Monday, October 30, 2006

Borderline and Jealous

Switch the biological sexes and relationship labels to make them politically correct.
Like "wife" can be "partner" or "spouse."

"Man can be woman." "Woman", "man". That sort of thing.

Sometimes a guy will bring a woman to marital therapy because he's jealous and angry, ready to leave the relationship. She just wants to go out with her friends. And chutzpah of chutzpah, doesn't necessarily answer the phone. The argument is on-going.

She's very responsible when she goes out, hardly even drinks, really. She doesn't use cocaine. She comes home in a great mood, albeit late, and she might even feel sort of loving. But inevitably, he's angry.

Why? He's done this many times, comes home really drunk. She's not even coming home drunk. She's the designated driver.

While she's gone he tries hard not to picture guys hitting on her, but it's REALLY hard to do that. Worse, because she's naïve about men (at least he thinks so) he thinks she'll put herself in an uncompromising position. She's out late, very late.

What kind of a girl stays out so late, anyway?

Let me tell you. All kinds of people are out at all kinds of hours. Some people actually work midnight or late shifts, and when they're finished with their jobs it's hard for them to go right home and go to sleep. They need a life, too.

So they aren't all loose women and men closing the bars early in the morning.

Ah, he tells me. His wife doesn't work a late shift.

But, she tells him, not everyone is out to hit on her or anyone else's wife. Most people, at 2 or 3 a.m. are getting quietly sloshed.

So I talk to her and learn that indeed, she does adore her guy, and has no interest in other men or other women, for that matter. (She is out with the girls, after all).

Our guy understands that. He gets it. His rational brain tells him exactly why she's out with her friends at this hour. She didn't get to act out at all as a kid, always wanted to socialize but couldn't, and now she's all grown up and, insert expletive here, she's going to do what she wants as an adult.

You go, girl, I believe is the expression.

He tells me that he flips between loving her more than anything in the whole world and trusting her, following our visits, usually, to over the top, unstoppable, painful jealousy and rage, not caring what happens to her, wishing she'd drop dead, or at least leave him, put him out of his misery.

And all over a coupla' beers.

He himself makes the connection that it is because he loves and trusts her, because he knows that she's the one he wants for partner, mother of his children, lover, and friend, that he becomes wildly anxious when he fears she may be in the process of abandoning him, cheating on him.

What we have here is psychotic anxiety and rage that is triggered by a fear of abandonment. These fears have to be worked on, you know. You can't let them fester forever.

Anxiety that's to the point of psychotic inhibits rational thinking. One's thoughts have no basis in reality but they feel very real.

What to do?

Well, marital therapy, obviously. She has to reassure him and to develop some kind of behavioral strategy that will chill him out. And he has to work on his abandonment issues, and his impulse control, rationally go over a few of the symptoms of Borderline Personality Disorder, see if they fit. And if they do, get to work on them.

If she doesn't want to make the proverbial call to him from the bar, always had to call her mommy and can't do it anymore, she can plant a note or two in the apartment that tells him that she's looking forward to coming home late at night.

That would be CODE for something nice.

He would get it.

If she's the romantic type, then she can be obvious about it, tell him how she loves his 4 a.m. shadow, stuff like that.

In a relationship therapy I'd have her be the one to reassure him, to hold him more. It's hard, I know, to hold someone who is angry.

He has to learn, clearly, to contain that anxiety and never to display anger (we err on the exaggeration here).

For those of you who like to see the feedback loops, how behaviors and messages in marriage reinforce problems rather than "correct" them, take a look at this one.
Guy and his girl are doing fine, he loves her, they're not fighting. → She wants to go out with her friends to have fun and he's okay with it, not real okay, but okay. →

She goes out, has a great time, but her phone is on vibrate and she doesn't want to call him. She's talking with friends. Those of you who know how intimate friendship can be know that answering the phone can be a REAL pain if someone's in the middle of something→

His natural anxiety and insecurity begin to rise→ His thoughts go to places that reinforce his natural anxiety and insecurity, i.e., she could be hurt, raped, at that moment someone could be holding a gun to her head or touching her in places that he feels are off limits to everyone but himself→

He begins to call her every ten minutes, entertains the notion of going out to find her → His anxiety is unbearable and morphs into anger. After all, anger and anxiety use the same arousal system, the Central Nervous System. We all have one. →

His thoughts go to angry thoughts, What do I need this bitch for in my life, she's nothing but trouble, she has no respect for herself, none for our marriage, she doesn't deserve me →

He goes from that to thinking that marrying her was a really bad idea, that she isn't the one for him, that he would rather be alone than feel the way he feels, think the thoughts he's thinking →

And oh, by the way, another girl would appreciate him more in every way→ Maybe, he thinks, he should give her some of her own medicine, cheat on her, or simply not come home→

His wife comes home, he's exhausted himself with his thoughts, sleeps on the couch, doesn't even say hello to her →

He sees me the next day, tells me all of it, still really angry, by the way, ready to end the marriage→

In therapy we keep it rational, go with what's real, the fact that she adores him, it is he who can't handle the separation when she goes out, and his thoughts and emotions →

Oh, and by the way, it's not as if he doesn't give her grief. He hasn't been the perfect mate at the end of the day. →

We arrange for him to work it out with her, he leaves calm→ the whole thing starts all over again. They do fine for awhile, love each other, don't fight. →

Then she goes out and it starts all over again.

So it makes sense to look at more than the behavior, obviously, to force the psychology, the why, here.


Copyright 2006


Anonymous said...

OK I get it---compassion mixed with independence over time---dont't be afraid to be myself---do my own thing with compassion for the guy that feels abandoned....instead of harboring resentments because it seems so irrational for him to have these fears for so many years.

therapydoc said...

You've totally got it. One would think a person could just "get over it," but they don't. When the brain gets hooked on something, it doesn't give it up easily.

In a committed relationship like marriage, when one has it in mind to work through the current issues with a mind to the past and an eye to the future (wow) there's a CHANCE, and a good one at that, to CORRECT BELIEFS and CHANGE BEHAVIOR.

It does take two, though.

Anonymous said...

How long is it reasonable for two people to try these things you mention if there is little or no change. If there's no appreciable change in 16 years of weekly marriage therapy has the situation become hopeless, unlikely to change?

Dasha said...

Could you please tell what is psychotic anxiety in your opinion? Is it something underlying in human nature or a pathological sign? How one can tell if he experience p.a.?
it`s not that I seek professional advice here - just your opinion on the term psychotic anxiety or diagnostic criteria - I`ve found only articles on Klein`s work so far.
and I`m far outside of US, in Russia, so I cannot stalk you and look in your windows at night.

therapydoc said...

Sure, Dasha. In this case it is anxiety that is based upon irrational thoughts, but the behavior that it influences isn't a fear generated behavior, like agoraphobia, or speechlessness, rather it is rage and paranoia. The anger is so intense that it is akin to that of a person who has schizophrenia who has paranoid thoughts or hears voices blaming someone else for things that will ultimately harm the self or others. I'm not sure that it is used anywhere else, to be honest. I might have made it up.