"Mom, I can't take this pain anymore"

[AlwaysAnxious]

This is a text I get multiple times a day.

"Mom, I can't take this pain" and I don't know how to respond.

I've offered support, I've offered to take her to the doctor, I've offered to take her to a psychologist.  I've offered to take her to the hospital. She has Ativan - she says it doesn't work and makes it worse.

She won't take pills so no antidepressants and anxiety meds.
She won't seek any help other than the counsellor she already has been seeing for 2 years. 

This text is usually followed by "I don't want to do this anymore". Another thing I don't know how to answer.

If I don't answer, she starts with abusive accusations.  If I do answer, it's more of the same until she's angry and starts saying I don't care.

 

AlwaysAnxious

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Josie C]

I surely wish I had the words that would make a difference, Always Anxious.  I can tell you that I understand the struggle.  Much of your experience matches what happens with my dd26. She has repeatedly begged me to help her die; when I won’t agree she gets furious and says that wanting her to live is selfish on my part.  She too has turned down offers of therapy, has had awful side effects from other meds so she won’t try anything new anymore. We offered to let her keep her current therapist of 2 years while we pay for additional more intensive therapy. At first she agreed to let us find someone, and once we found a practice, she refused to go. 

We often hear (mostly via rage) “you don’t understand the pain I’m in.”  And I  agree with her— I don’t understand.  Then I try telling her that I do see the pain and how it troubles her. I cannot possibly imagine what it is like to live with BPD, it must be beyond difficult, frightening, immobilizing at times.  It must be exhausting to hold that much anger, shame, guilt, fear.

Sometimes I try validating her distress.  I let her know that I see her, that I know she’s in pain, that wanting to end it all must be incredibly overwhelming.  I remind her that there are people willing to help her when she’s ready. 

Mostly, though, she’s already too dysregulated to accept validation or words of support. It usually seems that I can’t get it right—no matter what I say, it isn’t helpful. Perhaps there’s a window of opportunity that I’m missing, when the words will actually make a difference?

I really appreciate you for posting this, Always Anxious.  I’m hoping to get some ideas from others, too.

[CC43]

This is a tricky question. I tend to agree with the other poster that when they are in distress, they can’t process anything you say, as their distress is too great, and yet silence is met with more anger. Have you tried asking questions?  For example, what is upsetting you most right now?  Is this the worst you’ve ever felt?  Are you making plans to end it?  What are they?  Are you ready right now?  Are you feeling anger, or sadness, or hopelessness?  Maybe this could help her get in touch with her feelings, or maybe draw out an explanation, or just reassure her that you’re not denying that her pain exists, and that you don’t think she’s a freak for having such intense feelings.

I’m not sure about this because the pwBPD in my life invariably says she wants to be left alone. It’s ironic though, because she’s crying for help, and yet refuses it.

[CC43]

I’m following up with an example of a conversation. Once my stepdaughter was raging with hatred triggered by memories of a sibling who supposedly abused her in childhood.  Even though I knew her accusations were false, I asked her, what would possibly make her feel better right now?  She was taken by surprise. She had a hard time answering. She said that he should be punished. Then I said, let’s say he’s punished, and gets sent to jail. Would that make you feel any better?  I could see her thinking and calculating, that she wouldn’t really be better off in that scenario, despite feeling vindicated. But somehow the thought experiment seemed to take her anger down a notch. She left the room, as the conversation was distressing. But she appeared to get back to a calmer state fairly soon afterwards. I’m not saying that the conversation solved her problems. But it was a conversation that was less one-sided, and not just a repeat of the usual laments.

[Notwendy]

I read the title of this thread and wanted to add some perspective. I don't have advice on what to do- I wish I did- but hopefully the perspective will help a bit. When your D blames you for not caring about her "pain"- I hope you can keep in mind that when she expects you to do something about it, she's asking the impossible.

Our feelings belong to us- we have no control over someone else's feelings. Whatever your D is experiencing as pain- this is her feelings. You can be empathetic- but it's impossible to "fix" what is going on in her own nerves and brain and body. These are hers. A component of BPD is that they have difficulty managing their own uncomfortable feelings. This isn't your fault.

Likewise- what you are feeling is all yours too. I think your user name is a reflexion of this- it's understandable. You would feel less anxious if she felt better but this makes your feelings dependent on her feelings and so you feel out of control with yours- because her feelings are out of your control. She's looking to you to help with her feelings, you are feeling dependent on her's.

But it's a false pretense- your feelings are soley yours, hers are hers.

How to change this pattern? With a lot of personal work- for yourself. It's not easy- this is your child and parents will do anything for their children. It's just that sometimes the "anything" isn't as helpful as pulling back and letting the child figure out their own solution. The threats of self harm make knowing what to do difficult.

In my own experience, I have an elderly BPD mother and I am middle age- and your thread title caught my attention because of the frequent calls from her where the topic is "her pain". At this point, she has some physical conditions that cause pain too but it seems that for as long as I can remember, my BPD mother has been talking about her "pain"- emotional or physical- and it seemed her emotional pain would translate for her into some sort of physical pain. Our family focus was on how to make BPD mother feel better or avoid "causing" her any distress. BPD wasn't a known thing at the time my parents married. My father's approach was to try to emotionally ease her- as much as he possibly could, although easing all stress on her would be impossible- because this source of emotional pain is her own feelings.

This emotional pain seems overwhelming. I wish we knew how to help relieve it- if we knew how, we'd have done it.

What I see now with my BPD mother is that she is unable to self soothe- so she looks to others to calm her self down when she's upset or anxious about something. This is a skill young children learn when they are upset. Young children may tantrum until they learn this skill. It takes the ability to "self talk". Many have a transition object like a "blankie" or stuffed animal with them to help with this. Eventually they learn to self soothe and don't tantrum or keep the blanket. For this to happen- the parent needs to allow the child to be upset and learn to calm down. The parent needs to be able to self soothe their own upset at seeing the child upset.

How to do this when there are self harm threats is a challenge. It's very scary. We saw them too. Even now, my BPD mother makes them, but she's in assisted living with supervision so it's less of a concern on our part. However, we are also firm with her in that if we were concerned- we would call 911. It may be that a call to 911 is the consequence of your D's threats.

As a parent, it's instinctual that you want to help your child with her emotional pain and are afraid to pull back because of her threats. However, this also takes an emotional toll on you- to try to fix something for her that is not in your capacity to fix. She calls on you when she's feeling this- you are her emotional support person, what she feels dependent on to self soothe. I'm not blaming you- you are doing what a caring parent would do.

BPD mother will call me and say I need to help her feel better. She will then discuss whatever is bothering her and then later say "she feels better now" or "nobody cares about her pain" but it has helped me to know that I don't have the power to fix someone else's feelings. Also just because someone accuses you of something- that doesn't make it true. Of course you care- and what your D says doesn't change that.

However as long as you soothe your D's feelings for her- she won't have the chance to learn to self soothe. Can she? One doesn't know until they try to let it happen. Can you find the courage to step back on your part in this? I think it will take support for you. I hope you are in counseling- because it's hard and it's scary, but being able to see what is in your capacity to do for her and what isn't is a helpful step.

[CC43]

Notwendy,

I think your post is spot on!  Recognizing that you can't control your loved one's feelings is important.  So is trying not to be a sponge and absorbing her negative feelings.

As you suggest, most adults have developed ways to self-soothe, but some need extra practice during stressful moments.  My approach to self-soothing typically starts with taking deep breaths during tense moments.  I'll also do a reality check:  "Am I worrying unnecessarily about something that hasn't even happened yet?  Am I fretting about something that is beyond my control?  Why assume the worst?"  If I'm agitated, going for a walk and getting some fresh air really help me.  And if I'm really stressed or frustrated, typically I'll say to myself, "I'm too upset to do anything productive right now, or have a complicated conversation.  I'm taking a relaxing bath and going to bed early tonight.  I'll switch off my phone and my negative thoughts by reading a book for a few minutes.  Tomorrow my head will be clearer, and I'll be able to think straight and deal."  And:  "That interaction really got me mad.  I've written an email in response, but I'm not going to send it until I re-read it in the morning, and make sure that my anger isn't clouding my judgment.  There's no reason I should rush and say something I might regret."  And:  "I'm so mad right now, I have all this energy with no outlet.  I'll start cleaning to burn it off.  Re-establishing some order in my environment seems to make me feel a little better."

However, I think the internal dialogue of a pwBPD is very negative, and they get "sucked in," or "stuck," in a negative thinking loop, which devolves into a downward, self-destructive spiral.  They probably haven't learned to cope with their feelings in a healthy way.  And they might have a hard time even identifying what seems to be wrong.  It seems they are constantly viewing others as CAUSING their bad mood, rather than recognizing that their mood originates from inside herself.  Because of this, she probably expects others to FIX her mood.  Her coping skills seem so misguided, and her reactions so irrational and impulsive.

So if she's unhinged, and the conversation seems to go in circles, I think that she probably needs an "adult time-out."  Like you suggest, Notwendy, she might need more time and space to try to learn how to deal with her feelings on her own.  That's where DBT therapy can help.  I understand that DBT therapy teaches techniques to improve emotional distress tolerance, control impulsivity and recover from unhelpful thought patterns.  Like most things, it probably takes practice, to learn what works best for her.  But surely there are ample opportunities to practice.

"Mom, I can't take it anymore."  "I'm sorry honey, what would it take to make you feel better right now?"  Or "What is bothering you most right now?"  Maybe let her think about that for a while.  She's the one who needs to identify what's ailing her, and find healthy ways to cope that work for her, which don't involve endless venting and blaming you, and getting nowhere in the process.

[Notwendy]

Yes exactly. I am not personally familiar with DBT therapy but I think many adults need to also learn better self soothing skills. It is something we also work on in CODA and 12 step groups- because the partners or family members need to be able to manage their own emotions better too. The dynamics between family members where there's a family member with a disorder are very similar to where there's a family member with an addiction, so these groups help with BPD dynamics too.

It's a bit of chicken and egg too. Parents don't control the genes kids get. If a child has emotional regulation difficulties, the parent's also respond from their own hightened emotions- it's a natural response. Wanting to help your child is instinctual.  However, it may result in a pattern that may maintain the dynamics.

My father loved my mother and also couldn't stand to see her in emotional distress and so did all he knew to do to help her. It became a family effort with us kids trying to help my mother too.

It makes sense that I needed to do a lot of personal work on my own co-dependent behavior as an adult. These are well learned behavior patterns. It's not easy to let someone deal with their own emotions. I also understand the helping to coach them to do that - to the extent one is willing or able to. However, it has helped to learn that it is OK to let someone learn to self soothe to the extent they are able to as well.

[AlwaysAnxious]

This is very healthy and helpful dialogue. Thank you.

I have tried to ask those very questions of her. I say


- "What do you need right now to help you through this?" (She says she doesn't know or she needs to die)
- "What does your therapist suggest as strategies and how can I help reinforce those"  (She gets very angry at this question - says I'm pawning her off to be someone else's' issue)
- "What is bothering you the most right now" (I always get the same answer to this as she has a specific situational loop she's in) and so the question is generally answered with alot of swearing and accusations that I don't listen or I'd know")
- "I don't know how to help you." (She'll tell me she wants to talk but it's a review of the same things we always talk about and if I don't talk or if I pause for a moment, then she gets angry and says I'm not helpful or she'll tell me it's my JOB to know.)

I've also told her if she is going to threaten suicide, then I will call the police or EMS and she assures me if I call them or her therapist, that she will "pass their tests" and then she will carry out her action and be sure I know it's because of me.

I've called the police - they didn't go to her. They said it would make it worse.

Not answering her text or going on do not disturb if she's threatening suicide feels impossible - I don't know how to do that without adding to her feelings of abandonment.  She has called the suicide help line - they don't seem to help.

She won't take medicine or try a new therapist. She doesn't think the issue is her. She believes she was meant to be the recipient of all these betrayals and mean actions.

I'm truly so envious of those that have figured this out... I am waiting right now as she's gone to play a sport but I know when she gets back, she'll be blowing up my phone.  We are and have always been very close and talk several times a day even before she had symptoms and I'm the emergency contact for others so hard for me to just go MIA on my phone.

I do however, turn my phone to DND at night now - a new practice that she has had to accept.

[BowlOfPetunias]

We had years of unexplained pain that doctors and ER rooms said was just psychological.  A pediatric rheumatologist diagnosed Amplified Musculoskeletal Pain Syndrome. See https://www.chop.edu/conditions-diseases/amplified-musculoskeletal-pain-syndrome-amps.

[Sancho]

Hi AlwaysAnxious
You have offered everything, done everything you can. My suggestion is that you respond in a way that recognises DD"s choice not to accept anything you have offered eg

Start with affirmation - 'it is hard to cope with such intense emotional pain' - then a statement that acknowledges her choice - 'I know it's so hard but I have to respect that you don't want to look into any of the possible options at this moment. I do love you and do respect that you want to deal with this yourself.'

I would think of all the different ways that I could say something like that - also finding opportunities to say that you don't have the skills that she needs at this point in time.

You probably have tried this but just thought I would mention. It is just a way to say that THEY are making choices, and you respect and accept those choices.