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Tuesday, November 19, 2024

First Responder

Posted by fxckfeelings on November 7, 2011

Frequent readers of this site know that, when confronted by a crazy person, (or asshole ™), one should react the same way they would if they were getting charged by a Grizzly bear; don’t run, stay calm, and play dead. This is hard advice to follow when that crazy person is someone close to you whom you care about and normally count on to be sane, but if you take their symptoms personally and react to those symptoms with strong emotions, they’ll come at you harder than they would some stranger on the street/in the woods. With some people, the illness consists of surges of fear, anger, and despair that cast them and you in leading roles in a suicide-bomber psychodrama; with others, the fear is more centered in thoughts than feelings, which means less drama and less spite, but more crazy ideas that can’t be reasoned away. Either way, the challenge is to remember the difference between the person you love and the craziness going on, make no sudden movements, and wait for the attack to pass.
Dr. Lastname

When my wife is feeling fine, she’s a reasonable, hard-working, dedicated woman who believes in helping others, but then she gets into this grim, obsessed mood and knocks herself out and then gets mad about how people don’t respect or appreciate her and she just doesn’t care any more. Yesterday, she told the boss she didn’t care if he fired her, because she didn’t care. If he fired her, it would damage a career she really cares about and, besides, we need the money, but when I tried to tell her she needed to shut up, she told me she didn’t care about our marriage or about living any longer, particularly if I didn’t support her. What do I do to stop her from hurting herself?

As we’ve said before, there are a lot of people out there who either don’t believe in mental illness, or do believe it exists but don’t really understand what it is. The former usually believe in Xenu, the latter are baffled by “Hoarders.”

Either way, the easiest way to explain mental illness to those types is to describe the disease as a demon, and yes, it’s a sad fact that people are quicker to understand satanic possession over an actual illness, but such is the biz.

As for your wife, some good people get into very black, destructive moods that are hard to describe, even though most of us have felt it at some time in our lives. It’s the kind of mood when you’re ready to cut off your nose to spite your face (and then turn to a loved one, telling them they made you do it and you hope they’re satisfied).

Those good people have the demon, and, if it’s bad enough, it’s a kind of mental illness that can be sudden, random, and completely out of their hands.

Some people are more vulnerable to those moods because they’re particularly sensitive or perfectionistic; they forget their own priorities and lose themselves in doing a good job or caring for others or making someone else happy. If they can’t succeed, they get exhausted and flip out. It’s worse in the afternoon, or when they’re tired and haven’t eaten.

If you send them to their room, they’ll trash it, beginning with whatever they value most, to show you how little they care and how bad they feel—this is the cutting-off-your-nose business described above. There’s not much you can do to help someone who’s sick/possessed in this way except to try not to not make it worse.

Start with not trying to confront her; otherwise you’ll just become a target and foil for her negative emotions. Instead, let her know you appreciate her hard work, know how upset she is and share the feeling that life can suck. Offer her some hot chocolate and/or a foot massage.

Then tell her you support her quitting, but you want her to do it when she’s feeling better and can do it properly. If she hates you for saying that, tell her you’re happy to give her some alone time and take a walk. Then hope you come home to an intact living room.

Later is when you’ll discover whether she’s the kind of relatively normal demon-possessed person who has perspective most of the time and wants to work with you and/or a therapist to gain better self-control, or whether she’s a permanent victim who can’t get past her anger and is sure you’re responsible for it.

In the shrink trade, we call that kind of person a “bad borderline” or “severe character disorder.” We can’t help them, because that demon/disorder problem started when they were young, took over, and convinced them it’s always someone else’s fault.

From what you said, however, she’s got values and priorities that aren’t totally reactive to her anger, most of the time, and she doesn’t always blame it on you or the boss, so there are lots of things she can do to strengthen her rage-management. Medication sometimes helps, but in my experience, what always helps is “DBT”, a behavioral treatment that is a lot like AA, as explained in the book Skills Training Manual for Treating Borderline Personality Disorder, by Marsha Linehan.

Read what you can, talk to experts, whatever it takes to help you understand what’s going on. If you can see her illness as something she can’t help instead of Biblically evil or self-indulgent, you will feel less obliged to stop her attacks and better able to suggest management tools for keeping her demon/disease under control.

STATEMENT:
“I hate watching my wife self-destruct when she’s tired and enraged, but there’s only so much I can do without making it worse. I know the problem isn’t me and I’m sure it’s here to stay, so I’ll encourage her to work on managing it, particularly when she’s feeling better.”

My wife gets paranoid sometimes, in spite of the fact that, after every episode, she agrees she won’t let it happen again. She promises she’ll see her therapist and take her medication but then, for some reason, she decides the side-effects are unbearable and stops them without telling anyone. A couple weeks later, she tells me she can’t stand living with me and moves out. She also tells me they’re plotting against her at work and planting microphones in her desk and she’s going to go to her boss and, by the way, she thinks her psychiatrist has been talking with him about her so she won’t see him any more. She gets loony, and she sort-of knows it when she’s her usual self, but not when the madness is on her. My goal is to get through to her and prevent her from losing her job or leaving me for good.

Paranoia is hard to prepare for or prevent; it’s one of those disorders that makes you wish that it came with a rash or ache, because some very sane-looking people have paranoid ideas that are very plausible until you realize they’re talking about the aliens, FBI and/or Virgin Mary.

It sounds like your wife keeps her paranoia buried well enough for her to be a good partner most of the time, so treat her that way, despite the weird fears lurking behind her eyeballs. She’s a regular person whose “possessed” brain is whispering bad things in the background which you and she know aren’t real and aren’t her.

Of course, your feelings about the matter are strong–her relapses put you through hell—but if you push or infantilize her, you may trigger the paranoia, and you’ll be the target. So keep your intense feelings to yourself while making it easy for her to take her medications and see her shrink.

Have a plan B for the times when she loses it, so that you don’t lose it yourself; the calmer you are, the better you’ll be able to help her. Prepare yourself for the bad times when you have to go against all your spousal instincts and back off.

As you know from the times when she’s taking her meds, they’re not a cure and, so far, nothing prevents relapses. There’s no reason, however, to think that the relapses will get worse; and at some point, treatments will get better.

When relapses occur, however, don’t blame her or yourself. Treasure the times you have together when she’s herself and hope that her crazy spells will be brief and leave her career and relationships relatively undamaged.

Being a borderline and being paranoid are two very different things, but the rules for caring bystanders is the same; if you can’t avoid the illness, just do your best not to be a target.

STATEMENT:
“It’s awful to have my wife’s personality taken over by someone who fundamentally mistrusts me, but I know it’s not personal and we’re a good team when she’s herself. I can’t protect her, but I know the difference between her and her paranoia and maybe that knowledge will help her find her way home.”

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