New Member - Carer for Partner with BPD 20 years

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Hi, thanks for having me.

My partner has has mental health problems for 20 years and only recently been diagnosed with BPD. We have a long story of trying to get support for her and have spent 20 years getting nowhere. She has a pronounced health anxiety and has not left the house for the best part of 2 years. Perhaps we might get somewhere with this recent diagnosis but after a random switch to another mental health unit and waiting 4 months for the First Response team to refer to long term support, feels like same old story.

The reason I signed up here is that my partner and I struggle with communication sometimes and not many days go by without tension. I know her BPD gives her a negative perspective and believe me after 20 years my partner's negativity is well and truly embedded. It is very hard to have empathy for how she sees and feels the world, and I do not think the Mental Health workers can see what I do. So I wanted a place where I can share some of our conversation. This would give me a record I could share with my partner's support (when she get some!) and I would also value any comments from here. After 20 years my perspective must be a bit screwy as well, so an objective opinion now and then would be really helpful.

See you in the forum!
Hi and welcome.

MH problems are some of the most intractable problems people can face in relationships, in a way far worse than 'mere' physical disabilities or even, to an extent, dementia.

Do you think your partner has got worse over the years, or recently? As you'll know, MH becomes a habit, and the patient has no idea or recollection any longer of what 'normal' is, and so has no idea in a way how distorted their mental framework is. To them, their distorted framework IS normal.....

Do you have children? You don't mention it, so perhaps not? That at least makes things 'simpler' as it is just you and her in the mix.

What is it, do you think, that you actually WANT? Do you want her 'healed' (ie, 'normal' again - as much as any of us are!!!), or 'less bad than she is'? Do you want HER to change, or YOU to change your response to her?

Do you want to continue with this relationship, or call time on it? What are YOU getting out of it, and what is SHE getting out of it? Is there any question, do you think, of the dreaded 'co-dependency' between you (sadly, not in the least uncommon with an MH partner - there are probably some examples here on the forum if you dig down into the archives!). What is the 'right' thing to do for her, the 'best' way to behave towards her, etc etc etc.

What kind of psychiatric/therapeutic support would you actually LIKE, and what are you actually likely to get? And is there any alternative to fill the gap of what you are not getting!!!!

Are there key things about her that you would like 'improved' but others that you can tolerate and endure and even, to an extent, 'cherish'?

If you did call time on the relationship, what would happen to her, and is that a factor in your decision making (ie, you feel responsible for her?), and what would happen to you? (eg, you would be heartbroken.)

As I say, in the end, caring for someone, living with someone, loving someone with MH is maybe the greatest relationship challenge of you would doubtless agree with!!!
Hi Jenny
Thanks for the welcome. You pose lots of question, many I have to resolve for myself over the years. This may sound a little arrogant, but I am quite centred and make sure that I have a life. In an effort to force change and break habits we sold up and bought a few acres of land and built a house. My partner always wanted to rescue animals, so we said what the hell lets do it. A great distraction for a few years but over recent years she has slipped back. I do all the animal care and building coops and sheds and things, and I love it. I also run my own business, so always have something to do and it takes me abroad now and then. We also have grandchildren, we both have grown up children in their 30s and 40s from previous partners.I do a little visiting in various parts of the country but my partner never comes with me.

My partner is not getting worse in a dramatic sense, in fact I think things have evened out of late. But, she has "settled" at such a low level with no expectations and I see her perspective and logic is now fixed. I just want to see her smile again or go for a meal with her, or visit the family together. She used to be such a vibrant fun person. It is a great sadness and I will never give up fighting her corner.

There are childhood abuse issues behind all this and in 20 years no professional has ever asked her about that. Plenty of CBT that never sticks, I 'd like to see her have some DBT. Getting an agoraphobic in front of a psychoanalyst is a bit of a puzzle though, or even getting the rehab team to put together a plan that ends up with her getting more comfortable with a hospital visit seems to be an impossibility. They are just so uncoordinated (don't get me going on her mental health team experience!) She has a fear of hospitals. She was nursing when she first fell ill. Out of the blue, never left her bed for a two months. A proper breakdown followed by years on Seroxat, that I think embedded her illness.

Anyway, thanks for your reply. Really appreciated. I've had counselling myself so have wrestled with the "what am I getting out of this relationship" question. I'm in a good place. Not an easy one, but I still enjoy life.

You say there are childhood abuse issues which no professional has ever asked her about in 20 years? Seems unbelievable!

At the very least, surely (thinking here as a layperson) these issues need to be clearly identified, recollected, and 'verified' (ie, to deal with any possibility of 'invention' or 'exaggeration' or whatever, which then may have other implications), and then surely their impact on your partner needs to be examined, explored, analysed and, if at all possible, resolved in some way. All I can think to say really is that if the NHS professional seem supremely unconcerned by the potential damage that childhood trauma (of any sort!) has had, then would it be useful to approach an organisation like the NSPCC who have, one can only assume, teams of specialists who can address this particular issue in an appropriate way? As a charity, you might get 'free' attention, or it might possibly switch back to the NHS, or maybe you could self-fund at all???

Trauma per se, of any sort, does not HAVE to be emotionally and psychologically crippling, but it so often is if it is left 'unresolved' (not surprisingly), and even if resolution proves impossible, at least you/she would have given it a go!!!

That issue apart, it does sound like you have achieved a 'modus vivendi' that gives you sufficient quality of life, and a degree of QoL for your partner.

Mental illness does seem to me a dreadful 'waste' of a life, and with such usually negative impact on family too, that surely every attempt should be made to 'heal' it in some way if at all possible. I know that can sound facile, but I was raised by a mum with severe and ongoing MH issues, and it made her a very unhappy person, and my poor dad as well, and was pretty 'tricky' for my bro and me too. I always thought it was such a 'waste' of what could have been a very happy life. But there you go, I'm pretty 'biased' alas, when it comes to MH, so I'm probably just being daft to think that 'healing' is always possible....some forms of mental illness may just be beyond healing alas, however much I, personally, might hope they aren't!

(But if the 'root cause' of your partner's MH problems IS the childhood trauma, then that IS 'healable' potentially, if done skilfully and compassionately...)(Even if, yes, it leaves scar tissue behind....)
Thanks Jenny. It's all very long story, but a bully for a dad, marriage breakup, negligent mum, victorian new dad,death of a sibling (and not being told) and getting shot all are in the mix. I used to accompany her to the doc in early days once a week and asked for therapy, doctor used to say, "what do you need that for? I'm counselling you right now!" I've paid for psychiatric assessment, but the doc told us that he didn't have to take notice of it.

Took 15 years before we discovered that there was such a thing as a first response unit and that the doctor could have referred my partner to it at any time. She self referred in the end. Rehab team and regular psychologist has helped but all CBT and exposure. I've pushed for psychoanalysis for 5 years only for the MHT decide that the initial referral was to the wrong trust and transferred her case. They acted quickly and sent a consultant psychiatrist to the house to assess and medicate with a week's worth of prescription. Came back with the BPD (or Emotionally Unstable Personality Disorder) to replace the previous GAD diagnosis. That was nearly four months ago, haven't heard from them since. I ring regularly, and am told things are in hand, but there is some debate whether they can afford to take her on. My understanding is, stalled treatment is more harmful than no treatment and it is difficult not to despair or get angry. I'm pretty sure NHS have enabled her illness. Should have seen it coming I guess when she was sacked by the hospital soon after falling ill in the first instance. She was such a marvelous nurse Jennny, the kindest, most caring, engaging carer you could ever hope to meet.

THe NSPCC is a good idea, but need to bring this new referral to a conclusion. Sort of twitching at the prospect of starting a claim for negligence.

Thanks again
Don't know why I found this so upsetting. We were talking about our grandchildren and she was comparing the development between two who are 6 months apart in age. She wanted to know at what age would you expect all children to have the same skills having noticed that the younger of our grandchildren seem to develop the skills of the older in the 6 months between them. I have taught for over 30 years and said that I thought there was a set of core skills that you could reasonably expect the vast majority of children to acquire, but some never do, and as the skills to acquire got more complex and the pupils get older, the spread of skills got wider.

We went over this about 20 times but she was convinced that I did not understand her question and grew more and more impatient and kept asking at what age the 6 month differential would not matter. I had to really work hard to not appear frustrated and impatient and keep the mood light. At one stage I showed her Piaget's model of cognitive development, but that was "school stuff", and she wasn't talking about that. In the end she was frustrated and dismissive. She wanted a definite answer, an age. Wanted a black and white answer to a question where the answer was grey. Sort of pleased that I avoided a conflict but it was close and really unsettled me. Not sure why.

Ironic in a way. Her thoughts are markedly concrete.
Ok, found this...
Dichotomous (Black or White) Thinking
People with BPD also have a tendency to think in extremes, a phenomenon called “dichotomous” or “black-or-white” thinking. People with BPD often struggle to see the complexity in people and situations and are unable to recognize that things are often not either perfect or horrible, but are something in between. This can lead to "splitting," which refers to an inability to maintain a cohesive set of beliefs about oneself and others.
Hi, not quite sure if I understand what you were debating, but just wanted to point out (if this is relevant?) that younger siblings almost invariable are 'more advanced' for their age than the older sibling was at the same age, simply because they have 'learnt' from the older sibling!

This was very obvious in myself - I was 'advanced' for my chronological age because my brother is over 6 years older than me, so I always strove to 'catch up', which pulled/pushed me 'on' and also, of course, simply 'demonstrated' to me what 'older children' were capable of. I could see my bro doing stuff I couldn't do, and realised that (a) it could be done at all (!) and (b) I wanted to do it too!!!!

This lasted (and probably still exists to an extent) right through my school days. I particular remember that when I was in sixth form I used to read his university text books because I wanted desperately to 'catch up' with him.

It's my firm belief, based on this experience (and seeing it in action now as a parent, with those who have two children - I don't, mine's an only), with the younger one constantly 'snapping at the heels' of the older one, desperate to 'close the gap'.

As I say, not sure if this is what you were debating, but it's a very reasonable/logical proposition that I feel is often borne out in observing siblings.

(Ironically, of course, in very early childhood, the younger/youngest siblings can be seen to be 'delayed' in their development - eg, they talk later than their older siblings, and this is generally explained, so I believe, that the older siblings 'speak for them' - eg, 'Johhnny wants a drink now mum' the younger children don't bother to speak because why should they bother, when they have big bro/sis to do their talking for them!)

PS I hate Piaget! :)
PS - re the six month gap, I would say it also depends on whether two children six months apart have summer birthdays, ie, whether one is in the upper year at school, and the other in the lower. I suspect that a younger child in a class is 'advanced' compared with the older child in the year below, ie, the gap is MORE than six months, simply because, as with my older sibling observation, the younger child in the year above will be 'pulled upwards' by the more advanced subjects etc in the rest of the class, whilst being an older child in the year below, could be 'under stimulated'......

In general, however, the impact of a, say, six month gap between children will have some kind of mathematical formula, won't it, that has a 'coefficient of difference' or a calculus that accounts for the fact that at birth, a six month old baby obviously is WAY WAY WAY more 'advanced' than a new born, but that that gap 'closes' according to a particular coefficient, which may be arithmetical, or possibly exponential???

Speaking 'naively,' I'd give a rough punt to say that by, say, 13 or 14, a six month gap will be completely neglible in terms of intellectual achievement (all other factors excluded, eg, a 'pull' from an older sibling, or from being a young child in a year group.)
Hi Jenny thanks for this. I appreciate the effect between siblings, the two were discussing were from different sides of the family though. But you are right, brothers and sisters can be a great influence. I think you will be surprised though at the spread of intellectual capability as pupils get older (I was a teacher for 30+ years). GCSE grades have 9 levels, and you need them!

But, the reason I created this thread was to record interactions with my BPD that I was finding difficult and stressful. I've not recorded as many as I would like but, we are still waiting for treatment after 20+ years of illness and a catalogue of misadventures with NHS services. She has not left the house for nearly three years and had a 10 year episode of being housebound earlier. She has just been diagnosed with BPD, after all this time and we are still waiting (nearly a year now) for the mental health team to see her after three years of support from another team that suddenly decided that she was not in their catchment. So, I use this thread to record difficult instances so I have a record when the team picks her up, and I get some sorely needed advice on the way.

I am learning a lot about her perspective and how she sees things. Before we used to clash and not talk to each other for days. That's quite rare now and I am learning how to keep things going. The discussion about grandchildren was dangerous though and could have quite easily ended badly... but very stressful I felt.