I think my girlfriend needs psychiatric help—she has visual hallucinations and other symptoms I’ve promised to keep confidential. She doesn’t want to see a psychiatrist, as she and her family attribute her symptoms to supernatual causes; they believe that the “spirits” she sees actually exist. (Another family member—not a blood relative—also has psychiatric symptoms that are being treated and managed.) I really don’t want to go into further details because one time I promised not to tell my psychiatrist about her issues and then told him anyway and she freaked out when I admitted to telling him. (I admitted it because I can’t lie for shit and suck at keeping secrets, but that’s beside the point.)
Any advice? (“Break up with your girlfriend” will be ignored, unless you can convince me that it would be better for her if I left her.)
It’s going to be hard on you and worse on her if you stay together and you can’t respect her beliefs and behaviors. Best outcome is to have a confrontation and get her some help, second best is for her to reject you and your help directly enough for you to get out. Worst is to silently allow her to hurt herself and blame yourself about it.
Also, you should decide in advance what you’ll put up with, and set some lines you won’t cross. It’s very easy for this to gradually get worse and worse and you’ll feel trapped by previous acceptance.
It seems that part of the problem might be that she is afraid of being judged crazy or the equivalent. Having someone talk to her about her being crazy (which is how she will probably perceive it) seems like it runs a risk of being counter-productive. I think so far I’ve only told you what you are implying or saying.
If I have that right, you might think about finding a story—fictional or biographical—written from the perspective of someone suffering from similar symptoms and who resolved it through treatment. If she identifies with the protagonist, it might create some willingness to listen to alternatives.
What kind of advice are you seeking? Advice about how to convince her to seek treatment? Advice about whether she needs treatment? I don’t think you’ve given enough information to give any meaningful advice.
She thinks that she sees spirits, which are real. Thus, from her perspective, she doesn’t have psychiatric problems.
You, by contrast, think that she is hallucinating.
What does she think you think about her troubles, if I might ask? Like, does she know that you think her “spirits” are just her brain misfiring, or did you tell her that you believe her?
If the first, its really hard to see how you are in a relationship. Like would you be cool with going out with someone who thinks that you think they are crazy, but doesn’t mind you having that belief as long as you don’t act on it? Surely that points to some problems in her mental model of you.
If the second, you are betraying her trust. You don’t seem to have a problem with that, posting here, telling her shrink, etc, but its going to come up if you ever do actually try to do an intervention. After all, to get her to accept help you’ll have to get her to believe that she needs it, and a precursor to that is informing her that you believe that she needs it. It seems like she’ll be super upset about that last bit.
I’ve told her I don’t believe in spirits, but I have also told her that I believe she’s accurately reporting her experiences—that she really is “seeing” what she says she sees and not making up stories.
And yeah, our relationship is kind of shaky, although we’ve been together since August of 2014. I’m not willing to abandon her; I feel like she’d fall apart even further without me.
There’s no way to ask the following without sounding kind of offensive, but I swear its relevant to proposing a solution
Do you pay for all her stuff?
Sorry, I realize I’m jumping way way way out to conclusions here. Its just, well, the vibe here reminds me eerily of a few others situations I’ve seen. That’s too blunt of a way to put that, as well.
My question is much more “is she responsible”, or “if spirits split humanity into grown-up-clan and screw-up-clan which would you/she end up in?” but I don’t want to activate the “don’t talk badly about the person I’m in a relationship” pattern, and I’ve found that making it a factual question helps some with that.
I think I see where this is heading… Well, she held down a job as a cashier for five years, but I talked her into quitting it and going back to community college. (Not very successfully, though, but I’m working on that.) I have a passive income, pre-tax, of $2100 a month. I give her $200 a week to replace the lost income from work while she goes to school. She also is the primary caregiver for her 7-year old niece with “special needs”, which also takes up a lot of her time. (Other members of her household include her brother who has a heart condition and is on disability, her brother’s girlfriend who has her own psychiatric issues related to being abused as a child, and her 92-year-old grandmother.) On top of everything else, she has chronic back pain and Type II diabetes, both of which are going untreated for lack of health insurance. She also shows symptoms of what might be bipolar disorder or borderline personality disorder, but not being a psychiatrist I’m not qualified to make a diagnosis. (These aren’t the symptoms I’m not allowed to talk about, though.) She used to self-harm but hasn’t for many years.
So yeah, I’m fully prepared to admit that she’s a screw-up and I might be enabling her, but I really think I’ve helped her get better. Specifically, I’ve gotten her to go to the dentist for the first time in many years (her family paid), I got her to go back to school, I’ve helped her apply for Medicaid and it seems like she’ll actually get it this time, and I’ve helped her with self-image and self-esteem issues. I often feel like what she needs is a parent, but hers are dead and her family wasn’t and isn’t up to the task, so I’m doing the best I can.
Alright, so, with more background acquired I’m ready to try and propose a solution. Hope it helps.
You got right to what I was thinking when you mentioned that your relationship is more parent/child than two adults. Cross clan relationships between grownups and screwups always feel a bit skeevy, because can he/she really consent when the alternative is to starve? Its much more palatable to think of the whole thing as a strange version of parent/child.
If we do that, your dilemma is one that has been shared across the ages. How do I make my kid clean his room? Middle ages, folks would say to grab the belt. Recently, folks would say you need to negotiate, but screwup clan wouldn’t be screwup clan if they could trust their future selves to follow through on current commitments.
I’d recommend that you basically kink the feeding tube. Somehow, the situation has come about where you are paying her to go to college. That’s leverage. Give her carrot/stick of if she goes along with you you’ll pay for her psychiatry, if she balks you’ll stop paying for her college. It’s such a massive hassle to rearrange her entire life that she’ll probably take this deal. (If paying for her psychiatry isn’t in your budget then this whole thing is a non starter, since its not like she’s going to be able to pay for it.)
A word of caution: In a relationship between grownup and screwup it is nearly always the grownup who gives way whenever there is a dispute. You’d expect the opposite, but I’ve seen it over and over. The general reason is that the powerless party would have to recognize the truth of the situation if they ever backed down, while the person in the stronger situation can magnanimously give way.
Example: I want to go to bridge club. My kid wants to go to karate class. If I back down, I sleep just fine that night. I made the choice to give in and go to karate instead of bridge. If I don’t, they have to look at their life and face the fact that they just got dictated to. It’s sobering.
Ergo, the near constant result of grownup clan putting its foot down is some kind of self hostage taking. “You know I have a temper”, etc. Remain steadfast, because if you give in this time it’ll just teach them that you’ll give in the next time.
I’m not paying her tuition; her brother is (with financial aid). Most of the money I give goes to food. Also, I’m living at her house and sleeping in her bed, and I really don’t want her to make me go back to my parents’ house where my wheelchair-bound mother will drive me crazy. That gives her leverage, too. (And I’m barely not a screw-up myself...)
I have become aware of symptoms that she has had since before she met me but did not reveal because, well, she was afraid people would think she was crazy or lying if she told people about it.
Maybe you could bring to her attention laws about what clinicians have to do by law in certain circumstances. If she knows the boundaries of what it’s safe to say without them being compelled to act on her ‘craziness’ or ‘lying’ that might give her confidence to talk to someone. That was a big thing for me. Also, she might seek help on her own or if there is an emergency be coerced into it anyway.
If she is distressed by the symptoms, you could encourage her to contact someone that can educate her about treatment options. There may be a mental health advice line in your area that can refer her or you to free or low cost resources.
That strategy has a good chance of discouraging her from getting treatment later. Getting her to call a mental health advice line that she doesn’t trust likely won’t be positive.
Granted, but why won’t she trust the mental health advice line?
Basically because there’s a high likelihood that the operator on the other side doesn’t believe that the spirits she sees exist and suggest she’s wrong for believing they exist.
then she may want treatment now.
If that would be the case CronoDAS wouldn’t have the problem he has.
Often helpline workers are people who formerly needed mental health advice themselves. At least, they’ll have training on how to be helpful. I think it’s very likely they’ll be supportive, and unlikely that they’ll be judgmental.
However, this is from a US perspective. Things may be different in other parts of the world.
Are you concerned about the hallucinations or about the other symptoms? If the former, are you concerned about the hallucinations in themselves, or are you afraid that they are a sign of future problems?
Hallucinations are endemic. They just aren’t a big deal.
I agree: as long as the “spirits” aren’t telling her to harm herself or others, they’re no big deal. You said she might have bipolar disorder—depression and mania are both pretty big deals, so maybe you could ask her to seek treatment for depression. There’s less stigma about depression, so she might be more receptive.
Psychiatric insight into psychotic disorders tends to increase depression. Is her hallucinations episodic or persistent? Early intervention can reduce disability over the longer term. I’d recommend it if she’s also delusional.
I think my girlfriend needs psychiatric help—she has visual hallucinations and other symptoms I’ve promised to keep confidential. She doesn’t want to see a psychiatrist, as she and her family attribute her symptoms to supernatual causes; they believe that the “spirits” she sees actually exist. (Another family member—not a blood relative—also has psychiatric symptoms that are being treated and managed.) I really don’t want to go into further details because one time I promised not to tell my psychiatrist about her issues and then told him anyway and she freaked out when I admitted to telling him. (I admitted it because I can’t lie for shit and suck at keeping secrets, but that’s beside the point.)
Any advice? (“Break up with your girlfriend” will be ignored, unless you can convince me that it would be better for her if I left her.)
It’s going to be hard on you and worse on her if you stay together and you can’t respect her beliefs and behaviors. Best outcome is to have a confrontation and get her some help, second best is for her to reject you and your help directly enough for you to get out. Worst is to silently allow her to hurt herself and blame yourself about it.
Also, you should decide in advance what you’ll put up with, and set some lines you won’t cross. It’s very easy for this to gradually get worse and worse and you’ll feel trapped by previous acceptance.
Hack the system? Does she have spiritual guide you can convince that would convince her to seek professional help?
It seems that part of the problem might be that she is afraid of being judged crazy or the equivalent. Having someone talk to her about her being crazy (which is how she will probably perceive it) seems like it runs a risk of being counter-productive. I think so far I’ve only told you what you are implying or saying.
If I have that right, you might think about finding a story—fictional or biographical—written from the perspective of someone suffering from similar symptoms and who resolved it through treatment. If she identifies with the protagonist, it might create some willingness to listen to alternatives.
What kind of advice are you seeking? Advice about how to convince her to seek treatment? Advice about whether she needs treatment? I don’t think you’ve given enough information to give any meaningful advice.
Advice on how to get her to seek treatment. Hopefully her Medicaid card arrives in the mail soon...
She thinks that she sees spirits, which are real. Thus, from her perspective, she doesn’t have psychiatric problems.
You, by contrast, think that she is hallucinating.
What does she think you think about her troubles, if I might ask? Like, does she know that you think her “spirits” are just her brain misfiring, or did you tell her that you believe her?
If the first, its really hard to see how you are in a relationship. Like would you be cool with going out with someone who thinks that you think they are crazy, but doesn’t mind you having that belief as long as you don’t act on it? Surely that points to some problems in her mental model of you.
If the second, you are betraying her trust. You don’t seem to have a problem with that, posting here, telling her shrink, etc, but its going to come up if you ever do actually try to do an intervention. After all, to get her to accept help you’ll have to get her to believe that she needs it, and a precursor to that is informing her that you believe that she needs it. It seems like she’ll be super upset about that last bit.
I’ve told her I don’t believe in spirits, but I have also told her that I believe she’s accurately reporting her experiences—that she really is “seeing” what she says she sees and not making up stories.
And yeah, our relationship is kind of shaky, although we’ve been together since August of 2014. I’m not willing to abandon her; I feel like she’d fall apart even further without me.
You probably already know this, but that is not a healthy reason to stay together.
There’s no way to ask the following without sounding kind of offensive, but I swear its relevant to proposing a solution
Do you pay for all her stuff?
Sorry, I realize I’m jumping way way way out to conclusions here. Its just, well, the vibe here reminds me eerily of a few others situations I’ve seen. That’s too blunt of a way to put that, as well.
My question is much more “is she responsible”, or “if spirits split humanity into grown-up-clan and screw-up-clan which would you/she end up in?” but I don’t want to activate the “don’t talk badly about the person I’m in a relationship” pattern, and I’ve found that making it a factual question helps some with that.
I think I see where this is heading… Well, she held down a job as a cashier for five years, but I talked her into quitting it and going back to community college. (Not very successfully, though, but I’m working on that.) I have a passive income, pre-tax, of $2100 a month. I give her $200 a week to replace the lost income from work while she goes to school. She also is the primary caregiver for her 7-year old niece with “special needs”, which also takes up a lot of her time. (Other members of her household include her brother who has a heart condition and is on disability, her brother’s girlfriend who has her own psychiatric issues related to being abused as a child, and her 92-year-old grandmother.) On top of everything else, she has chronic back pain and Type II diabetes, both of which are going untreated for lack of health insurance. She also shows symptoms of what might be bipolar disorder or borderline personality disorder, but not being a psychiatrist I’m not qualified to make a diagnosis. (These aren’t the symptoms I’m not allowed to talk about, though.) She used to self-harm but hasn’t for many years.
So yeah, I’m fully prepared to admit that she’s a screw-up and I might be enabling her, but I really think I’ve helped her get better. Specifically, I’ve gotten her to go to the dentist for the first time in many years (her family paid), I got her to go back to school, I’ve helped her apply for Medicaid and it seems like she’ll actually get it this time, and I’ve helped her with self-image and self-esteem issues. I often feel like what she needs is a parent, but hers are dead and her family wasn’t and isn’t up to the task, so I’m doing the best I can.
Alright, so, with more background acquired I’m ready to try and propose a solution. Hope it helps.
You got right to what I was thinking when you mentioned that your relationship is more parent/child than two adults. Cross clan relationships between grownups and screwups always feel a bit skeevy, because can he/she really consent when the alternative is to starve? Its much more palatable to think of the whole thing as a strange version of parent/child.
If we do that, your dilemma is one that has been shared across the ages. How do I make my kid clean his room? Middle ages, folks would say to grab the belt. Recently, folks would say you need to negotiate, but screwup clan wouldn’t be screwup clan if they could trust their future selves to follow through on current commitments.
I’d recommend that you basically kink the feeding tube. Somehow, the situation has come about where you are paying her to go to college. That’s leverage. Give her carrot/stick of if she goes along with you you’ll pay for her psychiatry, if she balks you’ll stop paying for her college. It’s such a massive hassle to rearrange her entire life that she’ll probably take this deal. (If paying for her psychiatry isn’t in your budget then this whole thing is a non starter, since its not like she’s going to be able to pay for it.)
A word of caution: In a relationship between grownup and screwup it is nearly always the grownup who gives way whenever there is a dispute. You’d expect the opposite, but I’ve seen it over and over. The general reason is that the powerless party would have to recognize the truth of the situation if they ever backed down, while the person in the stronger situation can magnanimously give way.
Example: I want to go to bridge club. My kid wants to go to karate class. If I back down, I sleep just fine that night. I made the choice to give in and go to karate instead of bridge. If I don’t, they have to look at their life and face the fact that they just got dictated to. It’s sobering.
Ergo, the near constant result of grownup clan putting its foot down is some kind of self hostage taking. “You know I have a temper”, etc. Remain steadfast, because if you give in this time it’ll just teach them that you’ll give in the next time.
I’m not paying her tuition; her brother is (with financial aid). Most of the money I give goes to food. Also, I’m living at her house and sleeping in her bed, and I really don’t want her to make me go back to my parents’ house where my wheelchair-bound mother will drive me crazy. That gives her leverage, too. (And I’m barely not a screw-up myself...)
Did you find any of the advice from last time productive or counterproductive? That’ll help adjust advice you receive this time.
Since that time, I have become aware that her symptoms are worse than I had described. Again, I am not at liberty to discuss them.
Do you think hes symptoms worsened or do you think you have just become more aware of symptoms?
I have become aware of symptoms that she has had since before she met me but did not reveal because, well, she was afraid people would think she was crazy or lying if she told people about it.
Maybe you could bring to her attention laws about what clinicians have to do by law in certain circumstances. If she knows the boundaries of what it’s safe to say without them being compelled to act on her ‘craziness’ or ‘lying’ that might give her confidence to talk to someone. That was a big thing for me. Also, she might seek help on her own or if there is an emergency be coerced into it anyway.
If she is distressed by the symptoms, you could encourage her to contact someone that can educate her about treatment options. There may be a mental health advice line in your area that can refer her or you to free or low cost resources.
That strategy has a good chance of discouraging her from getting treatment later. Getting her to call a mental health advice line that she doesn’t trust likely won’t be positive.
Why do you say that? Also, if she is distressed, then she may want treatment now.
Granted, but why won’t she trust the mental health advice line? If she is distressed, she may be willing to consider help from new sources.
If she is not distressed, then CronoDAS can use the mental health advice line to get educated on the options in case she does become distressed.
Basically because there’s a high likelihood that the operator on the other side doesn’t believe that the spirits she sees exist and suggest she’s wrong for believing they exist.
If that would be the case CronoDAS wouldn’t have the problem he has.
Often helpline workers are people who formerly needed mental health advice themselves. At least, they’ll have training on how to be helpful. I think it’s very likely they’ll be supportive, and unlikely that they’ll be judgmental.
However, this is from a US perspective. Things may be different in other parts of the world.
Are you concerned about the hallucinations or about the other symptoms? If the former, are you concerned about the hallucinations in themselves, or are you afraid that they are a sign of future problems?
Hallucinations are endemic. They just aren’t a big deal.
I agree: as long as the “spirits” aren’t telling her to harm herself or others, they’re no big deal. You said she might have bipolar disorder—depression and mania are both pretty big deals, so maybe you could ask her to seek treatment for depression. There’s less stigma about depression, so she might be more receptive.
The peril of ignoring emotions
Psychiatric insight into psychotic disorders tends to increase depression. Is her hallucinations episodic or persistent? Early intervention can reduce disability over the longer term. I’d recommend it if she’s also delusional.