Trust issues and therapy

[Birddog]

Hi,

Have children, and spouse recently diagnosed with Schizotypal PD (cluster A), she has some borderline traits.

Any guidance on treatment and therapy? Spouse seems willing to work on issues on surface, loses interest quick and dives into next crisis with hypervigilance. She also Has a lot of same behavior concerns more associated with cluster b diagnosis (e.g. splitting, devaluing, distortion campaigns). Biggest thing see holding her back are trust concerns with diagnosis, all doctors, she looks for validation and plays victim with all doctors and therapist on what she thinks the answer is, when she doesn’t get that, moves to the next.

[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.

[once removed]

hi Birddog, and

really the primary things when a spouse enters therapy are 1. expect ups and downs, potentially wild ones, and 2. maintain realistic expectations. change is difficult. none of this happened over night, and its going to take a lot of effort, and trial and error.

how long have the two of you been together? what led up to the diagnosis and how is she taking it?

[No-One]

Have children, and spouse recently diagnosed with Schizotypal PD (cluster A), she has some borderline traits.

Biggest thing holding her back are trust concerns with diagnosis, all doctors, she looks for validation and plays victim with all doctors and therapist on what she thinks the answer is, when she doesn’t get that, moves to the next.

Hi Birddog:
Welcome!
Is she taking meds for Schizotypal?  Thinking that if she can get those symptoms under control, it can set the stage to work on the BPD issues.

What answer do you think she wants from medical professionals?

[Birddog]

She’s taking lowest dose of Abilify, Thyroid med seems to have also stabilized her, only 3 weeks in on meds.

We’ve been married for 21 years,  had one outpatient Er in 2012 for anxiety. She did councelling for a while, had a good mask on and didn’t see how deep the issues were with paranoia. Four health and welfare’s this year, 4 day inpatient stay, one restraining order last year against me out of nowhere, that one was completely out of the blue, she all of sudden got up with kids in middle of family movie and wanted to leave with kids. Called PD, they said one of us had to leave, so left for night to diffuse situation.

This last year and a half was a living hell to put it mildly, very erratic moods, blame shifting, devaluation, stonewalling. Took it to marriage  councellor. She was helpful. Later learned needed to focus on the abuse and mental health issues separate, once that was sorted out move back to MC.
Finding I have codependency issues of my own, and starting to work on loving myself again so to speak, continue with outlets, listen to my feelings, easy to get into protective self mode. The interests keep me going, however don’t completely fill the void. Kids are tremendous, and want them to have a health mom. A lot of times take them somewhere on the weekend. I am tired, and mindful of CPTSD if don’t work on appreciating my own inner self. I am not perfect and sticking the course has been a very hard personal decision.

There are up days,  and see some progress that give hope..

Also been working on SET-UP, been positive, still have to walk away from the no wins, very important to set boundaries on bad behavior, protect the kids. I feel a lot of guilt for not finding SET-UP sooner.  Also guilt for being in dark on PDs, wish therapist would have been direct with us and not tiptoed around. The trust issues and paranoid delusional thinking make this very difficult to address.

A side of me wants to get in and be more involved in therapy, point the direction, drive the care, however trying to keep what little trust if any is there is intact.

Looking at DBT options,with once a week therapy not seeing the traction needed to succeed, not sure how to shop for once a day group, even resident therapy. It’s quickly becoming my limit for staying with the marriage for health and safety reasons.

Last month she has been stable, the delusional thoughts , anxiety, paranoia, hypervigilance are still present.

[No-One]

Hi Birddog:
You have been through a lot.  I'm so sorry - it has to be a big challenge. I'm glad you are doing some things for yourself and your children.  It's important that you take care of yourself and keep finding ways to relax.

She’s taking lowest dose of Abilify, Thyroid med seems to have also stabilized her, only 3 weeks in on meds.     

These type of meds can take 4-6 weeks to really kick in.  The doctor might titrate her up to a higher dosage after a while.  If they start out slow, it can help prevent some side effects.

Also been working on SET-UP, been positive, still have to walk away from the no wins, very important to set boundaries on bad behavior, protect the kids. I feel a lot of guilt for not finding SET-UP sooner.

Do you mean SET (Support, Empathy & Truth)?

A side of me wants to get in and be more involved in therapy, point the direction, drive the care, however trying to keep what little trust if any is there is intact.

Looking at DBT options,with once a week therapy not seeing the traction needed to succeed, not sure how to shop for once a day group, even resident therapy. It’s quickly becoming my limit for staying with the marriage for health and safety reasons.     

What Country/State do you live in?  Have you checked with the current therapist about some DBT options?  Attending DBD training in person is probably best, but you might find some possible online training options to consider.

[Birddog]

Yep, SET-UP

Got it from “ How to Communicate with Someone with  BPD”

Support EmPathy Truth,

The up is understanding and persistence when all else fails.

Found a bunch of DBT groups today on psychologynet, will pursue, difficult  finding time to follow up, might work better to hand off to spouse to make the calls. Format on site is pretty straightforward. I’m located in eastern US, trying to stay fairly anonymous.