[onmyway]

Hello there. This is probably going to get long, but I am at a loss and need information. My ex and i have 7 kids together. Last july i was hospitalized for severe postpartum depression/anxiety after we almost lost our youngest child, and was in there for almost 4 months. My ex was left to deal with the kids and home alone.

I have (as have others) long thought he suffers from bipolar disorder though he's as yet undiagnosed. He also has a history of drug abuse which started in his early teens. He had been clean for a few years, but under the stress he went back to drugs (meth) halfway through my hospitalization. He also cheated on me during this time, and we broke up because of it, although we remained friends and still slept together at times. The children were not apprehended but are currently living with his parents; we came close because they were not being cared for properly and we can get them back, but need to prove to child welfare that we are capable. Their main requirement for him is a minimum of 1 year of drug rehab.

A few weeks ago I started seeing someone else, and this triggered him badly, as he has made it clear he would like us to get back together, though I have made it just as clear that, while we're sleeping together, we are friends and likely will never be together again. He became actively suicidal with several attempts, severely anxious and depressed. He is currently in the psych ward and I am quite sure he is in early stages of psychosis. He is literally obsessed with me, and yesterday i found out he is now hearing voices and seeing people walk beside him who tell him i'm out to get him, hate him, just using him, that i am only with this other guy to hurt him and that the 2 of us are playing sick mind games. He says that me visiting him is the only thing keeping him grounded. He said the voices are getting louder and harder to ignore, that he can't sleep because they won't shut up. When asked if he believes these voices (which he talks about as if it's normal, the fact that he hears them does not alarm him), he says he doesn't know what to think, that he doesn't WANT to think such bad things about me because he loves me but that they're getting louder and he's starting to. He says that if i stop visiting him (and this was said to other people, not just to me), this will 'prove' i hate him and am just out to get him and he 'knows' the voices will take over and he doesn't know what will happen then. He's not remembering parts of the day, and was discussing with someone else about banging his head against the wall, but he doesn't remember why, and was talking about this in a happy voice, and at the same time saying he was having such a fantastic day.

Sigh. I guess what i want to know is.. what do *I* do? Do i keep visiting him or will that make it better or worse? He is adamant it would be worse. What do i say/not say? What can i do? Am I in danger? It is quite the obsession with him and every day he is less grounded in reality, defintely becoming more manic and delusional. Does this go away on it's own? I am way out of my depth on this one!

Any insight is appreciated, thanks!

[onmyway]

Anyone?

Yesterday we talked to the nurses and told them about his head banging, the voices he's hearing and that he's seeing people walk beside him and that those are the 'voices' who are talking to him.. when asked, he told them he doesn't recall banging his head, and denied hearing or seeing anything. The nurses said he seems 'calm and collected and happy'.. ummm... you mean, manic happy?!? Talk to him for a minute, you'll realize he can't hold a conversation, he is obsessed and no matter what topic you bring up he comes back to me, that he flips between REALLY happy to depressed and monotonic in the same conversation.. Last night he told us on one hand that the voices are not as loud, going back to whispers, on the other hand he then said (same conversation) that he's starting to believe what the voices are telling him; but the nurses are not worried because 1) he denies it, and 2) they are not commanding voices.. yet.. They must've listened somewhat because on the phone they were saying 'no doctors are in on weekends, you must talk to the drs about this.' because we were saying GET HIM OFF PAXIL!!!!! Paxil is strongly contraindicated for bipolars, and whether that's his formal dx or not, get him off paxil! He exhibits too many signs of bipolar 1.. later on in the day when we talked to them, they said they took him off and switched him to prozac, which they couldn't have done without a doctors permission, so at least SOMETHING we told them got through, i guess.

How do you deal with someone who's hearing voices, telling him things that is something that's an obsession with him? How do you get through to that person to let them know it's not real and show them reality? We're simply not sure. And most concerning is, he hasn't asked once if he's crazy or psychotic. These voices do not concern him, he's only annoyed because they're 'too loud' and it's 'annoying' that they won't shut up.. but the fact that they're there seems normal to him. To me, that is a bad sign, yes?

Someone please give me insight. I have never dealt with this before, and am way over my head!

[spiritual_emergency]

Hello onmyway,
I suspect the reason people haven't yet responded is because it's clearly, a complicated situation. For myself, I can see three factors that likely require some attention:

- The relationship itself
- Drug use
- Some form of mental illness/distress

In terms of your ex-partner's current experience, I've found the following simple framework to be helpful:

Fragmentation <----- Inflation <----- "Normal Ego State" -----> Deflation -----> Fragmentation

An individual can shift from a relatively "normal" ego state into one of Deflation or Inflation. If their sense of ego (self-identity) becomes too deflated, we call it Depression. If their sense of ego (self-identity) becomes too inflated, we call it Mania. I suspect that if either of those states goes on for too long, it can produce Fragmentation (ego-collapse) of the self-identity. This is what we call Psychosis.

There are numerous factors that can produce ego fragmentation/collapse. At least two of these are stress and drug use. Your ex was using drugs and although I can't know to what extent the conflict in the relationship contributed, I think it's reasonable to suggest that the relationship difficulties that are currently present are likely causing him some stress now.

I would suggest that you come to a firm answer in regard to your own intent in this relationship. You say you are no longer with your partner, have begun seeing someone else, but were also continuing to have a sexual relationship with your ex. If that were me, I'd feel confused by that. There will be no way to avoid the pain or grief associated with the end of a significant relationship but knowing for sure if it has ended or is going to carry on in similar fashion can help to minimize confusion.

There's also issues of infidelity -- he cheated on you and I can appreciate that this would hurt. I don't know if your decision to get involved with someone else was a retaliatory response (that he might have experienced as an equal betrayal) or if it was just timing. Either way, the ongoing sexual relationship suggests to me that neither one of you is ready to let go of the relationship.

I can also appreciate that given the infidelity and while he's in this state, you might not know if you want to continue in a relationship with him. It might be good for you to seek some support for yourself so you can make that decision one way or the other. In turn, this may minimize some of his distress associated with the relationship difficulties.

Aside from that, he doesn't yet have a diagnosis. He's in the hospital. He is being provided with medications. If those medications are going to help him that will become apparent soon enough. It's also possible that they won't help or that they will make things worse. The only thing that can be done is to wait and observe to see what the outcome is. No doubt, some form of drug rehab will also become part of his treatment.

In terms of voice-hearing... people attribute different causes to the voices. Some believe it's purely a case of crossed neurological wires; others believe the voices are coming from some other form of reality (i.e., a ghost or form of telepathy); still others can locate the voice as their own or the voices of those they have known in the past. This may be especially so with individuals who have undergone forms of trauma. Intervoiceonline.org is a good resource for voice hearers and may also offer some insight for their partners/family members. You may find it helpful to review some of the reading material there: Intervoiceonline.org.

You will likely have additional questions. I hope that this response might help you begin to find some answers for yourself and that you will continue to share any other questions or concerns that come up.

Good luck to you and your family.

[costello]

Hi onmyway:

I'm confused by your story and a little distressed by side issues (like your children - I'm not clear on why you're embarking on a new relationship when child welfare is involved in your life and the children's father is apparently in the midst of a serious psychic break).

Some thoughts:

First, spiritual_emergency has given some great advice and information. I particularly agree with her thought that continuing a sexual relationship with your husband is confusing. He seems pretty fragile right now. Please refrain from giving him conflicting messages.

The fact that your husband isn't bothered by hearing voices (that he thinks it's normal as you say) doesn't surprise me. Maybe it is normal under the circumstances. I'm also not concerned that he denies hearing voices to the nurses. The staff at the hospital have worked with people who hear voices before. They'll recognize it. BTW it seems to me a bit of a conflict to say he thinks that hearing voices is normal, then to say he's denying hearing voices. The fact that he would deny it seems to indicate he does see it as being abnormal in some way.

I'm also not concerned that he hasn't asked if he's crazy or psychotic. I doubt if that's how he's experiencing his situation.

One thing I wanted to ask is who are "we"? You say "we told the nurses ...", etc. Who is/are the other person or people?

[onmyway]

Just to clarify, what I meant was, I am NOT currently sleeping with my ex. That stopped early-mid May. I have since made it clear to him on many occasions that, no, we will no longer be sleeping together; no, there is not a chance we will get back together; yes, we are friends and I want his friendship, but as far as any romantic relationship is concerned, I do not feel that way about him. I hope this clears up your confusion. Also, no, me seeing someone else has nothing to do with him cheating on me.. he cheated last summer and I've come to terms with that. I also do have a psychologist I see for therapy, for my own anxiety/depression issues.

As for the voices, according to him, he sees a group of people following him around where ever he goes, and they are the ones talking to him, telling him things.

Costello, it's a very complicated situation with the kids. Technically, and i realize this doesn't make sense, I'm not sure how this works, but child welfare is NOT involved any longer. They closed the file when the kids went to live with grandparents, deeming that their involvement was no longer necessary as the kids were in stable environments; and my kids were never apprehended. However (the part I don't understand) is that they need to be alerted when the kids are to return home so that they can come and make sure that the father/I/whichever one they come back to are stable enough to have them back. My ex because of his drug issues and lack of stability financially/home-wise, and me because of my anxiety/depression and because before going into the hospital I was not able to cope with them, or life in general (hence admitting myself to hospital lol). Why am I embarking on a new relationship in the midst of this? *shrug* The guy has been a friend for 13 years and it's something I hadn't planned, but just happened. It's not like I'm moving in with him tomorrow or planning on marriage, just a lets-see-where-this-goes type thing. In no way does it interfere with me doing what I need to do (ie: therapy, parenting classes etc); it's not like I'm putting him first, he's just *a* part of my life, not the focus of it. Some things just happen.

Perhaps he does deem the voices as abnormal in some way and perhaps I worded that wrong. In my defense, I am asking for advice becasue i don't know how this works and have never dealt with this before. But where i got that statement from is that when he talks about them (voices) it's as if he's talking about the weather, as if everyone has people following him around telling them things. It's just very matter of fact and he doesn't question WHY, and the only thing that he says bothers him about them is they 'get very loud and obnoxious' particularly when he's trying to sleep, and it's annoying because they keep him up because they're so noisy.

When I say 'we', I mean a mutual friend and I. He has given permission for both of us to talk to and have information about him with the staff; in fact, he has said ONLY us two and one other person, a cousin of his, and he doesn't want anyone else having permission, including his parents, grandma, etc.

I hope this clears up any confusion. I realize it's a complicated situation.

[spiritual_emergency]

Hello onmyway,
Thanks for providing that additional information.

In terms of you understanding his experience of voices, and the ease with which he speaks of them, I'll try to drag in a model that may be helpful. It is a Jungian based psychological model. I use it because I've found it to be the best model for explaining and understanding these kinds of experiences to others however it is not a model that works for all people or circumstances.

According to Jungian thought, most people are consciously aware of their persona (the face we present to the world) and they also have some degree of awareness of their personal shadow (the parts of ourselves we try to hide from the larger world for various reasons), but that's about the extent of it. The ego mediates between these two parts of the psyche -- it may, for example, determine that a life experience will not be considered acceptable to larger society and therefore, might shove that experience into the shadow.

With psychosis, the boundaries of the ego (all that is conscious) break down so that now, all that was unconscious flows forth. For some people, the content that emerges in psychosis (voices, visions, fears, etc.) can be linked directly back to the unconscious aspects of the psyche. It is for this reason that Jung believed psychosis/schizophrenia could be an attempt for the psyche to self-heal (by bringing unconscious content into conscious awareness).

That's a very brief introduction and I don't know if it will make sense to you. Hopefully it might and just as hopefully, it will actually apply in your ex-partner's situation. If it does seem to apply then it may be helpful to share that model with him. Further, if that is the case, then it may also be helpful to encourage him to write down what these voices are saying to him so that he can later study that "unconscious content" and thus, bring it into awareness.


See also: Jung's Model of the Psyche

[mgran]

One thing I would say is that if he's prone to mania's then prozac probably isn't the best thing for him either... it sent me completely manic, and I know it's done this to other people on the schizophrenic bipolar spectrum.

[costello]

Originally Posted by onmyway

I am asking for advice becasue i don't know how this works and have never dealt with this before.

I can understand that. I too have had to work to understand my son's experience. It's very challenging. It helps to remain open and flexible - and to listen to what your husband (and others who've walked in his shoes) tell you. I've been at this some years, and I still make tons of mistakes. It's a long journey.

Don't forget to take care of yourself and your children as well.