anything.  Once they finally swallow that pill, can they revert back to denying that there is something wrong with them again.  Right now I'm being extremely cautiously optimistic.  Has anyone else been through similar situations?

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[Radcliff]

It's impossible to say how things will turn out, but it's a very fortunate turn of events that she is interested in getting help. 

I think you would find it valuable to look at this page on how to get a borderline into therapy.  There's a video at the end by a clinical researcher who figured out how best to approach the challenge of getting someone to get past unawareness of a mental illness and into therapy.  In the video, he says that one of two things needs to happen to make it likely for someone to stay in treatment:  1. Awareness that they have a mental illness (usually not going to happen, but in your case it has), and 2. A relationship with someone who listens without judgement and thinks they'll benefit from treatment.

The gold standard treatment for BPD is Dialectical Behavioral Therapy.  To find a therapist trained in DBT, look here:
https://behavioraltech.org/resources/find-a-therapist/

Meanwhile, it's important for you to start to beef up your skills for coping with the situations BPD presents you with.  What are a couple of the difficult situations you face with her on a regular basis?

RC

[RolandOfEld]

Hi Zakade and joining Radcliff in welcoming you!

No matter where your wife goes from here, I think the most important thing to note is that you've reached a turning point by coming here, and one you will not move back from. It's only progress from here on out, regardless of what choices your wife makes.

Seconding Radcliff that it is impossible to know what your wife will do for herself. My only suggestion at this point is that if you intend to stay, you are ready to play the long game. It may be that your wife does not commit to therapy or change right now, but it might still be a first step forward that she follows up on at a later time. Like Radcliff said the first key thing is to develop your own skills.  

I hope I can share a lot more as you tell us more of your story. What behaviors and recent events have made you certain of a BPD diagnosis?  

Sending you strength,
RolandOfEld

[Zakade]

Thank you Radcliff and RolandOfEld for welcoming me and thank you for the information.

We have identified a place that specializes in DBT.  I am putting it on her to make the necessary steps to get the help.  It seems appropriate to let her take the steps to get help for herself.

To answer about difficult situations, I could name a hundred+.  At times she'll get mad, but it's usually about something that we can't do anything about after the fact.  For example, she'll get mad about where we went to eat if something unforeseen happens while out to eat.  Then she'll blame me for picking the restaurant claiming that if we went to the place that she told me she wanted to go, that this wouldn't have happened.  There was nothing verbally said about where she wanted to go or she may mention a place but not insist that we go there as she claims after it's too late.  

We bought a house in 2008. Just in time for the housing market to crash.  My house was devalued by $15k almost overnight.  We did talk about only living there for a couple of years and then selling it after that time to find a bigger house.  The idea was that the market was going to continue up for the next couple of years like it had.  I was wrong.  Shortly after we moved in she started accusing me of bullying her into the house and that she never wanted the house to begin with.  I tried to include her in every step of the process so that this wouldn't happen again (same story different situation). There were many times when she would break down crying about how much she hated the house.

Whenever I wanted to go out with my brother to enjoy some time away from the house, she would start fighting me about it right up to point of me walking out the door.  And then the silent treatment follows when I get home.  Sometimes more fighting but mostly three days of silence for the most part.  So this has "encouraged" me to push off telling her that I want to do something as late as possible and that starts a fight because I don't let her know until the last minute that I'm planning something.  (no win situation)

And the last story I'll share involves my wedding ring.  At one point, I took off my wedding ring off and put it in my car.  When I got home, I forgot to grab the ring.  Later, she took the kids in the car to eat and when she got home, I remembered that I had left it in the car.  When I went out to find it, it wasn't there.  I asked her about it and she said that it was probably stolen out of the car while they ate.  I turned the car inside out looking for it, never found it.

A year later, out of the blue, she asked the kids if they wanted to clean the car and that she'd pay them. She's never concerned herself with my car and now she wants the kids to clean it?  My son comes running in with my ring in his hand showing me that he found it.  I asked where he had found it and he said that was on the front passenger floor sticking out from the carpet and the floor mat.  That's just not possible that it's been in my car all this time and then when she asked our child to clean the car, he finds it.  When I asked her about, she is offended that I would accuse her of such a thing and gets mad at me.

Zakade

[Zakade]

So now after watching the video on helping people with metal illness, I'm questioning whether I should leave it totally up to her or help her with calling to get help.  This is so challenging when I don't want to fall back into the trap of caretaker.  It feels like I have to withdrawal too much because my boundaries seem messed up.

I am being supportive by talking with her and asking if she'd like me to be there when she calls or offer to help  her prepare questions that she wants to ask.  I'm not leaving her totally out to dry by herself.

Is it appropriate to let her do it for her self or help her with the process since she is probably really confused and scared?  

[once removed]

hi Zakade, i want to join Radcliff and RolandOfEld and say

Is it appropriate to let her do it for her self or help her with the process since she is probably really confused and scared? 

i think the short answer here is help, be supportive, dont overstep. let her lead, let her (help her) communicate her needs from you in terms of support. and in supporting her, check your motives, and dont approach it with an agenda.

thats somewhat vague and generalized, i know. a lot depends on the specifics of your relationship. for example, if i had a teenager that had say, severe social anxiety, but wanted help, and my teenager asked me to place the call and schedule the appointment, i might consider doing so initially, rather than the rigid approach of "they need to do everything themselves". thats just one example.

in terms of next steps though, i think a lot of this depends on examining our role in the relationship, changing our responses, and learning how we can best support ourselves, as well as our partners.

At times she'll get mad, but it's usually about something that we can't do anything about after the fact.  For example, she'll get mad about where we went to eat if something unforeseen happens while out to eat.  Then she'll blame me for picking the restaurant claiming that if we went to the place that she told me she wanted to go, that this wouldn't have happened.  There was nothing verbally said about where she wanted to go or she may mention a place but not insist that we go there as she claims after it's too late. 

a lot of couples fight over this, but when it comes to BPD, people with BPD tend to have low self esteem and low self efficacy, and can be subservient or dependent on other people, resent themselves deeply for that, and then, over time, resent you for it. there are ways to navigate this sort of conflict, that can give us a lot more emotional breathing room, and improve communication with our partners.

how long have the two of you been married?

[RolandOfEld]

I'm questioning whether I should leave it totally up to her or help her with calling to get help.  This is so challenging when I don't want to fall back into the trap of caretaker.

Hi Zakade, you will need to find a balance. I would make the process as smooth as possible for her by providing her with all the information she needs for where to get help, but let her arrange and follow through. If she was to join a DBT program, I think a great form of support would be getting a copy of the textbook yourself and working through it at the same pace as her. Or, if the instructor and time allows, you could consider joining with her. This is what I would call "support".

As example of "care-taking" would be arranging all her appointments for her and chasing after her to make sure she goes.

It's also very important to identify her motivation for seeking help. Do you think she genuinely sees herself as having a problem, or is doing it just to appease you and keep you around? If its the latter its unlikely to pan out.

Sharing a bit about how it went with me. At one point I had more or less blackmailed my wife into seeing the doctor who runs the DBT program at our hospital with threats of getting her arrested and her losing the kids (she was stealing / destroying my property and physically assaulting me at the time). She ended up going and seeing the doctor. The doctor thought she needed DBT but thought she would be too busy with kids and work (thanks Doc), so she prescribed a course of meds. My wife takes them religiously. The meds have not cured her but they have softened her extreme behavior a little and made it easier to communicate. But she still needs DBT, and our MC has given her some recommendations here recently. Will see if she follows through.

~ROE

[Zakade]

Thanks for the welcome, Once Removed.

And thanks for the feedback about helping my wife.  I that it's sounds advice.  I know that my motivation is to help my wife feel better about herself. 

ROE, thanks for sharing a bit of your story.  It's always helpful to hear that I'm not struggling alone.  I know that I'm not alone but affirming that others have similar problems is somehow soothing.  I hope things for you are getting better and do get better every day.

As for my wife, I do think that her motivation is genuine this time.  This is not me being the hopeful, pining care-taker that I've played in the past.  I heard words come out her mouth in the last few days that I have never, ever heard her say.  She broke down in tears a day later about what I mentioned about her childhood and growing up with her father, causing extreme terror in her and she was sick of having low self-esteem all the time.

She had set up an appointment with a counselor that we have seen in the past and now, on her own, she has said that she doesn't know that this counselor will give her the help that she needs.  She started looking for someone that has DBT experience.  This was completely unprovoked by me.  I was fine with whatever she decided.  She bought a book on DBT and has started reading through it.  I didn't tell or ask her to do that either.

I did talk to her about her apprehension about calling the certified DBT place that we did discuss.  She said that she wants to call but she is afraid that she would start crying on the phone.  I agreed if she wrote out the questions that I would call and get the information for her.  I did not agree to set anything up for her at this time.

I've been married to my wife for 16 years and been with her 20.  It's been a roller coaster to say the least.  It's also been a long road for me to dig myself out of the trenches of low self-esteem and I'm still struggling.  I can share my childhood with my BPD mother and alcoholic/drug abusive father sometime. 

Right now, I'm focusing on me and learning to use tools that I was never taught growing up.  I want to find my life that I've been denying myself most of my life.  I can't get back to my life since I really haven't known myself to begin with.  The discovery will be a great adventurer that I gladly accept.  I hope that my wife can come with but I'm not waiting around anymore.  If she doesn't come with, it will be her choice to stay where she is.

[Skip]

Glad you were directed to Xavier's video and that you watched it. There is a wealth of perspective there. 

You can help her with her fears right now. DBT is a behavioral therapy. It not about digging into her past behavior - its about how to handle and react to situations going forward. It is like training.

We teach members here to use DBT skills. They are helpful to us all. Later, she may want to try schema or talk therapy to address the why.

Also, know that a the leading indicator of success in treatment is a supportive family member. That doesn't mean a doormat or a babysitter. It does mean someone who is going to stand by her through the up and downs - not a "conditional" partner. Someone who is going to have perspective and be real, but be benevolent about it.

So going back to the ring incident. Do you see what that was likely about?

[Zakade]

Skip,

That video was amazing.  It gave me a lot of insight that I've been looking for.  Like, why is it nearly impossible to convince someone with BPD that they have a problem.  It's so easy for me to see.  It's so easy for everyone around you to see, why can't you?  WOW!  Now I understand and it makes a ton of sense.

I'm not 100% sure what the motivation was about the ring but I suspect that she wanted the ring to "disappear" so that I would run out and buy a replacement to prove my love for her.  There were a few times that she mentioned getting a new ring throughout that year.  But then when I didn't replace it, she panicked because I looked available without the ring and gave it back.  This is just a S.W.A.G. conclusion but it fits in line with the other things she has said.

I'm working on being an unconditional partner in this situation but I do fail from time to time.  I think that the hardest part is trying to separate old habits from a slip up.  I don't think that there is a set number of times to say that someone can screw up and  you say, "That's it, we're done. It's not working."  At the same time, when a year has past and you realize that you are still in the same leaky boat, how do you hold on to hope?

[Skip]

At the same time, when a year has past and you realize that you are still in the same leaky boat, how do you hold on to hope?

It's tough. It's also real.

She has BPD and she will sense if your are not "all in" and it will play on her insecure attachment and she will react to it. It's almost as if you have to be "all in" until you decide you are out, and then get out.  Being in the middle ground will bring out the worst in her.

I suspect the ring was her insecure attachment reacting. You weren't wearing your ring may have meant you weren't committed. Taking it away was a subconscious test to see how you would respond. You see that.

How do you attend to her attachment style meltdown in a case like this without being a doormat and running out and buying a ring? This is what you are tasked with when you have someone with attachment issues (and likely engulfment issues).

There is a way... .a style.

Same with the reaction to her planting the ring back. How do you react in a constructive way?

[RolandOfEld]

ROE, thanks for sharing a bit of your story.  It's always helpful to hear that I'm not struggling alone.  I know that I'm not alone but affirming that others have similar problems is somehow soothing.  I hope things for you are getting better and do get better every day.

Zakade things actually for the first time in 10 years are getting better, so I want you to know there is hope. Part of the reason things are getting better is because my wife did go to the doctor and get medication that has seem to had some help. Also she got a new job she really loves after 4 years stay at home.

But I think a much bigger reason is the work I've done to rebuild my own life, such as hiring babysitters to support me since my wife is unreliable, reaching out to family and friends, and working to build a little support community for myself.

When I say "better", I should clarify that I don't really say so in the context of a marriage. It's more in terms of the life I'm building independently for myself and the kids. Actually, we negotiated a trial separation during our last MC appointment, living together but as independent people. This is what I need right now to get better. 

This isn't an endorsement for leaving the relationship, but only on the idea of focusing on yourself and the space you have to change things first and foremost. I think the way you are supporting your wife is great and it really sounds like she is making an effort. My wife is, too, so it's possible we might get back together at some point, after I've healed.   

So I think you are totally on the right track. Keep up the great work!

~ROE

[Zakade]

Same with the reaction to her plating the ring back. How do you react in a constructive way?

Definitely in the past I would accuse and blame.  I was a gluten for the dance.  Now-a-days, I don't get mad at all.  I ask questions and find out what she feels happened.  I still disagree and she could get mad but I don't allow myself to fall for it.  I do still revert back to some unhealthy things like ignoring and being silent but not before telling her that I'm not able to continue talking about it.

This has lead to her continuing but now I listen but don't respond.  If questioned, I reminder her that I can't talk about it right now.  This has helped me deal with the huge waves of anger.   

[Skip]

Remember... .you want to be modeling the behavior she will be taught to do herself in DBT.  Best you lay that groundwork now.  It's good relationship skills.

This is incident is mostly about her feelings about the ring being in the car and not on your hand.

In a time of goodwill and calm, ask her what she felt that day and why, and listen and understand. Listen ask questions, don't judge. Do the Scotty Peck thing    https://bpdfamily.com/content/listen-with-empathy At some later time, casually mention that "if something like that happens, lets talk about it - maybe wait a day for the feelings to cool and lets talk". At some even later time, casually tell her that "thanks for getting my ring back to me". At some even later time, casually tell her that "we can handle this better than what I did and you did with the ring".

It's all about reconditioning the ingrained responses that the two of you have developed. Be a safe, calm person, and at the same time, start laying down a better way and increasingly, hold her to uphold her end.

She may try and succeed and try and fail and try and succeed. She may not even try.

You will know what to do then.

[once removed]

She started looking for someone that has DBT experience. 

has there been any update on this front?

[Zakade]

The only update that I have right now is that she had a lot of homework to get done earlier in the week so she wasn't able to do too much.  She has been reading a little bit of her DBT book every night, so that's encouraging.  She has been smiling more than I've seen her smile in a long time and it's a genuine smile.  The last two days have been a bit of a struggle for her that I'm not sure what is happening.  I have offered to talk and spent time holding her.  The only thing that she has volunteered so far is that she has been really struggling with strong feelings of unworthiness.  I gave her some kind words and held her some more.  I have not found it appropriate to ask her about the counseling thing so I'm hoping that she spends some time today coming up with questions she would like asked of the places we are looking at that offer DBT.  She is off work today.

She has mentioned still having to come up with questions and at those times we talked about possibly quitting her job to focus on DBT initially.  This would be a win for both of us because she is in the last couple of weeks of completing her goal of school and will be looking for a different position anyway and I have some encouragement to have her take action to look for a job.

Things are slow but I'm still happy with the progress.

Zakade

[Radcliff]

Hi Zakade,

Do you have any thoughts on Skip's reply above?

RC

[Zakade]

Skip, thanks for the advice.  I can see that this could be effective in opening up the communication with her about the subject.  Right now is probably not that time.  She has been opening up to me about her fears and concerns.  This weekend I talked with her about how she seemed withdrawn and she talked about her insecurities.  She thought that we had a great time on Tuesday and she was hoping that I would tell her that I loved her and check in with her (because she is right and I didn't do those things).  Instead of blaming me for not caring, she said she felt bad that I have to be with such a needy person.  BIG TIME STUFF!  She has never done that before.  She has never wanted to acknowledge that she may be overreacting to situations.  I reassured her that I was still with her because she is worth it.

She feels worse about herself in some ways right now that I don't want to pile more on her at that level.  I do express myself but I'm trying to keep it real lite at this point to help encourage progress.  When I think that she is stronger and more self aware, then I will begin trying to slowly resolve the long standing issues.

[Skip]

How do you attend to her attachment style meltdown in a case like this without being a doormat and running out and buying a ring? This is what you are tasked with when you have someone with attachment issues (and likely engulfment issues).

There is a way... .a style.

Same with the reaction to her planting the ring back. How do you react in a constructive way?

I was not suggesting taking any action with her.    I was suggesting a postmortem on the ring incident and to explore ways to have done it different.  This is modeling and drilling - so when the next event comes into play, you have an alternate response.

Looking back at the ring incident, know she has insecure attachment and what her reaction was all about, what is a different way to play it out?