Talking with BPD mother about her diagnosis

[cle216]

Hi everyone,

I've posted a little before here, but a quick background leading to my post today...my mom received counseling in the past, maybe about 2-3 years ago now to address some things in her life that were difficult. Her 6th marriage was ending at that time and she was looking for some coping strategies. The therapist started exploring her childhood and that started to upset my mother, she thinks she should just be told what she needs to do different rather than understanding the root of these difficulties. Then it led to the therapist discovering things that prompted her to mention that she believes my mom may have BPD. I clearly remember my mother telling me about this and her being upset/offended by it and talking about her ex husband who was diagnosed with BPD and how "horrible" he was. The therapist also suggested she speak with a psychiatrist. These suggestions resulted in my mother deciding to no longer see her.

Fast forward to about a week or two ago. My mom is now in the process of ending her 7th marriage, but still has behaviors that seem very confusing to me if she is sure about it or not. Anyway, she reached out to me via text and said she is searching for a therapist because she "has no idea what's wrong with her". She explained that she wasn't sure what method is best for her since she doesn't know what is "wrong". I thought it would be helpful to start from where things left off so I mentioned to her that her last counselor had mentioned BPD and that it tells me that DBT may be a helpful approach to look for in a therapist. She immediately went into a rambling of text after text. Not with anger that felt directed at me but it felt elevated. She immediately said she does not remember that being mentioned at all and referenced again her ex-husband and specific behaviors he showed that she doesn't believe she displays. I tried to remember some things I learned from here and thought of validating and calmly redirecting to facts so I just told her very clearly "You had mentioned that she mentioned BPD. I'm just starting from the information you had shared before. Of course an accurate diagnosis is important to have an effective approach". I also went on to remind her that I can understand how hearing that could make her feel and reminded her she had brought him up in the original mention of it years ago and that I understand that from her personal experience that this could have been difficult for her to hear. And that all people are individuals and that she may not necessarily have the same challenges that he did. She just went on and on the rest of the day in a way that seemed she was trying to prove to me she didn't have BPD. Mentioning different diagnostic criteria and one instance where she did something that was different than that criteria. I did not respond to all of those and just reiterated that maybe she should just focus on her challenges and what she wants to work on regardless of what it may be called...but also that unfortunately with insurance and connecting a helpful treatment that there may be a name for it at some point, which doesn't have to be any one's business. Mostly I let her ramble because responding too much feeds that rambling and I occasionally jumped in to validate or make a simple statement...it's hard not to get pulled in. Then I asked her if she could remember the details of why she was asked to speak with a psychiatrist (thought maybe that was a better approach than me telling her what I remember). She remembered that suggestion but couldn't remember why. While frustrated, this also made me feel better that she's just having difficulty remembering or dissociated from that uncomfortable and painful memory.. At first when she told me she didn't remember this diagnosis being discussed it made me feel out of my mind...questioning myself. But I know she mentioned it, and I remember the mention of her ex, and then ending treatment. I remember being in disbelief about it too and then after learning about BPD and reading "The Borderline Mother" I can relate more than I ever would like to. It was as if the more she tried to prove to me she didn't have BPD, the behavior and way she was going about it actually support the BPD even more.

If you've gotten this far thank you. I suppose the point of this post is to ask for better ways to talk about this with her if she brings it up again. My mom sometimes will sit on things for awhile and suddenly learns more herself and may come around to making some realizations. I tried to share with her that maybe the name of the disorder isn't fair and is stigmatizing and it's more of a disorder of emotional regulation and difficulties with relationships. She mentioned she thinks she has some PTSD, and I let her know that the childhood trauma is often connected...trying to help her see it's not her fault necessarily and it may feel good to have an explanation. I've decided I won't bring it up again but in the chance that she brings it up to me, I'd like to be more helpful in encouraging her to think about BPD in order to find the right treatment.

[Harri]

Hi cle, it is good to hear from you again.   

I've decided I won't bring it up again but in the chance that she brings it up to me, I'd like to be more helpful in encouraging her to think about BPD in order to find the right treatment.

Not bringing it up is wise.  I can't say for sure but it seems like she dissociates at the thought of it and falls into another defense, denial.   The thing I like to remind myself of is that a persons defenses are there for a reason.  They are for protection not to pull the wool over our eyes but to protect them from things they are unable to process or accept.  Sometimes poking at those defenses can be harmful if they do not have a support system, in this case i would say a non-family member, there to help them.

I would see where she goes with it when she brings it up.  If she is more comfortable with the label of PTSD or c-PTSD, does it really matter in terms of getting her help?  DBT helps lots of people with or without a diagnosis of BPD and even without any diagnosis.  Talk therapy is effective for a lot of people and disorders.  The behaviors and thought patterns of c-PTSD are very similar to those of BPD.  So if possible, I would stay away from a label and definitely focus on what she says about her behaviors and getting her in to see someone.  I would try stressing getting in with a therapist, preferably a psychologist (Phd) who focuses on anxiety disorders and trauma.  Leave the labels out of it.

Thoughts?

[cle216]

Hi  @Harri!

I appreciate your feedback. Once she responded, I immediately regretted mentioning BPD, but my intentions were good as she was initiating asking for help and what my thoughts were on where to start. I probably just got excited about her saying she wanted to seek help. I thought that picking up where she left off was good but now I know to frame it differently since the BPD label puts up her defenses. I also quickly remember that even though my mom asks for advice she still always does what she wants anyway...she should, she is an adult after all. But I mean that it can get draining when she comes seeking advice and then does not have any plans to consider it. So it was at least a reminder to me to not exert too much emotional energy and maybe to put the thinking back on her to consider what it is she wants to work on. I'll try to give guidance to the PhD option if she asks my thoughts.

[Harri]

 

Sometimes just listening with empathy and validating her feelings can go a long way as you have figured out.  I think i would have a hard time letting go of the hope and excitement I would feel too.  Ugh.  Managing expectations and our own hopes and letting others figure things out can be so hard and draining like you said.