Q. Dear Dr. Heller,
My mother's behavior is almost always frighteningly erratic - could it be BPD?
She reacts to the slightest criticism with behavior ranging from devastated hurt ("How could you do this to me?") to intense fury. She often works herself into a low-grade rage grumbling, then yelling to herself, slamming doors and objects. She sleeps all hours of the day. She has lost at least 2 jobs in the past several years and is now currently unemployed. Apparently she's churned through several romantic relationships since my father left her in 1993. Every negative event in her life is always someone else's fault - the loss of a job ("They never liked me, they were out to get me"), the loss of a relationship ("I don't understand why he left"), chronic illness ("why do I always get sick?") . In short, she believes she's always the victim. She refuses to accept responsibility. She's also been an serious alcohol abuser for at least 15 years. Her behavior is only slightly less erratic during sobriety, however. Every attempt to make a positive change in her life is very short lived, be it seeking counseling, finding another job, etc. Things most people consider a part of every day life are insurmountable colossal efforts to her, forcing her to give up. Also, she looses concentration frequently; forgetting what she's saying in mid-sentence, etc.
Worst of all, she's in complete denial. She doesn't admit that she has ANY problem. She was hospitalized for a week, and had weekly sessions with a therapist for a year or so - all several years ago, during her separation with and divorce from my father. Looking back, she sees that treatment as having been temporarily necessary due to loosing my father, not something that continues to be necessary.
Currently her brother and mother are paying her rent and subsidizing her life. We've all agreed this can't go on and want to get her into an appropriate program. We want to give her an ultimatum: "Get into a program or the financial help stops", but I'm not sure that approach will work. I know people have to want help to be helped. Is there nothing we can do?
A. First of all what you described is much more than the BPD, IF the BPD is even present.
What you're also describing is "enabling" on your part. As much as you care about your mother, she's still an adult and has to land on her own two feet. You are preventing her from seeing the consequences of her actions.
You may have to face up to the realization that there may indeed be nothing you can do - except make things worse for you, your family, for her, and her relatives.
There may be medical problems present as well, such as the lost concentration. The only way you can force someone to get medical attention against their will is to take legal action and have a judge rule her incompetent.
Probably the best thing to do in the short term is for you to get into counseling. The more you understand your feelings and motivations the easier it will be to deal with her.