Re: First psychiatrist appointment. (Part 3)

[boogs152]

This topic has been split off from a previous thread that reached its post limit:
https://bpdfamily.com/message_board/index.php?topic=331543.0

I’m so thankful for the help here. It really has made a difference in my life. It’s helped me have more compassion for my partner and a greater understanding of his condition.
In response to your question Radcliffe... .
 Can I discuss touch with him? I haven’t really tried. His facial expressions and body language often convey a confusing almost standoff-ish expression? He has mentioned before that rejection is very hard for him. He reminded me of this yesterday. We were watching something on television that must have triggered him to say that again.
Overall this week has been one of the most positive in some months. He has been relatively upbeat and doing a lot of art. I don’t know what has brought on a lighter mood this week.

Today has been emotionally a little harder for me. I just want to be taken on date. Have a little attention on me... .some consideration... .Anyway just some thoughts.

[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.

[Bnonymous]

Hi Boogs152,

I'm really glad to hear that it's been a good week and that you're feeling a bit less overwhelmed by everything.

Today has been emotionally a little harder for me. I just want to be taken on date. Have a little attention on me... .some consideration... .Anyway just some thoughts.

I bet that would do both of you the world of good. Why not initiate? Maybe book a table at a fancy restaurant? I don't know how he does with surprises, so, if he wouldn't like having something sprung on him, maybe ask first - say something like "I keep thinking how much I'd enjoy going out for a romantic meal with you - would you be up for that one night this week?"

[boogs152]

Thanks Bnonymous. I took him out for dinner last week. I deliberately chose an Italian restaurant because it’s his favourite cuisine. I wanted to get him out of the house. He resisted the suggestion at first. So I responded to his resistance in a blunt manner and then he agreed. I like that you gave me a specific way of making the suggestion again. Positive re-enforcement.
I can get flustered and become blunt sometimes and it doesn’t feel good.

I’ll book another table this week and say  things exactly as you suggested.

[boogs152]

One good week and he’s now spiraling again. Son promised to see him over Christmas break and now not coming. I read somewhere that sometimes pEople with BPD can have a “favourite person”. His son is by far his favourite person

It’s one thing after another... .

I’m just hanging on.

[Bnonymous]

Hi Boogs152,

I'm glad you had a good week but sorry to hear he's spiralling down again. It's hard to deal with when it's relentless, but, sometimes, it's even harder when it's on and off - we just start letting our guard down and relaxing a little and then there's that "here we go again!" feeling. *sympathises*

I can imagine that having his son cancel Christmas plans has triggered his abandonment feelings big-time. At this time of year we're bombarded by media images of impossibly perfect families enjoying impossibly perfect joy, closeness, and tranquility, and the gap between that and real life can amplify other feelings and issues. He'd probably be feeling abandoned and rejected whatever time of year this happened, but he may well be feeling it even more so because of the holidays. He'll need a lot of empathy and validation over this (which I'm sure you're giving him) - try to find some time to take care of your own needs where you can, so that you don't get too burnt out and exhausted taking care of his.

One thing that's piqued my curiosity - you say his son is his favourite person, using the present tense - I'm wondering if that's just a matter of phrasing or if it means that he hasn't "split" his son over this... .If he hasn't "split," if he hasn't suddenly decided his son is a terrible person who always lets him down and who secretly hates him (or similar) that's a pretty good sign that the help he's receiving might actually be getting somewhere.

Are you seeing any signs of splitting in how he talks about this? Or is he just expressing feelings of sadness and disappointment etc?

[hope2727]

Sorry you are having such a tough time. I can totally relate. The whole son changed his mind and refused to see him was a familiar pattern with my pwBPD too. Its hard on them when they have to deal with disappointments. It hits them much harder that it hits other people. DO you have anything you particularly enjoy doing together? A shared hobby or something? I am asking because I would often suggest we partake in ours and it would help.

[boogs152]

He just seems to shut down. Retreating to his room. He only emerges for a cigarette or when I’m in the bathroom taking a shower. He doesn’t wish to engage or communicate. I stand back... .stay back. He’s breaking me down. Breaking down my confidence in communication with him. I’m in a no win situation. He doesn’t want me to help him. So I won’t for the time being.

[Bnonymous]

That's rough on you, Boogs 

Isolating himself to this extent isn't particularly healthy for him or for the relationship. But, I'd look at it this way: it may be the healthiest choice out of the options available to him at this present moment.

In the past, he has used violence (against men) and substance abuse as coping mechanisms. He knows this and doesn't want to do these things again. He may have discovered that isolating himself works as a less destructive coping mechanism to ones he has used previously. If he hasn't yet learned truly healthy coping mechanisms, then this one might be the best he has in his current repertoire. One task of therapy (and of you modelling your learning for him) will be to increase his repertoire, so that he has some truly healthy options to choose. In the meantime, he may feel that withdrawing is the best he can do.

So... .Respect his space and try not to take it personally (I understand how personal it can feel when loved ones withdraw from us like this).

And bear in mind the patterns with physical contact, as this is similar. You want to give him space, freedom, choice, and respect. But you don't want this pattern to set/harden to a point where it's hard to break out of.

What I do when my boyfriend is retreating like this is to remind him that I'm there if he wants me, and then immediately withdraw, i.e. I say it, but I don't wait around for a response, in case this makes him feel pressured and speak defensively.

So, if he's come down to the kitchen to make a drink, I might pop in and fetch something. Then, as I'm leaving the room, I stop in the doorway and say something like "I'm trying to respect your space at the moment. But I care. If you want me for anything, I'll be in the living room". Then I turn round and walk into the living room, without waiting for a response.

Now that I've been handling it this way for many months, I am finding that the time it takes for him to reach out is decreasing. He now tends to come and join me within an hour or two - it used to be days. (We don't live together, but he stays here for a few nights a week - in the earlier days of these withdrawals, he would often remain shut away in self-imposed exile right up until he went home. That hardly ever happens now).

What do you think?

[Radcliff]

Like Bnonymous, I found that being out of my pwBPD's way, but nearby and available, was the best way to provide opportunities for her to reach out.

When he is ready to reconnect, what does it look like?  Does he give you a particular kind of cue?

RC

[Bnonymous]

How are things going, Boogs152? Has he started engaging with you again yet?

[boogs152]

Yes reconnected intimately. He’s had an pretty good two weeks. Recovered quickly after son bailed on Christmas plans. He’s been quite upbeat and I’m trying to keep him busy which seems to have good results generally. I don’t push him when he’s in lock down.

Reconnecting intimately has been interesting. How should I say... .I’m apprehensive unfortunately. Waiting for the crash again.
I did discover a link that someone posted recently. It was www.gettinbetter.com. Made me look at my situation from a different angle. Definitely got me thinking that’s for sure.
I feel like I’ve been too passive perhaps. I don’t know.

 The mind boggles.

[Harri]

Hi Boogs.  I have been following your story and I am glad that you were able to connect again with your bf.

Here is more information about Shari Schreiber:
Shari Schreiber: Online Reputation, Independent Review

[boogs152]

Thanks Harri, I have looked at the first Link regarding Shari but the second link doesn’t seem to working?
I really appreciated scanning some of the thread on Shari.

[Harri]

Ooops.  Sorry about the second link I posted (I will remove it).  

What did you find helpful from reading the link? 

About Shari, I found her message to disjointed, angry and somewhat shrill in tone. 

[boogs152]

Well I found that reading the thread on Shari to be a more balanced reflection of her image? It’s good to see both sides and then make up my mind. When it comes to BPD it’s hard to find a balanced approach

[boogs152]

So here we are three days after Christmas. My partner is sleeping a lot the past few days. He’s behaving in a detached manner and seems exhausted and agitated. I think he’s trying to not take it out on me. I’m probably to blame for something. Not sure.

I’ve started to thinking again. He doesn’t seem to show much of an interest in me generally... .for most of our relationship actually. We just hang out... .shows little affection. Hasn’t told me he loves in many months. We had our one year anniversary last week. He didn’t even mention it even though I gave him a card and a small gift. Birthdays Christmas and small intimate meaningful moments are so hard... .detached.
It affects me a lot... .it’s like being rejected every single time. I’m coping with emotional eating and it’s getting worse.

He’s being admitted into a clinic in few days. I’m just holding on. Things feel so empty at times and when the those fleeting positive days arrive I keep wondering when the crash will come again.
Don’t worry I’m keeping busy, going out, working and all the self care stuff included. Just so sad and empty sometimes.

All the effort and love and hope... .the utter patience... .the waiting in silence for the tide to turn. Slowly.

[Radcliff]

boogs152, I'm sorry to hear that you are feeling so sad and empty.

Can you tell us about the clinic?  What kind of treatment, and how long will he be there?  Will he be staying there full time for a while, or just partial days?

RC

[boogs152]

My head is spinning too much to even know where to start with your response Radcliffe. Thankyou for taking the time to offer some guidance. Hopefully have him in a clinic in the next 48 hrs. I’m going to take him there and refuse to leave. It’s a private clinic and has cost us a lot of money in private health up until this point. We’re past  the two month wait period for private health. All the psychiatrists have been away for Christmas New Year. I’m so broke financially. All the money spent on my partner... .the psychologists... .the massages... .The therapies... .the private health.  Nothing much left for me at this stage. We’re begging for help. It’s all a waiting game unfortunately.

[Bnonymous]

Thanks for updating us, Boogs152. I hope you're able to get him into the clinic. Let us know how it goes.

[boogs152]

Thanks Bnonymous. I will get back you later in the week.I’m at burn out point.

Hugs x

[boogs152]

It’s no wonder people end up dead. I’ve been trying to get my pwBPD suitable support for a few months now. We’re either on waiting lists or long awaited appointments that can take weeks to eventuate only to be useless and unhelpful.

I’ve been paying big money for top health cover with a two month wait. We’re now past the two month wait period only to be told that the private clinic offering DBT therapies cannot take him as many psychiatric doctors are still on holiday. I asked if they can still admit him given his circumstances and his state of mind and they won’t help.
They said that it could take a couple of weeks before a doctor can take him even though that have plenty of beds.

I was in tears on the phone... .we’ve been asking for support for months... .and nothing... .nothing with any traction has been offered... .nothing.

I don’t know if what I’ve written makes any sense.

[boogs152]

And now, because there’s been delays with getting help he’s refusing to go into treatment.


Well of course he is. I should’ve seen this coming.

[Radcliff]

boogs152, I am sorry, so much of this is beyond your control, and you're doing a valiant job trying to help him.  As hard as it may be, give it some time.  The doctors will return from holiday.  The system sounds incredibly frustrating.  Slow, steady pressure over time is what is most likely to win with these things.  Hang in there.

RC

[boogs152]

Yes a lot of this is beyond my control. You’re right. Is there anything else I should be saying or doing at this point or am I better to just say and do nothing for the time being?

Thanks Radcliffe

[Radcliff]

I don't know if you're asking about what to say or do with the folks in the mental health system or with your partner.

When I'm dealing with service folks in an upsetting situation, at every step I try to ask myself what I control, and what I don't, as well as what the person I'm talking to controls and what she doesn't.  It keeps me from the pain of unrealistic expectations of myself, and the anger of unrealistic expectations of others.  Allow yourself to take comfort in doing everything you can within your control.  You can probe and ask questions and look for creative solutions, but try not to pile energy on past when it's being effective at getting results.

With your partner, I'd avoid increasing the pressure to go to therapy.  Keep working in the background, and where appropriate give him invitations, but don't try to win the point with him.

I might have already recommended it, but have you seen this link on how to get a borderline into therapy?  In addition to the article, there is a video at the end.

RC

[boogs152]

I’m not going to pressure him into therapy and you give good advice. Also I have to respect that at the end of the day he knows what’s best for him in any given moment. What else can I do but have faith in that?
I did see the video you suggested and I found it very helpful. I ordered him the DBT workbook which arrived today. I took it out of its packaging and left it on the table. I didn’t say a word. Later that day I found him reading it and then he thanked me for getting it for him.
I can only stay positive and hopeful for the future for that alone.

[Radcliff]

I'm impressed you watched that video.  It's long!  You are doing a great job.  I'm happy to hear he was reading the workbook.  DBT is impressive, and different than what people expect from therapy.  Great idea to start exposing him to it.  I've heard there are videos available online, but have not seen them.  Perhaps another member who has seen them might chime in.

RC

[boogs152]

Yes Radcliffe I’d like to see some videos. I’ve done my own research about DBT and BPD on YouTube and there’s always more to learn.

Btw... .

He’s decided to go to the clinic. He will be admitted tomorrow.
 
The journey continues.

[Bnonymous]

Hi Boogs152,

I'm sorry you've experienced these obstacles and setbacks to getting him professional help. I second Radcliff in saying you're doing a great job. Your commitment is impressive and inspiring.

You posted as I was typing this, so I've just seen that he'll be admitted tomorrow - that's brilliant news! I'm really pleased to hear this. How are you feeling about it?

[boogs152]

I just checked him in about an hour ago. He seemed calmer than I expected. We went through the formalities of paper work etc and then they took us to his room. Almost immediately then he wanted me to leave. I didn’t push anything then told him I loved him and left. I didn’t try to make a big deal about anything. I didn’t tell him I was proud of him or how happy I was that he was going into treatment. It was hard but I didn’t want to stir up any triggers.
I was a bit disappointed when he asked me to leave only 20 minutes after admission because I was hoping to hear what the nurse was going to say in terms of his treatments therapies etc. I have noticed that in the past when we have dealt with health care professionals that he doesn’t ask questions and is very agreeable and submissive. I was hoping to feel more informed at this point about his clinical treatment.In my experience if you’re not informed then important issues get over looked. I’ve learned that if you don’t keep pushing and pushing then nothing seems to have traction. It’s really only because I’ve kept making the calls and pushing and pushing and asking for help that we’ve even come this far. I honestly don’t know where my pwBPD would be at this point without it. Perhaps still living on the streets. Who knows?

I think that when it comes to your loved one with BPD you have to keep looking at the bigger picture... .See the best in who they are... .See their potential but also be realistic and patient. If he doesn’t want to do something today then maybe they may want to do it tomorrow.
You’ve got to have hope. It’s hard but hope is all you have if your partner is reaching out for help. Hope and faith.

I just want him to stay the distance. He’s very bright and willing to learn so I feel positive. But on the flip side a part of me wants to protect myself... .the part that’s waiting for the crash again. There will be a crash and that’s okay as long as we keep steering the ship in the right direction.

[Radcliff]

That is fantastic news that he has been admitted.  Thank you for sharing with us.  How long will he be in the clinic for full time?  Will you have any contact with him?

While he is being cared for, what are you going to do for yourself?

RC

[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.

[boogs152]

His first day at the clinic and they have advised that he remains at the clinic as an in patient for a full month. He has also been categorised a classification 1 patient  which means high suicide risk. He will be detained at the centre and unable to leave for the next three days.
They have changed his medication. One of the meds is an antipsychotic which is something he’s never been on before. I think the seriousness of his circumstances has really hit me tonight and I’m feeling overwhelmed and out of my depth.

My mind keeps swirling around in circles... .playing out different scenarios... .wondering how he has even survived the incredible amount of emotional pain he’s endured in his life. Then my mind jumps forward to the present and is deeply concerned about his wellbeing as these heavy medications take hold of him in coming days.
I feel kind of sad. He thought he was only going to be there a week or so and I can imagine his heart sinking when they told him that he should stay a month.

What am I doing for myself? Nothing, just kind of numb and she’ll shocked.
 
-I might try to see a film on the weekend or catch up with my brother and his children.

Does anyone has any advice for me at this stage? Is there anything I need to be made aware of regarding his treatment? Any important questions I should be asking his doctors? What should I be expecting at this point in time?

[Radcliff]

That must have been difficult to find out that he would be there longer.  I'm sorry for that, but also glad he's getting the care he needs.

You are on top of things w.r.t. his treatment; I don't think you need our help with that (though I do have a question about whether or not the clinic has educational or support programs for loved ones of patients).  Where you need encouragement is on taking care of yourself.  You are a carer who has been given a respite by other carers.  Take maximum advantage of it.  And I'm not just talking about hot baths and walks.  What gives you joy?  Are there any activities you've allowed to fall by the wayside that you really enjoy doing?

So, yes, see a movie *and* catch up with your brother and his kids.  And more.  Connect with healthy people, spend time with others.

RC

[boogs152]

No family support offered to families of patients being treated at the clinic

[Bnonymous]

Hi Boogs,

I'm sorry to hear they aren't offering support.

I know that when my partner went into a residential detox programme, I was "free" to collapse a bit. You've been caring for him and focusing on getting him help and you might not have had time or opportunity to deal with your feelings about it all while that was going on. So you might find that, now he's in a place of safety, and you can afford to drop your guard a bit, all those feelings are suddenly hitting you with full force. Is that what's happening?

[boogs152]

Hi Bnonymous. Thanks for taking the time to reply. I’m actually feeling much better now I’ve got some space. What I’m looking for is strategic ways of moving forward. I would also like to receive some validation too by talking to others that understand what I’m going through. I find it quite shocking to be informed that one of the best private  clinics in the country doesn’t offer family support. Speechless really! Baffled.

On the positive, I have found a community group especially for family and loved ones with BPD and will attend this week.

I’m meeting my pwBPD psychiatrist at the clinic for the first time this week. How do I have a measured conversation about my pwBPD in front of him with his psychiatrist? Any tips? I’m really keen to discuss BPD  with his doctor. How do I do this whilst limiting triggers in my pwBPD,

[Bnonymous]

Hi Boogs,

I'm really glad to hear you're feeling better and have found a community group - that's great news!

I’m meeting my pwBPD psychiatrist at the clinic for the first time this week. How do I have a measured conversation about my pwBPD in front of him with his psychiatrist? Any tips? I’m really keen to discuss BPD  with his doctor. How do I do this whilst limiting triggers in my pwBPD,

Difficult. Have you asked them whether it would be possible for you to speak with the psychiatrist alone (either in person before your pwBPD joins the meeting or by telephone beforehand)?

[boogs152]

Yes that’s a good point. I’ll try to speak to his doctor first via telephone.

Big thanks.

[Radcliff]

For the psychiatrist visit, a very important thing, as you probably know, is to not discuss labels.  Talking about BPD likely not go well with him, and is not necessary.  It is important, though, to take advantage of the fact that you can provide a window on his behaviors that his care team would otherwise not receive.  The safest things to say would be things you think he's likely to agree with anyway.  But you may need to take a little bit of risk to tell them important info they might not get from him.

DBT uses something called "targets," which are unhealthy or ineffective behaviors the patient exhibits that need work.  The psychiatrist may be looking for ideas for "targets" from his talk with you.  I'm thinking the most important targets would be things that are really keeping him from functioning, and things that you think the care team might not be able to figure out just from talking to him.  With this in mind, do you have an idea of what things you might want to bring up?

RC

[boogs152]

Not especially Radcliffe. I’m at a loss.

[boogs152]

I’m struggling to find the words associated with “targets” as you suggested.

Should I just go online and research BPD traits then simply select the ones that mostly apply to his behaviour?

[Radcliff]

Sorry if my explanation was not the best.  Don't give his carers a list of generic BPD traits.  They are likely to be most interested in your observations.  One way to think of it is by thinking of examples of his behavior.  I'm just thinking out loud, but you might consider two buckets, "basic functioning," and "relationships."  What are the ways in which you see that his basic functioning is impaired?  How do you experience him in a relationship?

Don't feel that you have to do this perfectly.  I remember being at the stage you are at, giving information to my BPDw's therapist.  I was heavily invested in the outcome and was very anxious.  It took me a long while for me to come to terms with how much was outside of my control.

Try not to worry too much.  Just jot down a few examples as you think of them on basic functioning and relationship stuff.  Tell them how you experience him, and you'll have made a big contribution to his care.

RC

[Harri]

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