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Does "tough love" work for someone who is manic?

K

keith74

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My wife is going through a manic episode. Throughout all this, her sister (who has dealt with her past manic episodes) is insisting that the "tough love" approach is recommended. Basically refuse to engage her unless she accepts her diagnosis and gets back on her full medication. Her sister says that if I don't, then I am "enabling/rewarding" her behavior and she will see no need to change. I have been trying that with some mixed results. In some cases, it made my wife take her meds a bit because she was worried I may leave her. But it didn't last long. She is currently hospitalized but is resisting treatment and not listening to the doctors. I have been continuing my "tough love" by minimizing communication with her when she is hostile to me. Her sister again is saying to not engage unless she is more agreeable to the treatment proposed by the doctors. My wife is accusing me of abandoning her while she is stuck alone in the hospital in difficult conditions. I am torn about the "tough love" now. I stuck to it for awhile and there was a day when I felt she was calming down and I started communication again... then she was back to her aggressive manic self.

Basically I'm asking is if the "tough love" approach works at all or if so-called "enabling" is not as bad as some people make?
 
Tawny

Tawny

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I am not sure about the approach plain and simple like that. A person i knew, her husband set a date for something special like a special meal out, to encourage his wife to get well for. She still refused medication but was forcibly injected by the nurses. Eventually she was less manic and started to take medication. In her mind was this meal so they must have talked about it when he visited her.

I don't think he ever stopped communication. She needed him to talk to, and her friends would come in to the hospital with him too.

For your own mental health, it is better to step back when she is aggressive though.

I think your sister in law has her way, and you need to have yours. Maybe your way will be more effective. You will make mistakes and learn from them, but you are husband now and the sister can step back and let you take over, for the most part. If you are polite, it should be ok.
 
HLon99

HLon99

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Dear Keith,

There is nothing wrong with setting clear boundaries on and of course some behaviours will never be acceptable and you should absolutely make that clear to her, but only when she's in the right state of mind. When talking about a loved one going through a manic episode, I don't think that 'tough love' is going to work. When a person becomes manic, they begin to lose touch with reality and lack insight and awareness into their thoughts and actions. Thereby, it is unreasonable to expect that she can fully understand the gravitas of what is going on around her.

I think the fair thing to do would be to strike a balance. See and talk to her regularly, but don't cave to her every wish. Talk her through her problems and help her get on the right track toward recovery but don' indulge her with attention. And if she becomes hostile towards you, you should absolutely prioritise your own safety. In summary, tough love has its time and its place, but not helpful during a crisis. Try to exercise reason, I'm sure you already know what the right thing to do is.

I think that her sister is just telling you to do this because over the years she must have lost patience with her, but you should see is as a virtue. BE FIRM BUT BE FAIR.

all the best,
-H
 
K

keith74

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Thank you Tawny for your feedback. I have been leaning on her sister a lot because she has dealt with my wife's past 3 manic episodes and my wife has always recovered from them pretty well. This is my first try and my "being nice" approach didn't work so I tried my sister-in-law's approach with mixed results. I think I need to have my own approach - don't tolerate the aggression but let her vent (even if the venting doesn't make sense) if she is being nice.
 
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Nukelavee

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tough love is one of the worst concepts ever created by white parents. Ever. Really, it's just a control thing, and often does more harm than good.

Admittedly, your wife is being hurtful and out of control right now... but, you do realize she'll remember being treated with tough love and feeling abandoned/etc, and there's a good chance she'll hold it against you.

I've had depression, and BPD, since being a young teen. My parents read a few too many Reader's digest articles and made for TV movies, and decided to apply tough love to me. Besides ignoring the actual issues for another 20 years, all it did was give me anxiety and make my depression worse.

I have a decent relationship with them, now, but there was nearly 20 years where I could barely talk to me Dad without it becoming ugly.

tough love and enabling are on the extreme ends of handling people with issues, somewhere in between is the sweet spot, where you can be both understanding yet firm when you need to be.
 
K

keith74

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Dear Keith,

There is nothing wrong with setting clear boundaries on and of course some behaviours will never be acceptable and you should absolutely make that clear to her, but only when she's in the right state of mind. When talking about a loved one going through a manic episode, I don't think that 'tough love' is going to work. When a person becomes manic, they begin to lose touch with reality and lack insight and awareness into their thoughts and actions. Thereby, it is unreasonable to expect that she can fully understand the gravitas of what is going on around her.

I think the fair thing to do would be to strike a balance. See and talk to her regularly, but don't cave to her every wish. Talk her through her problems and help her get on the right track toward recovery but don' indulge her with attention. And if she becomes hostile towards you, you should absolutely prioritise your own safety. In summary, tough love has its time and its place, but not helpful during a crisis. Try to exercise reason, I'm sure you already know what the right thing to do is.

I think that her sister is just telling you to do this because over the years she must have lost patience with her, but you should see is as a virtue. BE FIRM BUT BE FAIR.

all the best,
-H
Thanks H. I think I was playing it too tough. Her sister kept stressing that if I express my displeasure over her behavior, she will think I don't want to be in the relationship and that will "encourage" her to take her meds. As mentioned, this kinda worked a bit in some cases but not always. After one very harsh call where she ripped me to shreds and told me she never wanted to see my face again, I stopped communication for awhile, which really bothered her. She is now yearning for more contact (even though she is still a bit aggressive) and while her sister is saying I should refrain, I may indulge her more.
 
K

keith74

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tough love is one of the worst concepts ever created by white parents. Ever. Really, it's just a control thing, and often does more harm than good.

Admittedly, your wife is being hurtful and out of control right now... but, you do realize she'll remember being treated with tough love and feeling abandoned/etc, and there's a good chance she'll hold it against you.

I've had depression, and BPD, since being a young teen. My parents read a few too many Reader's digest articles and made for TV movies, and decided to apply tough love to me. Besides ignoring the actual issues for another 20 years, all it did was give me anxiety and make my depression worse.

I have a decent relationship with them, now, but there was nearly 20 years where I could barely talk to me Dad without it becoming ugly.

tough love and enabling are on the extreme ends of handling people with issues, somewhere in between is the sweet spot, where you can be both understanding yet firm when you need to be.
Thank you for sharing your story Nukelavee. Sorry to hear of your experience. I always felt that my wife would understand my stance when she comes out of her mania but you are right, some things may never be forgotten. I need to find the sweet spot so to speak - to show some compassion but to not let her take it too far so that I feel abused.
 
K

keith74

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One thing I want to mention is that she is fighting to get out of the hospital because she thinks "she is fine". She desperately wants me to support her. I feel that she needs to stay longer, even against her will. This makes her very upset/abandonded but I feel I am being "firm but fair"?
 
N

Nukelavee

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Yeah, I do think you need to be firm on that. Neither of you needs to go through this sort of thing again, a few more days for her to regulate more could save a lot of heartache.
 
K

keith74

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It is our anniversary tomorrow. I was originally going to be silent (tough love) but I am going to drop off some things at the hospital to make her feel better.
 
HLon99

HLon99

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Thanks H. I think I was playing it too tough. Her sister kept stressing that if I express my displeasure over her behavior, she will think I don't want to be in the relationship and that will "encourage" her to take her meds. As mentioned, this kinda worked a bit in some cases but not always. After one very harsh call where she ripped me to shreds and told me she never wanted to see my face again, I stopped communication for awhile, which really bothered her. She is now yearning for more contact (even though she is still a bit aggressive) and while her sister is saying I should refrain, I may indulge her more.
In this case, I would say give a bit more time to reflect on the way that she behaved during your last phone call. Of course don't cut off all communication, but she has to start understanding the impact that her behaviour is having on you. Understand that actions have consequences, once she realises this I think she would be more inclined to get onto the right track to recovery. Be supportive, but don't over indulge her.
 
K

keith74

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In this case, I would say give a bit more time to reflect on the way that she behaved during your last phone call. Of course don't cut off all communication, but she has to start understanding the impact that her behaviour is having on you. Understand that actions have consequences, once she realises this I think she would be more inclined to get onto the right track to recovery. Be supportive, but don't over indulge her.
That call I was referring to was almost 2 weeks ago and I cut all communication for over a week despite her calling and leaving angry and pleading voicemails. Then she seemed to calm down to the point where when she asked calmly why I shut her out, I replied that it was because of that phone call. She sort of apologized (not fully) but I started communication again and then she jumped back in to her more manic self, with a bit of slight aggression, but has not crossed that line yet so maybe she did learn a bit from her last actions.
 
K

keith74

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My wife just called me. I originally was thinking if not picking up (tough love) but I decided to answer. Was prepared to cut it short if met with aggression but she talked to me calmly and just want to say hello. Probably one of the most peaceful conversations we had since she was manic. Glad I picked up... and I picked up based on the feedback I received here. Thank you all.
 
S

Steve1981

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Adelaide
My wife is going through a manic episode. Throughout all this, her sister (who has dealt with her past manic episodes) is insisting that the "tough love" approach is recommended. Basically refuse to engage her unless she accepts her diagnosis and gets back on her full medication. Her sister says that if I don't, then I am "enabling/rewarding" her behavior and she will see no need to change. I have been trying that with some mixed results. In some cases, it made my wife take her meds a bit because she was worried I may leave her. But it didn't last long. She is currently hospitalized but is resisting treatment and not listening to the doctors. I have been continuing my "tough love" by minimizing communication with her when she is hostile to me. Her sister again is saying to not engage unless she is more agreeable to the treatment proposed by the doctors. My wife is accusing me of abandoning her while she is stuck alone in the hospital in difficult conditions. I am torn about the "tough love" now. I stuck to it for awhile and there was a day when I felt she was calming down and I started communication again... then she was back to her aggressive manic self.

Basically I'm asking is if the "tough love" approach works at all or if so-called "enabling" is not as bad as some people make?
Hello. A quick point. It is far easier to withdraw from the person than to be with the person in this situation. The time place and style of tough love are important. I think asking the person to be present and open for five minutes to discuss ways of increasing their likelyhood of recovery is a form of tough love. I am opposed to shaming or abuse of any form used to coherse a person to comply. These are just my opinions I hope you find them useful.
 
K

keith74

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Just an update. My wife called again this morning and I picked up. She was in a more irritable mood, but wasn't too aggressive towards me so I let her have a long venting session, despite the call making me anxious. Some of what she was venting about wasn't fair or accurate, but I stayed quiet and just let her get it off her chest. I felt it was not the time to try to correct or argue any points. I think that was ok.
 
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