Ask Allison: My partner's personality disorder is frightening

Q I’ve been in a relationship with a man for a year. The relationship started very well and he came clean with me and told me how he suffers with a mental health issue called EUPD. He seemed to be in control of it and was regularly taking medication and attending counselling.

However, things have changed and he doesn’t take his medication properly and his counselling sessions have come to a close. He is not eating properly and he has become very agitated and has also become quite aggressive. I too suffer with mental health issues but not as extreme as his. He has recently become so aggressive that he has called me all sorts of profanities and he almost looked like he would like to hurt me. I’m at my wits’ end because my mental health is being affected and his issues are now affecting the rest of the family.

He says he feels isolated and that we don’t care about him but the truth is we do care but we no longer know how to help him because we are constantly walking on eggshells and we are frightened of him. I miss the man I fell in love with and I want him back but I just don’t know what I can do for him anymore. I feel like if I continue, my mental health will suffer, and I can’t afford to become unwell myself when I have a young child from a previous relationship. I don’t want to leave him and I feel if I do then he will make an attempt on his life. I’m really stuck and I don’t know what to do.

A Thank you for your email and I’m sorry to hear about this difficult experience for you all. How do you feel about your partner having EUPD, which is an ’emotionally unstable personality disorder’ or borderline personality disorder.

You say he came ‘clean’ by telling you this, I imagine that must have been an incredibly daunting thing for him to do, as there is so much stigma with mental health. He knew it would be a risk, but one that he took to give you the choice of what to do next. In terms of intimacy, by being vulnerable this would have been a pivotal and fearful moment as the choice was and is yours about whether to accept or reject him because of this.

Long-term mental health issues that directly impact the ability to maintain and sustain relationships can be heartbreaking for all involved. There is no quick band aid that ‘fixes’ it. The complexity compounds the relational experience for all. If you reject him, it confirms his negativity bias that he feels he is unlovable and that he can’t trust in relationships. Leaving him feeling deep shame, anger and abandonment. The self-destructive nature of this condition can create a self-fulfilling prophecy as his behaviour wreaks havoc on having a healthy relationship in the first place. This is where deep, on-going therapeutic work is required to work on changing destructive behavioural problems.

I would encourage you to learn about EUPD and to understand how it impacts the person For example, when faced with his anger, which you feel threatened by, he may experience what may feel like an emotional storm. Intense conflicting emotions from fear to rage to not wanting to lash out at you but the inability to self-regulate these emotions leading to overwhelming frustration to vitriolic words directed your way. The speed of being on either end of the pendulum from utter admiration to what may feel like contempt may leave you feeling confused and conflicted about what to do next.

Has he tried DBT (dialectical behavioural therapy)? This can be individual and group work that can be very helpful. If he would like to do this, he will need a referral from his GP.

Can you speak to him about how you feel? Can you say that you are concerned about his mood swings and you can see they must be incredibly painful for him but that it is also impacting you and your child.

Then you need to ask yourself what is acceptable, for you and your child? What I mentioned above about the type of treatment he may or may not seek is up to him. You have very little control over that. You do have control over where the line is, in terms of acceptable behaviour and what constitutes stepping over this.

The issue in stormy relationships is that the intensity and drama may feel exciting. This can lead to abusive and unhealthy patterns of behaviour as you can get stuck in the memory of the beginning of the relationship when you fell in love. The question is, can you love him in his entirety? This is not your responsibility, as I am concerned that when the threat of violence and or suicide are present that is a form of emotional manipulation, not to mention any safety fears.

I am in no doubt that he is experiencing huge amounts of pain at the moment and it is an incredibly difficult situation for you all. In terms of explicitly stating your boundaries, you could express your concerns for his well-being at the moment. You can say this with great kindness and connection. It is not an accusation. You may voice your concerns for his self-care which he seems to be neglecting at the moment and this is not a good sign. Has he ever experienced psychotic episodes before?

Could you suggest or ask for him to speak with his GP again as the basics such as eating are not being tended to at present. I wonder how he is sleeping? Psycho-education on the basics such as good quality eating and sleeping have such an impact that it can be hard to see the negative influence they have when absent until it’s too late. The increase in agitation if he stopped his medication without weaning off, or under his doctor’s care may be exacerbating how he is feeling.

There is no easy answer to this. Establishing your own boundaries and ensuring that you are minding your own mental and physical health is essential. Understanding why your partner is acting like he is can be helpful in recognising why he accuses you of seeing him as a monster, as he may be experiencing acute self-hatred right now. However, you must assess the impact this is having upon you.

It is incredibly difficult to not take personal attacks personally. Being part of a multi-disciplinary team can provide not only support to your partner but they can provide support to the family members as well.

Please get support yourself, and be clear and careful about your own emotional, psychological and physical safety.

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