Re: First psychiatrist appointment. (Part 3)

[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

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[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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