More threads by unknownliza

This is about my best friend with whom I've been friends since primary school. For now I'll just call her Charlie. I know that she's not doing well during the last months and it seems as if things are getting worse, and I don't know what to do or how to help her. So that's why I'm writing here, hoping someone who knows more about such things than I do or got some personal experience might have some suggestions for me...

I'm actually the only one whom she tells these things and I can be sure she's honest with me. It's not that she actually wants to talk about it, she just gives an answer whenever I ask and doesn't mind that I'm asking. Whenever she tells me that stuff she's not emotional, doesn't seem sad or anything, it's more like she's giving a report about a topic she doesn't care about.

I don't know where exactly to start, as I think many things are important to know if I want to give you a picture – so sorry for this text being so long.

At first, something about the back story:

First, she's got Asperger's syndrome. This (and together with it, an IQ of 137) is the only thing she's ever been diagnosed with, and it happened when she was 20 and needed the diagnose so she could avoid taking part in some college events she was horrified of. She told me she had always guessed she had Aspergers since she read about it when she was 9. She hates doctors (due to some bad experiences in the past), but apparently the image of taking part at these events seemed worse. Except for that she has never seen a psychologist or psychiatrist.

Other things that might be important: She has experienced quite a few cases of sex assault/sexual harrassment (I'm not sure how to categorize this, rape never happened, but stuff like forced touching and kissing, first time in elementary school, then when she was 13, and then some more when she was an adult).

She was bullied at school as well, and quite badly... things like a group of kids beating her up, or taking away her shoes and clothes, forcing her to walk home in her undies through the snow, some elder kids chasing her around with a motorbike, and so forth, you know. There were even some teachers who took part in this, she told me of one who used to scrunch chalk on the ground and then telling her to get down on her knees to clean the floor with her bare hands, such things.

At home there were problems as well, her sister (one year younger) was the cute girly-girl with lots of friends, hardworking, good at school, sociable, nice, to make it short, everything Charlie was not. Her parents expected her to do like the sister did and always compared her to the sister... not good... the end of it was she stopped telling them anything, started stealing a lot, even things that were useless for her, went partying and binge-drinking from the age of 14 (for her parents it was "sleepover at her friends house" and until today they just got NO idea). She became quite a talented liar and was pretty creative (things like a fake arm in plaster to avoid piano lessons, printing cheat-sheets on a t-shirt and so on).

Okay, besides that she's not really the cliched victim-type-of-person... there were times when she took revenge, and she's one who can become really violent. She threw a classmate out of the window once (and by that broke his wrist) and in return for teasing, Charlie's sister got beaten up by her each day (which resulted in Charlie being punished at home...). When she was 17, I don't know what she did to the girls who had been bitching about her for years, but when they showed up at school one day, their faces were puffy from crying and it stayed like this for one whole week. I guess you get the picture.

She does have a tendency for self-harm as well. I know her doing things like punching into walls until her knuckles bleed, or cutting open an arm or leg, or purposely kicking against something sharp-edged (and by this hurting her leg) and so on. This does not happen very often, more like every few months or weeks, and the reason, as far as I know, is always anger.

Somewhat later (16-18) she started doing drugs. She had always liked to drink and she did drugs for some years, never too often so she never got physically addicted. But apart from that, I always found it kinda worrying that she took everything she could get her hands on, which means there's pretty much nothing left she hasn't tried yet... it seemed always like very close to something bad that would happen. That's probably not a good description, but that's how it felt for me.

Okay, so when she was 20 she met a guy. Charlie never wanted to have a boyfriend and never, ever was like the "typical teenage girl having a crush on XY". She had never been interested in anyone (or at least not shown it). So he had to work hard to gain her trust.

In the end they were together and she moved out of her parents house into his apartment. She seemed to get much better and they were the perfect couple for four years and hardly ever had an argument. Then last autumn he left her. She had no idea he had been cheating on her with another woman and also stolen some of her money. Within a second (a week before he had been talking about marriage) he suddenly told her he wanted to break up and was gone. She found out about the woman and the money herself and when he came to pick up his stuff she threw his huge-and-expenive-flatscreen-TV plus five giant speakers out of the window onto his car. Fourth floor. So much for that.

She then called me and told me things matter-of-factly, like "Hey, Lisa, how are you doing, ah, and by the way, P. just broke up.". Not that she cried or at least sounded sad, just nothing. I was more shocked than she seemed.

That's the point from which things got all worse. She seems not able to handle her daily life. There's a lot of paperwork for her to do (because of him moving out and everyting)... then she's a college student and has a lot of work to do for this, and moreover she has to work at an office (she gets no money from her parents) and since the guy left her, her worktime has doubled, as she needs more money for living on her own.

She's always been chaotic, forgetful, messy and bad at organizing her daily life, which might mostly be because of her diagnosis, and she never had to live alone before.

So for now, she sleeps like three to five hours maximum, has no eating routine, sometimes it's like a single hotdog a day. Since November she lost nearly 20 lbs and by now she's below 120lbs which is not much for someone who's 5'9''. It's not that she wants to loose weight, more like she doesn't care much about food and ignores the hunger, or forgets eating as there's too much other things to do.

Then there's the thing about drugs and alcohol. It increased during the last time. First, I guess, simply because she's living alone now and doesn't have to do it secretly (he never knew and wouldn't have liked it) but second also because she's overworked and troubled and all that. I know that from time to time she overdosed or mixed stuff you shouldn't mix, not caring much about the possibly lethal outcome (I know that once she had cardiac arythmias for more than two weeks). Or she did things like taking a hot bath after eating an insane amount of sleeping pills with the logical consequence of nearly dronwing in the bathtub (which she commented "Well, so what, nothing happened in the end, right?").

If I ask her why she does this, she tells me she wants to have her peace, to sleep, or not to think about the stress around her (actually, she called it "turning off my brain").

When I asked her if she had wanted to die she just shrugged and said "If I'd die I'd not be existent any more, so I wouldn't care about being dead."

She also did other risky things like driving wrong-way on purpose and some other things that, luckily, did not endanger other people, and told me she liked the adrenaline rush.

I asked her if she wanted help, she asked me back why. I asked her if she was not feeling well the last months, she said she has no idea (if she is really not aware of that I thought maybe it is an Asperger's thing...?). I asked her why she did what she did and she seemed a bit clueless and said "I just felt like doing it.". Not helpful.

To my suggestion to see a doctor she told me she wouldn't know what to do there and wouldn't have anything to tell.

In my opinion there clearly IS a problem, although I have no idea what diagnosis or whatever it might be (I'd say clearly not depressive... but maybe PTSD? Or a personality disorder? Or... whatever?). In her opinion I'm making a lot of fuss about nothing.

And I have no idea what to do, how to help. But I'm seriously worried! Sometimes I keep calling her for days and she doesn't answer the phone, doesn't open the door (or is not at home, I don't know) then I'm afraid that now it happened... until she finally calls back.

Okay, this part might seem selfish, but she is the only "real" friend I have, in fact more like a sister, and next to my parents she is the most important person in my life, and loosing her is one of the worst things I can imagine.

But what can I do, or what should I tell her she could do? I have no idea. Help...
 

Daniel E.

daniel@psychlinks.ca
Administrator
To my suggestion to see a doctor she told me she wouldn't know what to do there and wouldn't have anything to tell.

It can be very hard if not impossible to convince someone to get professional help. On the more positive side, some people are more open to seeing a therapist than a psychiatrist or vice versa. I have read that family members sometimes even resort to trickery or bribes :) but, as a friend, your options are obviously more limited.

Often, if not usually, the only thing you can do is continue to be a good friend.

---------- Post added at 07:31 PM ---------- Previous post was at 06:40 PM ----------

BTW, something therapists sometimes do is "motivational interviewing" (MI). Some insights from MI:

Motivation to change is elicited from the client, and not imposed from without...

It is the client's task, not the counsellor's, to articulate and resolve his or her ambivalence...

Direct persuasion is not an effective method for resolving ambivalence. It is tempting to try to be "helpful" by persuading the client of the urgency of the problem about the benefits of change. It is fairly clear, however, that these tactics generally increase client resistance and diminish the probability of change.

http://forum.psychlinks.ca/therapy-and-therapists/22996-motivational-interviewing.html#post168970

Anyway, even people who rush to therapy usually have some level of "resistance to change" since personality tends to be rather stable over time, maladaptive habits like self-injury do provide relief in the short term, etc.
 
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