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Doctor Rao
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Experience:  MBBS,MD,DPM,MRCPsych
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My counselor believes my sister may have borderline personality

Customer Question

My counselor believes my sister may have borderline personality disorder. She has many of the symptoms. Of course, getting her formally evaluated is something she may never agree to. My question is how to deal with the way she changes history and situations to put herself in the best possible light and avoids responsibility for her actions? It appears she creates delusions not based on the facts or reality. She is convinced these things are true and has convinced her doctor's as well (MD's she sees for Chronic Lyme's, babesiosis and other illnesses). She ruined my sister's wedding by over=medicating herself, which she denies. She was so out of it, my sister did not want her walking down the aisle. She bullied her way in line and proceeded to walk down the aisle anyway walking like she was intoxicated, refused to sit in a chair in front, and stood up in front swaying and nearly passing out the entire service next to the other bridesmaids. All the attention was on her, not on the sister getting married. After that, she vomited on my aunt's shoe during picture taking, and kept falling asleep in her food at the table, refusing to leave the table. She has blamed the whole thing on either babesiosis and now neurological low blood pressure, and continues to try and prove her point 2 years later. She will not admit taking mediction, although I saw her do it. This is just one example of how she changes situations and they become ingrained as the truth. Is is worth it to go and see her counselor and explain this type of behavior (she will let me go) or do we just nod and smile and let her be with her version of events?
Last week, at the time my father was passing at home on hospice, she refused to leave his home at the and became belligerent with 2 of my siblings. The next day, she acted like nothing happened, trying to hug them, and refusing to talk about it. When she did agree to discuss it she created excuses for her behavior and completely minimized her actions. When she does this, you cannot convince her otherwise and it is frustrating because she changes what really happened, even if there are witnesses. All 5 of her siblings are weary of her chaotic, unpredictable behavior. We have created boundaries to keep us from being used and manipulated (for example, we no longer give her rides anywhere). This is because she is not ready when we get there, and insist we wait for her, or help her get ready,causing us to to be late (30 min to 2 hours) and involving us in her chaos. How should we respond to her delusional thinking and stories? I went to counseling with her once and she minimized everything she did and changed the events that happened so much I just gave up trying to correct history, I just agreed to disagree, which didn't get us anywhere. All 5 of us siblings have very strained relationships with her.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Doctor Rao replied 2 years ago.

Doctor Rao : Hi are you online
Doctor Rao : It does seem that your sister has some traits of personalit disorder in the form of interpersonal difficulties, impulsivity, splitting, change in mood and presentation.
Doctor Rao : As you rightly pointed out it might be very difficult to help her if she is not willing to accept the issues and seek support. You might want to give more information about the problem to see but she might completely disagree with you.
Doctor Rao : One way you can help her and yourself is by keeping the boundaries, avoiding confrontation and criticism as often they won't take criticism lightly which might trigger another row.
Doctor Rao : You can help to improve the understanding of interpersonal relationship issues as usually once they start looking at them, accepting the issue and willing to change their situation would completely change from the family dynamics point if view.
Doctor Rao : Lastly she might not agree to see the psychologist or counsellor But might agree to see her Family physician. This is important because it is important to rule out any mood disorder before anyone confirm personality disorder as some of the symptoms do overlap between these two,
Doctor Rao : Please do not hesitate to contact me if you require more information. If you find the answer helpful, please provide positive feedback. Finally I can appreciate how difficult it is for you and other siblings But have to say you are doing what you can. Thank you
Customer :

So, when she starts talking about things that aren't true, do we agree with her? I understand we need to avoid ciritcism.

Customer :
8:38 AM
You can help to improve the understanding of interpersonal relationship issues as usually once they start looking at them, accepting the issue and willing to change their situation would completely change from the family dynamics point if view.
Can you explain the above? I am not sure I understand what you are saying here.
Customer :

One more thing: We do try to avoid confrontation, however that is difficult. For example, she agreed to come see my dad and leave at 8pm. At 9pm, she said her ride was on the way. At 10 pm, my brother and sister offered her a ride home, and she exploded. No one had mentioned the fact that she was already late in leaving before 10pm, so there was no prior confrontation.

We were trying to get everyone out of the house so my mom could go to bed, and she refused to leave. How to you avoid confrontation then? My mom was ready for her to go home. She will often refuse to do what she earlier had agreed to.

Doctor Rao : I understand that. It must be difficult for you and the family. In the situations you have mentioned you can challenge her,confront her to an extent But she might be sensitive to criticism. Haing said hat it is atmost important to place firm boundaries and make the bOundaries explicit. They do have low self esteem,self confidence which from time to time show up as angry outbursts with the people involved. She would also have fear of abandonment and sensitivity to rejection. So, firm boundaries do help. I would suggest if possible to go through the book below. Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder [Paperback]Paul Mason MS (Author), Randi Kreger (Author)
Doctor Rao : I hope you find the answer helpful. I wish you all the best. Thank you.

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