Restoring contact

[g-scared]

I wonder if maybe any of you have some advise for me, as I have recently begun to interact again with my x-boyfriend who has something very similar to paranoid schizophrenia. I say this because he has not yet been properly diagnosed with anything besides psychosis not otherwise specified.

I would like to be there for him from time to time, but not get sucked in to his life. I don't want to feel responsible if he decides to threaten suicide again. I've already suffered a great deal and my life has been pretty stable and productive lately.

I guess I have another question as well because the situation has gotten so out of control that his mother has resorted to medicating him through his coffee. Do you think this is ethically wrong? I would probably think yes, but for the fact that without it he might have died by now.

 

[ThatLady]

Re: restoring contact

I think your thoughts on not getting sucked into your ex-boyfriends life are good ones, g-scared. As you say, you've had enough difficulty in your life, and you're now enjoying stability and productivity. Those are not things to be taken lightly, and not to be sacrificed for a situation that you cannot change. Dealing with psychosis is something to be left to the professionals. We laymen cannot do much to help psychotic people. We can care about them, and we can offer a tentative hand of friendship (which many of them are incapable of recognizing or knowing what to do with when in a psychotic state), but to offer up our own peace and security is just not a good bargain.

As to the ethics of his mother medicating him through his coffee, that's a very sticky question. Is it ethical? Probably not. However, I can certainly see where she's coming from. If he doesn't take his medications, his psychosis will return full-blown and may take his life, her life, your life, or someone else's life. By that, I don't necessarily mean he'll kill someone, but that his needs will be so pervasive that they'll suck the life out of anyone and everyone around him. It's not his fault. It's the fault of the disease, and the disease needs treatment - a fact that he might not always realize. Therefore, I guess I agree with you. He needs someone to take charge and someone to see that he gets the treatment he desperately needs. That's what his mother appears to be trying to do.

 

[David Baxter PhD]

I wonder if maybe any of you have some advice for me, as I have recently begun to interact again with my x-boyfriend who has something very similar to paranoid schizophrenia. I say this because he has not yet been properly diagnosed with anything besides psychosis not otherwise specified.

I would like to be there for him from time to time, but not get sucked in to his life. I don't want to feel responsible if he decides to threaten suicide again. I've already suffered a great deal and my life has been pretty stable and productive lately.

Assuming he does suffer from schizophrenia or anything similar (e.g., schizotypal, schizophreniform, schizoaffective), he likely has a difficult time recognizing and respecting other people's boundaries so that's going to be your biggest challenge. You should first try to decide what would be confortable/acceptable for you and determine what you want your boundaries to be and then be very firm and diligent in enforcing those boundaries. This isn't unkindness or meanness. This is simply survival.

I guess I have another question as well because the situation has gotten so out of control that his mother has resorted to medicating him through his coffee. Do you think this is ethically wrong? I would probably think yes, but for the fact that without it he might have died by now.

There is a real controversy in the US (and to a lesser extent Canada) these days about this issue (see references to Kendra's Law). To me, it's not an issue of freedom of choice as some people are claiming, because someone who suffers from a psychotic illness is, when in a psychotic state, incapable of informed choices and, even when relatively stable, many lack insight into their illness. Thus, not to try to take action in a way that will help the individual is unethical, in my opinion - sitting idly by in the name of free choice just seems cruel to me.

 

[g-scared]

Thus, not to try to take action in a way that will help the individual is unethical, in my opinion - sitting idly by in the name of free choice just seems cruel to me.

I agree. If he was being given inhumane treatment or a debilitating drug I would protest. However, the medication, abilify, has had a remarkably positive affect on him. He seems just as intelligent as before, and very considerate of others, even has a good sense of humor. Now he is looking for a job, and thinking about going back to school next semester. But as soon as his meds wear off... he digresses to being paranoid and disturbed again. The old conflicts and interrogations come back. It kind of caught me off guard the other day. I think the drug is exactly what he needs, but I wish there could be a more permanent solution.

Assuming he does suffer from schizophrenia or anything similar (e.g., schizotypal, schizophreniform, schizoaffective), he likely has a difficult time recognizing and respecting other people's boundaries so that's going to be your biggest challenge. You should first try to decide what would be confortable/acceptable for you and determine what you want your boundaries to be and then be very firm and diligent in enforcing those boundaries. This isn't unkindness or meanness. This is simply survival.

Yes, I have to put some thought into this, and maybe put some boundaries on myself as well. We dated for four years. I wouldn't dream about having an intimate relationship with him now, but we do sometimes act like a couple. It's just so subtle though that I have a hard time drawing a line. I don't want to tell him that he's not allowed to hug me ever again. It's not even that, but the other day we shared a meal, drank coffees, and went to the apple store three times. We didn't hold hands or anything, but we were walking close to each other and I can't put my finger on it, but we were acting like a couple again. It just happens so naturally, and it's very difficult because he acts like his old self when he's on his meds.

It's probably not good that he told me he wanted to marry me, and deliver pizzas so he could pay off my student loans. It's really sweet, but I know that he could just as easily turn on me again. It's kind of terrifying when he's psychotic.

He called me today and left a text message after I didn't answer. I feel bad ignoring his calls, but I knew he was going to the apple store again, and was afraid that he would want to stop by. I initially wanted to keep my visits wit him sporadic, but now am thinking about visiting again next weekend. That would be two weekends in a row, the fourth visit in two months. Do you think once a week is too much or too regular?

Thanks
-g-s

 

[David Baxter PhD]

Only you can really answer that, g-s. What are you comfortable with?

As you say, you were with him for a long time and it's easy to fall back into familiar patterns, but you also know that's not healthy for you.

Try to figure out where it stops feeling healthy and doable and where it starts feeling either stressful or "too familiar"... that's probably where you want to draw the line.

 

[g-scared]

Thanks.
I'll keep that in mind.
g-s