BPD advice - how to support friend - long

[theancientmarinader]

I have a close friend who has BPD and alcohol addiction. She has been in and out of rehab facilities and MH programs for about four years. She first went to rehab for her alcoholism about 10 years ago and had a great interim period where she was dry and her MH was much better. I've been very heavily used as a support resource for about four years, including 18 months where her dd lived with us, as she was unable to live at home due to her mum's MH and alcoholism. Her dd has found her mum's illnesses very hard to deal with, and has been in long term counselling. We have also supported the dd through suicideal ideation and depression as a direct result of her mum's emotional abuse. Friend had also made many suicide attempts when her dd was still living with her/ hospitalisations etc. Very unstable. The dd moved out of our house about a month ago and is now living with her stepfather, after my friends marriage failed. (This has been on the cards for many years on my friend's side, but he finally decided he was unable to be in a relationship with her any more about ten mos ago.)
Friend finally felt well enough to work (she has been in receipt of disability benefits for a few years) and has found a live-in position working at a children's camp. She failed her CRB equivalent, but was given a chance to explain the circumstances of her run-ins with police (camp extremely short staffed and having enormous problems recruiting). She told them she had a breakdown over her marriage separation and that she was now fine. They decided to give her a second chance. The children's camp are unaware that she is still in receipt of disability benefit for BPD, and is an active alcoholic. Anyway, they took her on. (To be clear, work is extremely beneficial for her as it limits the time she can spend inside her head, and limits her time for drinking/ damaging behaviours - I am one hundred percent in favour of her working as part of her recovery).

She did really well for first couple of weeks, but now seems to be coming unravelled. I have spent about fifteen hours this week trying to support her as she moves through incoherent rants about her ex, her daughter, the fact everyone hates her. Her dd is largely no contact due to emotional abuse. She veers wildly between promises to cut everyone off completely, and pretend they are all dead, and threatening to stalk them until they die and never let go, because she doesn't want a divorce, still loves him, and will die without him. I've been trying to get her back into counselling - she dropped out of both counselling and her MH program three months ago. She has been waiting for a concurrent disorders program, but when it came up, she decided to not to go, and to look for a job instead. She has been increasingly relying on alcohol to get by.
Yesterday she lambasted me for an hour about how I support her husband and not her. The fact that I have spent hours and hours and hours trying to talk her down and stay calm enough for work (amid threats she can't go to work because x, y or z - usually that her x hasn't replied to a text) is irrelevant. (Nor have I spoken to her ex).
I know that the majority of her behaviours are linked to her BPD and low self esteem, and that the 'everyone hates me' is something she genuinely feels. It's blatantly not the case though. She is unable to see that her BPD behaviours are damaging to her relationships. You can only say 'you want me dead, you hate me' to someone so many times before they start to question their love.
I reminded her that I have supported her for years, but that I wasn't going to be a punching bag, and said I was backing off to calm down.
She seemed okay - it calmed her right down. She is now suggesting that as she is completely healthy now, she probably needs new friends who can see beyond her past.
Is it actually worth me trying to continue any sort of discussion? She is still drinking, and her BPD behaviours don't seem to have abated at all - except that thankfully she is not suicidal now (this is a huge plus - I'm not trying to minimise it.). Having known her sober and healthy, I really want her to be happy (essentially she keeps repeating she will be unhappy until the day she dies, and everyone wants her dead anyway).
Is she right that it would be better for her to get new friends? Should I just gently disengage and wish her well?
If she throws her job away because her ex won't reply to her, she is going to be both homeless and unemployed. She has been relying on both booze and her friends to talk her down for hours, three or four times a week in the last couple of weeks. She has already missed a mandatory team building day as she worked herself up. She seems to be spinning out of control again. I'm concerned that if I challenge her 'I'm completely well' narrative that will be seen as me being disloyal to her again, and could damage her self esteem further.
I know it's not my job to keep her alive/ well. But she is my friend and her illness causes her so much pain.
Any ideas? What can I do?

[FreakinScaryCaaw]

Bpd us an extremely complex illness. Even psychiatrists have trouble with it.

Have you read much literature or online information on bpd? Addiction is very common.

You can't help your friend but I think you know that.

I don't know what to advise but I couldn't invest in this sort of friendship. It would affect your own life too much. But it's up to you.

Is it affecting your personal life?

I'm glad the dd is getting support.

Is guilt making you stick around? Or do you actually get something from the friendship?

[FreakinScaryCaaw]

The cycles is common too. Seeming ok then spiralling.

[FusionChefGeoff]

I think you need to listen to the self preservation voice that's telling you to disengage.

This person is using hours and hours of your time and huge amounts of your personal emotional strength and shows little sign of doing anything tangible to help herself.

If you do anything, I'd try to get to an Al Anon meeting as they support friends / carers / families of alcoholics. They will tell you the 3 cs - I think they are:

You didn't cause it
You can't control it
You can't cure it

I'm an alcoholic in recovery and I take it bloody seriously and it's really really hard at times. But until I was ready for help, I just took everyone hostage.

I can't comment on the BPD element but to be honest I've uncovered so much about myself in recovery I wouldn't be surprised if a huge number of the behaviours could be improved with a 12 step programme.

I also speak as someone who had to step away from a similarly destructive, chronic depressive alcoholic who was 100% self centred and consumed by his disease, the past and other obsessions. He died - as I feared he would - without ever getting well or sober and yet I still know I couldn't have done anymore for him and don't regret my decision. I regret that it ever had to happen, but I can still see absolutely that it would have happened with me there or not. It just would have taken a lot longer and would have destroyed me and my family in the process.

Step away, with love and kindness.

[theancientmarinader]

I don't know what's making me stick around tbh - a belief that it's the right thing to do? I haven't got anything out of the relationship for a year or two. She is really unable to focus on anything that doesn't involve herself and her own overwhelming feelings.
It isn't even as though I feel sorry for her/ pity for her - I miss the friend I had, and a part of me thinks if she could only get well again... but it's not really being selfish - I want her to be well for herself. Her life is utterly utterly miserable for her right now. It would be easier to walk away if she was well. Hmm. So maybe that is guilt?

I'm very good at offering three c's type advice to others who are involved. And I reiterate a lot to her dd. Just can't seem to put it entirely into practice for myself.

Dh has been brilliant about having the dd, but is openly relieved that period is over. He is not overly impressed by the sheer amount of time that my friend takes up. It has become easier to detach from that now I am reasonably confident she is not suicidal. But I still keep hoping that there is something I can say that will ease her hurt. It's brutal when she calms down and I relax, but then an hour later is distraught and angry and ranting again.

Those of you who have managed to disengage from similar scenarios - did you manage it gradually? I don't want to exacerbate any problems. I know realistically that it won't make much difference to her - so I suppose it's a bit egotistical to worry about it.

[FreakinScaryCaaw]

Your dh sounds great.

I work with people with bpd so know how destructive it can be to relationships.

I hope you can ease off and not feel guilty. You have no need to.

[Neolara]

Her working in a children's camp and behaving like this is extremely worrying.

I would walk away. She sounds exhausting.

[CardsforKittens]

Friends with BPD can be very hard to deal with - they can push you away while wanting you to chase after them to reaffirm that you care. But I'm sure you know this: you've been doing it for a long time.

I do think that setting clear boundaries can help. You could decide that you will only engage at specific times of day (mornings? No late in the evening rantfests?) or limited periods of time (no more than two hours?) or only when she's sober, to the extend you can judge as some alcoholics can be quite lucid even when drunk. Or set limits around what behaviours you will tolerate, so explain that you will not listen to extended criticisms of you. Or all of the above. Only you can decide what you feel is an appropriate and acceptable level of engagement.

And it's ok to disengage if you feel you've given enough of your time and energy. You can't provide the professional relationships she needs and you can't force her to seek help. So you have to look after yourself. If she gets support, gets sober, and comes back you can always re-evaluate.

It's hard wanting to help while knowing you can't save someone. Really hard. But you've already gone way beyond what most people will do for a friend. You can give yourself permission to step back.

[Bluerose27]

It sounds like a really difficult situation. You've done all you can and more for so long. It might be time to put yourself and your DH first.

Maybe your friend needs professional help and relying on you is preventing her from accessing the help she actually needs? (Apologies if this is not the case).

Can you manage another 40 years of this? Can your husband? Even if you can- at what cost to your own mental health?

[theancientmarinader]

Blue, she has had bucket loads of professional help. Her line is that her counsellor's and program advisors are 'horrified' that her friends and family aren't supporting her properly. I find this mental illness so hard - she engages with professional support when it supports her view of herself as a victim, but disengages when it starts to challenge that view, or tries to get her to work to question her own disordered thinking. It's very sad. She has been in residential programs five or six times (for periods of between one and three months), and has recently walked out of a non-residential but full time program that specifically addressed her mental health. After three years of refusing to allow anyone access to her therapists (she would have no family sessions/ no contact between her team and her husband) she recently signed the paperwork to allow me and her sister to be in contact with her therapist. (Since doing this, she has removed herself from all therapy, so although we were able to discuss 'before', there can be no ongoing dialogue.) She was also offered weekly DBT and a three month concurrent disorders program, but has decided not to attend (for various reasons - the main one being she doesn't like the city she was living in.)
Cards - that's what her ex does. He has told her he will only speak to her before noon. He blocks her when her contact gets too much (she will text and call constantly - sometimes 70 or 80 times). He has considered legal action to prevent contact, and at the moment is trying to include that in their separation agreement. She ignores boundaries and turns up at his house all the time. She has taken to texting me and demanding I contact him and tell him to unblock her. I always respond that I am not going to be a go-between.
It is endless and exhausting. Without any professional help I can see her spiralling further - as though her BPD is unchecked without a counsellor to keep her addressing issues? Her drinking is undoubtedly increasing.

I think giving myself permission to step back is what I need to do. I definitely can't do another 40 years.

[FreakinScaryCaaw]

Sounds like emotional blackmail. And the professionals won't have said it.

[MissMoneyPlant]

I've had professionals say similar things - they seem to have really high expectations of family and friends.
Bit concerned that you think anyone but her should "have access" to her therapists? There seems to be a whole load of dodgy dynamics here - dont just scapegoat her and blame it all on her.

[Orangecake123]

My honest advice here would be to step back and look after yourself first. I have BPD so I can honestly understand her, but Individuals with BPD have very intense emotions and usually tend to be very unstable. You have already gone above and beyond there is no point in burning yourself out trying to save someone else. Nobody can make her go to therapy or change if she is not willing to do so. Putting yourself first isn't selfish but vital at times to protect your own sanity- I honestly feel sometimes my therapist struggles to deal with me and that's with years of training.

[Bluerose27]

Ok so she is getting professional help, but only on her terms.

Easy for me to say, but you really need to take a huge step back. If this were a friend of yours with this issue what would you advise?? Probably time and space away from this energy vampire (sorry, but she's draining all she can from you, and giving nothing back except abuse)

So treat/advise yourself as you would a friend.

It's not as if you giving her all the time and energy she is taking from you is even helping her , she's still unstable (though perhaps more stable than before?)

Allow yourself to step back, you've done all you can , you need to take care of yourself and your family xx

[MissMoneyPlant]

Sorry, can I just say I agree to a certain extent with PPs, my comment was a bit random on its own! Just those two things leapt out.
Some professionals do have ridiculously high expectations of friends - expecting them to be a 24/7 crisis house or something! But it sounds like you are doing a lot. You need to work out what support you are willing to give and stick to it.
And I dont think it's healthy or reasonable (or ethical!) for others to have access to her therapists so that might be stirring up the dynamic for her (it would for me!)

[theancientmarinader]

Thanks folks. Money, I understand the issues with therapy/ confidentiality/ access and it's really tricky. No one wants unfettered access (and I absolutely support her right to privacy). It's more in the context of 'how best to support' - advice from her therapist for her husband (or indeed any of the people that she is asking for support from) would be invaluable, as we have all been wandering round in the dark for years being castigated for not doing it 'right'. But you are right - it is very triggering for her to think people are talking about her/ having access to her private space. That's not really what would have been useful. The program she was on offered friends and family sessions alongside the private counselling, but she wouldn't offer that option to her husband. It did contribute to their separation - she expected unequivocal support even when she was being violent/ abusive (all due to her fear of abandonment) and while he desperately wanted to help, eventually he had to back off for his own mental health. I guess we all hoped that if we could get specific advice on how to react when x,y z we felt our support would be more productive. It's too idealistic, really, and deep down I know that. Mental health isn't that straightforward.
I try to be really clear to her that I'm not scapegoating - I spend a lot of time arguing with her that she's not a terrible person, and that they have all had a rough few years. But I do try to get her to engage with counselling as her main source of unhappiness is that she is essentially no-contact with her dd, and that really is as a direct result of issues around her BPD. I don't know how to cushion that, so I try to avoid it. I spent a long time trying to get them both to keep doors open, but eventually realised they had to sort it out themselves. It's not my business. That's hard, because I know how much it means to the mum, but I also know how damaging contact is for the dd.
Thanks again for your thoughts everyone, especially those with BPD. I don't want to cause harm.