View Full Version : Can't get himself to want to?


Cecily
04-25-15, 12:34 PM
Is this related to ADD?

My husband (ADD/bipolar) is a very stubborn man. For years, on one hand he has wanted help because he feels completely lost and overwhelmed and running his life into the ground, but he refuses most help offered him. He knows what he needs to do to get his life together, but strangely, he says that he cannot get himself to want to do what he's got to do. He is digging himself into a deep hole of depression and self-hatred, but he feels completely unable to change his own mind.

Is this ADD?? His therapist just keeps saying he's got to choose. It's all a choice. But he sits there with tears in his eyes saying that he does not know how to choose!

Any insight into what is going on with him? What is the real issue?

kilted_scotsman
04-25-15, 02:30 PM
This isn't ADHD.... it's whats called ego-dystonic behaviour. The ability to "change one's mind" ie use what Schwartz calls "mental force" so that we can initiate the process of altering the network of connections is the basis of several humanistic therapies, particularly CBT.

What I find interesting is that your partner says he

cannot get himself to want to do what he's got to do

the use of the word "got" is significant..... he is not saying he cannot get himself to do what he WANTS to do.....

also the idea that one can consciously force oneself to "want" something is illogical... "wanting" is something that comes from deep inside our being.... it is not a higher level cortical function.

His conscious awareness that he needs to initiate an action may be in conflict with a subconscious fear of the consequences of that action. This is the realm of longer term psychotherapy, which is likely not to be covered by insurance policies....

I would suspect his therapist is rushing things.... he does not "have" to choose, "not choosing" is as much of a choice, albeit a static one, as choosing. Forcing him into choosing an action is likely to increase the self-loathing as it reinforces the pattern that he can't do what he "should" do.

In this scenario a therapist may use person centred approach for a considerable period of time (6 months+), before moving into something like Gestalt or transactional analysis (6-12 months), and then into CBT or CBT with hypnotherapy for the final stretch before entering the ending process. The therapist may also recommend mindfulness activity involving the body, such as five rhythms dance, yoga or voice work.

kilted

Fuzzy12
04-25-15, 07:09 PM
I can imagine that it's related to ADHD. I often feel that I can't do what I should be doing. Not because I don't want the long term benefit of doing the task or whatever. I do want that. But i still cant do it because the task that has to be done at that moment isnt what i want to do and I can't raise the motivation and energy to do stuff that I don't absolutely want to do.

Yes, of course it's all a choice but our ability both to choose andto act according to our choice isnt the same for everyone. For many adhders I can imagine a lot of things that seem obvious choices to others are thing we hugely struggle with. Not because we don't know what the right, the wise and healthy and long term beneficial choice is, but because we just can't act accordingly.

VeryTired
04-25-15, 07:16 PM
Hi, Cecily--

My sympathy to you and your husband--it sounds as though things are very uncomfortable right now at your house. I just wanted to say that my partner has ADHD and I have seen him in a very similar state of wanting and needing to do things (particularly big, high-stakes, scary life changes) and yet be unable to make the decision … he never phrased it the same way your husband does, but I have feeling he's felt something very simulator to not being able to get himself to feel like doing what needs to be done. And he definitely has a very, very hard time with making choices, sometimes to the extent of choice triggering panic attacks.

Let us know how things go with you and your husband … wishing you both the best

icarusinflames
04-25-15, 08:40 PM
But I do think a person can have a disconnect between willing themself to do something that they actually NEED to do to stay clean, healthy, fed and housed. Some people with ADHD are actually more hypoactive than hyperactive, although I think they still express hyperactivity in intellectual things as well as manifesting repressed hyperactivity through finger tapping, hair twirling, wiggling or other subtle physical movements. Some people even have tourette's comorbid, so they are impulsive verbally and repeat phrases. some will stutter. Anyhow, everyone is different. There is not one type of ADD/ADHD person. It's how it manifests for the person. If he had this in childhood too, then it could be ADD/ADHD. But the symptoms and signs could have been more in the inattentive type where you can actually seem hypoactive and experience alarming paralysis at times. This can be a state of mental paralysis only, and you appear to be going through the motions. or it can be a physical paralysis. I remember when I was a child, there were times I felt like I could not will myself to even stand up. Thankfully that passed. But in my teenage years it became a tendency to stay in bed for longer than I should, and to to lay down a lot on the sofa or my bed. I would be there too long, and I realize now it was my tendency to get STUCK in whatever I was doing. Therefore, if I was sleeping I would sleep 12 hours without an alarm clock. If I was on the computer, I would be there for hours. If I was doing homework, I would be doing it for too long. Most importantly, it would always take me 2 or 3 times as long to accomplish ANY task, whether work or pleasurable. Also there was a great difficulty in switching tasks, or starting a task, and with ending a task.

And during all these years of not knowing why I was like this, I was getting berated, humiliated and shamed on the job, at home, and from friends.

is it any wonder I was depressed and anxious and hesitant to do anything? When I could function, you can bet I had a tendency to be more reserved or cautious. My impulsivity was displayed more internally with my racing thoughts, random thoughts, inappropriate and sometimes aggressive (often negative) thoughts. Ruminating become my area of action, I guess.

If your husband has a tendency to internalize things and to see the negative side of things. and if he tends to take away messages from situations that he's not acceptable or that he feels worried about himself (i.e. humiliated)... then you may want to make sure that he is not feeling that way in therapy. The therapist's insistence that he must make a choice could be taken by ME as an insult in some way. I mean, that is how I may take it, and the message I may internalize and not discuss with the therapist. In that sense, as his spouse, you could be invaluable to him by helping him in that perception issue. You may want to ask how he feels about the therapist ,and if he feels misunderstood, he can raise that in the therapy as well as look for another therapist. There are a billion therapists around, honestly. And they say you need to go through many therapists before you will find the right one for you. I would find one who says they have some experience with ADHD in Adults at least. It's very important that it be adhd in ADULTS because that's a very different picture. Most experts (lower level therapists, IMO) who associate ADHD with hyperactive boys getting in trouble with school are doing a disservice to their patients who are presenting depression & anxiety symptoms, as well as the disorganized behaviors... but they don't make the connection there.

daveddd
04-25-15, 09:02 PM
he's got to choose what? you say he refuses help offered, but then say he has a therapist

thats a huge step in it self and one he should be proud of

anyway , is it ADHD? tough to say

related or a result of adhd, probably . a biological inability to choose whatever he is suppose to be choosing, probably not

we can tend to use avoidant behaviors to avoid states or situations that bring us discomfort, unfortunately in the long term it makes things worse as you're noticing

Cecily
04-26-15, 01:37 AM
he's got to choose what? you say he refuses help offered, but then say he has a therapist

thats a huge step in it self and one he should be proud of



What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

He knows why he's about to lose another job. He knows he's wreaking havoc on his marriage and as a father. The stakes can't get much higher. And yet, he feels powerless to do what he knows he needs to do in order to keep himself and his family afloat.

BellaVita
04-26-15, 02:21 AM
What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

He knows why he's about to lose another job. He knows he's wreaking havoc on his marriage and as a father. The stakes can't get much higher. And yet, he feels powerless to do what he knows he needs to do in order to keep himself and his family afloat.

It might be he means what he says, that they ARE too hard.

He might be getting confused on the steps, which order they go in, or where to begin at all.

When I hear "tools" and "skills" I get flashbacks of NTs trying to force me to do things their way, even if they mean well...I still couldn't do what they wanted.

That's unfortunately what comes with ADHD: impairment

Maybe he also feels overloaded...

stef
04-26-15, 02:51 AM
it doesn't sound like your therapist has the right approach. it's like he's up against a wall and paralyzed. it's not about making a " choice" anymore even if before, he willingly chose not to use whatever " tools " were available.

sarahsweets
04-26-15, 05:08 AM
Adhd isn't a knowing disorder, its a doing disorder.

kilted_scotsman
04-26-15, 06:15 AM
What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

He is right that "pills don't teach skills", but what the pills CAN do is buy time to do the firefighting. Often ADDers are "big picture" we can see the way issues interconnect and that makes it difficult to prioritise and take the baby steps needed to move toward change.

What made a biggest difference for me was moving from an environment where I had to continue to try to be someone I was not..... into one where I was accepted for who I was and also supported to grow into my potential.

This process took years and required significant change. I went to a retreat centre for many months and this gave me space to rebuild the routine of my life. It was good because it provided a no stress structure, included rewarding physical work, and also gave me experiences in several different approaches to mental health. I was open about my diagnoses and that I wanted to work out how to live without meds. (I became contra-indicated for ADD meds because of a heart condition from the stress of living with undiagnosed ADHD). The most important part was experiencing a completely new kind of way of being with people.

I agree with stef..... asking someone who is this far into the hole to make a choice and implement it often has the effect of making the hole deeper. In this situation the therapist is coming from a "power over" position.... making it seem like the choices are simple and doable, when your partner feels they are anything but. For someone in your partners position even the process of making a choice is an exhausting prospect, hence the "too difficult" response.

What your husband needs are partners, in particular his therapist has to be with him WHERE HE IS NOW in order to build trust and rapport so that when the therapist suggests a baby step forward your husband won't reject it out of hand.

In good CBT the therapist uses Person Centred techiques to show "Acceptance, Genuineness and Empathy" before moving on to use CBT proper to look at behavioural issues and develop a cognitive strategy to access mindfulness techniques to reorientate the thought patterns of the client. This frequently takes many months if not years to accomplish.

I suspect the "skills" your husband has learned look obvious and simple to someone functioning well, however to someone in the depths of clinical depression just getting up and cleaning ones teeth is a victory.

Someone in your husbands position has a VERY limited amount of what some psychotherapists call "physis" (life force). How he spends that energy is crucial.

There is a metaphor called "Spoons" which you can find here (http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/).

Someone who knows they are wreaking havoc on his marriage and as a father is already in a dark place.... the first thing to do is for YOU to reassure him that he is not wreaking havoc on his marriage and that deep down he is a good dad.

The stakes can't get much higher......
he knows he needs to do in order to keep himself and his family afloat.

Sorry to be the bringer of bad news, but if your partner is bi-polar, ADHD that was undiagnosed for a long time and is possibly clinically depressed it's not his job to keep the family afloat.

Therefore the most effective things you can do for him are

1) Reassure him that it's not his job to hold things together, he can completely flake out and he will still be a good man, husband and father. Keeping the family afloat is a partnership and how the roles and responsibilities are shared out depends on each persons capacity AT THE TIME.

2) Accept that, for the moment, it's your role, to hold things together and he may have to be absent, literally or metaphorically for a while.

3) Move toward understanding your own place in the family dynamic. This may well mean examining closely your own assumptions about families, relationships and gender roles. This is likely to mean finding your own therapist

kilted

Cecily
04-26-15, 11:26 AM
Kilted, thank you, I needed to hear all that.

Cecily
04-26-15, 11:33 AM
What should be my role in regards to this: We live 3 hours from the nearest CBT therapist. I greatly desire to move to be nearer help and support and options for our family, but my husband is understandably highly resistant to that idea because of the risk and stress involved.

When he has gotten paralyzed in the past, I have tried to take the lead, make the decision, and get whatever it is done for his and our family's sake. But more often than not he straight up says "no." What do you do with a paralyzed person who refuses help to move?

Little Missy
04-26-15, 12:10 PM
You make up for each others capabilities and limitations and if he doesn't take the initiative then go for it.

If he does not want you to do it he'll step in. :)

daveddd
04-26-15, 03:57 PM
What should be my role in regards to this: We live 3 hours from the nearest CBT therapist. I greatly desire to move to be nearer help and support and options for our family, but my husband is understandably highly resistant to that idea because of the risk and stress involved.

When he has gotten paralyzed in the past, I have tried to take the lead, make the decision, and get whatever it is done for his and our family's sake. But more often than not he straight up says "no." What do you do with a paralyzed person who refuses help to move?

just a side note, i would really look into CBT before he tries it if he decides to

its thought to be contraindicated in adhd

third wave therapies are recommended


just a thought

Cecily
04-26-15, 04:35 PM
You make up for each others capabilities and limitations and if he doesn't take the initiative then go for it.

If he does not want you to do it he'll step in. :)

This is usually how it goes: He and I agree that one thing or another needs to be done or changed, but in the midst of it he short circuits and is "paralyzed." I step in to begin it or finish it, and he refuses my help. If it's a decision that needs to be made, he rejects my decision. If it a dozen steps that needs to be taken to reach a goal, he abandons the goal even if I've already accomplished most of the steps for him. If it's organization or prioritization that needs to be worked out, I'll lay it out for him just to have it rejected.

I feel like he's fighting gravity. It's futile to fight fundamental realities of life, but he won't stop fighting it. He doesn't trust himself but he won't trust anyone else either.

Cecily
04-26-15, 04:39 PM
just a side note, i would really look into CBT before he tries it if he decides to

its thought to be contraindicated in adhd

third wave therapies are recommended


just a thought

Third wave... is that like ADD coaching coupled with CBT?

Fuzzy12
04-26-15, 05:26 PM
What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

He knows why he's about to lose another job. He knows he's wreaking havoc on his marriage and as a father. The stakes can't get much higher. And yet, he feels powerless to do what he knows he needs to do in order to keep himself and his family afloat.

Pills don't teach skills. That's true. It's not the job of stimulants to teach skills. We don't need the stimulants for that. Our learning isn't inherently impaired. What's impaired though is the capability to use the skills we have learnt.

Before I was diagnosed I tried every strategy and tool that I'd hear of or could dream to help me with my issues but nothing helped. Rather I couldn't use any Strategy or behavioural tool for longer than a day at most though I could see the benefit in them. I just couldn't stick with them.

With the meds i can. It's still tough but at least it's not impossible anymore. The meds allow me to use all the skills and tools that I have learnt.

kilted_scotsman
04-26-15, 05:37 PM
I wouldn't say CBT is contra-indicated for ADHD.

Third wave is taking CBT and other types of therapy and adding in mindfulness techniques gleaned from a variety of sources.

Third wave therapies blend behavioural and humanistic therapies with the new advances in neuroscience to give a framework at both the mind and neurological level... so it's way more than CBT + Coaching.

kilted

daveddd
04-26-15, 06:09 PM
Pills don't teach skills. That's true. It's not the job of stimulants to teach skills. We don't need the stimulants for that. Our learning isn't inherently impaired. What's impaired though is the capability to use the skills we have learnt.

Before I was diagnosed I tried every strategy and tool that I'd hear of or could dream to help me with my issues but nothing helped. Rather I couldn't use any Strategy or behavioural tool for longer than a day at most though I could see the benefit in them. I just couldn't stick with them.

With the meds i can. It's still tough but at least it's not impossible anymore. The meds allow me to use all the skills and tools that I have learnt.

several people with add lack self help skills, interpersonal skills, emotional regulation skills

i know the 'doing not knowing disorder" is a common phrase but i think it really oversimplifies

add does not affect intelligence , but it can be pervasive otherwise

daveddd
04-26-15, 06:15 PM
I wouldn't say CBT is contra-indicated for ADHD.

Third wave is taking CBT and other types of therapy and adding in mindfulness techniques gleaned from a variety of sources.

Third wave therapies blend behavioural and humanistic therapies with the new advances in neuroscience to give a framework at both the mind and neurological level... so it's way more than CBT + Coaching.

kilted

i used that line from an ACT book , i thought about why long before

i believe people with severe ADHD, especially that crosses into bipolar may lack insight, cognitive awareness and so forth that may make CBT very difficult

i could be wrong, i just think mindfulness and acceptance strategies could be crucial in those cases to start with

Cecily
04-26-15, 10:37 PM
In everyone's experience with CBT and other more specialized therapies, would you say that these are absolutely essential to growth for someone as entrenched as my husband?

How essential is it that we get this kind help for him and our family? Essential enough to move to a new community? Essential enough to put my foot down and insist that we move whether he likes it or not?

BellaVita
04-27-15, 12:27 AM
In everyone's experience with CBT and other more specialized therapies, would you say that these are absolutely essential to growth for someone as entrenched as my husband?

How essential is it that we get this kind help for him and our family? Essential enough to move to a new community? Essential enough to put my foot down and insist that we move whether he likes it or not?

What if your husband never changes?

Could he be feeling lots of pressure from you and external sources, causing him to go on lock down and become paralyzed?

Maybe he really is doing the best he can.

Some people improve, but only to a certain extent. Even with meds, many of us are still a train wreck.

He might need more support and "accommodations" types of things.

icarusinflames
04-27-15, 01:26 AM
What do you do with a paralyzed person who refuses help to move?

By the way, I was wondering if you also have an outlet for yourself, to get your own support and help. I know it's incredibly hard and stressful to be the caregiver for someone. I took care of my grandmother in the final years of her life, and now I'm currently the caregiver for my husband who has lung cancer. I found out during this time that my lifelong depression was probably ADHD too. So it's majorly stressful for me, all of the things I have endured and how strong I have tried to be, but feeling weak and wanting so much to just be taken care of.

What I would do for someone who is feeling paralyzed, unable to act for their own well being or others, is to take care of them as best I could, while also getting fully educated on what I am dealing with (adult ADHD, plus other issues he may have). I'd make sure they see the best professional they can, because honestly I remember being in the loop of seeing a bad therapist and really wasting my precious life's moments in therapy for a year or 2 or 3 years. Not getting any results is a terrible feeling when you are depressed.

Going to a professional when you are in your greatest emotional pain of your life, and then failing to be understood there too is just awful.

So one thing you can do as his loved one, is make sure he doesn't waste too much time seeing the wrong individual. I would make the phone calls for him to locate a new and more specialized therapist who claims to help individuals with adult adhd, for example.

You can research any other possible therapists and professionals in the area, options for treatment and also some tips on transforming your home into an ADHD friendly place.

icarusinflames
04-27-15, 02:00 AM
In everyone's experience with CBT and other more specialized therapies, would you say that these are absolutely essential to growth for someone as entrenched as my husband?

How essential is it that we get this kind help for him and our family? Essential enough to move to a new community? Essential enough to put my foot down and insist that we move whether he likes it or not?

In reading about ADHD online, I stumbled on this quote that really seems pertinent to this question you ask:

“Ask not what disease the person has, but rather what person the disease has”
― William Osler

I think there are a few options for therapy types and medications, but the individual and their unique personality and situation would affect things. Also, where the individual is at in their development, perhaps even how they feel about their situation.

The reason I think it's important to have a therapist who fully understands ADHD in adults is because of the danger that ADHD people have in being gravely misunderstood! The behaviors that we have are very provoking and inflammatory to other people, since we appear like we don't care and we are not making any effort. It makes us have lives filled with negative feedback from everyone from our parents to our romantic partners to our friends to our bosses, etc. It seems like everyone reads negative intentions in to our behaviors because we display carelessness, which is less forgiveable than mistakes.

So your husband could be in danger of being misunderstood by his own therapist, which would actually be more harmful. I have had so many therapists who I felt just did not get me! I will NEVER forget how painful it was to ride the bus home in the dark of night, in a bad part of town from my last therapy appointment where I had told my therapist that I had decided to discontinue therapy at that time. He told me then, "I have one thing to tell you that I have realized as a constant refrain in your behavior: You always talk about what you want to do and how you want to change, but you never actually do anything that you say you want to do!" He said this to me like it was this huge revelation that would change my life, but I honestly just felt so judged and NOT helped at all. Because I had just spent a whole year talking to this man every week for an hour, and he never spoke to me at all about any advice or tips or anything. He only told me to do cognitive behavior therapy, and then he was surprised I guess at how little of it I would actually remember to do during the weeks. I remember talking to him a lot about how lonely I was and how much I feel I don't fit in, and how hard college was for me. But he couldn't offer me any help other than to tell me that I never do anything I want to do?

I never could follow through on the cognitive behavioral therapy! I just could not do it, and it always felt like homework to me. Then I realized recently, in the light of knowing I have ADHD now, that of course I could not do it! It was homework and it was to be done alone, later. I would never really consistently want to do that work, nor would I follow through on it except initially when it was NEW. I always wanted things to be new. I also wanted to be included and feel like I was relating well with others,. But I was always rejected by people. First by my parents and then by people in the neighborhood, and later at school. In marriage, I was then looked at as the problem all the time too because I had embarrassing shortcomings where I could not keep the house cleaned up, and I feared going to work.

What I needed was for someone to literally hold my hand and help me all the way through the process. What I needed was impossible because nobody would have the patience to help me that much. But what would have been immeasurably helpful is for someone to simply hang out with me more, while I had to go through those boring steps to do X, Y, or Z. I could use someone who would have breakfast with me, and help me come up with a simple and short list of prioritized things to do that day.

Oh also, I would be remiss to not say your husband should get a full check-up from his doctor, and you may have him checked for vitamin deficiencies. Some people as they age will get thinning of the stomach lining which interferes with the absorption of vitamin B12. Also, the use of antacids can prevent the absorption in the stomach of B12 vitamin. With low vitamin B12, you can experience dementia like feelings from low vitamins, such as a slowness in the mind or in the extreme result, slurred speech. I think all people should get health checkups as they age too. Men should have a heart exam that also checks the aorta for a potential aortic aneurysm. I have heard many stories of men who started to act very withdrawn in the last year of their lives prior to a major heart attack. Sometimes people also have very mild strokes that cause their personalities to become more withdrawn. I would never suspect that for an individual who behaves in an emotional manner though, as the person I saw who had a small stroke was very unemotional and quiet. Sleep disorders are supposed to be common for people with ADHD, and that can make them worse because they aren't sleeping right. It's good to be checked out, especially if there's snoring or awakenings, albeit brief.

kilted_scotsman
04-27-15, 10:33 AM
In everyone's experience with CBT and other more specialized therapies, would you say that these are absolutely essential to growth for someone as entrenched as my husband?

There is only one thing that is essential to growth, the desire to grow.


How essential is it that we get this kind help for him and our family?

Once he decides, REALLY decides he wants to grow then he may see that some form of assistance is essential. What form that assistance takes doesn't really matter. It's important that he understands that each time he tries something it's an experiment..... give each experiment a bit of time, then if it's working great.... if not... move on and try something new.... just doing this is growthful.... because it begins the process of self reflection.....

by asking the question "Is this working?" metacognition (the self thinking about the actions of the self) comes into play.

There have been studies in psychotherapy that have shown that about 80% of the success in therapy is down to two factors
1) the willingness of the client to grow
2) the relationship with the therapist.

The type of therapy and the frequency make up <20%... which reinforces the view that it's likely that he may move through a couple of therapists before finding the right one.

Remember that it's often chance that provides the impetus to growth, and this can be reaching rock bottom and realising the only way out is through ones own mental effort.

This is often the point of first "metacognition"

Essential enough to move to a new community? Essential enough to put my foot down and insist that we move whether he likes it or not?

One of the most important factors here may well be your OWN access to support.... if you are living in a remote place without access to mental health support systems or "alternative" groups and therapies then you can legitimately say.........

"This place is no good for me, I need things this place cannot provide. I feel we need to move."

Then accept that you take the brunt of the process of moving..... and if you truly believe you are moving into a more supportive environment for you then the process will seem a little easier.

Someone once said to me when choosing between guilt and resentment.... choose guilt.

If you stay where you are... you may become resentful of your partner. If you move and it doesn't work out for him/you/your relationship.... you may feel guilty, but at least you tried.

I would also say that it doesn't have to be therapy..... simple activities such as yoga or meditation or gym.... done regularly are often as effective.... the key is building a basic routine.... bit by bit....

I found that my weekly visit to the therapist was useful in this regard..... for a long time it wasn't the therapy, but just the act of clearing a space for myself once a week and making the effort to turn up, week in week out.

This one thing provided an anchor round which the rest of my life began to take shape..... I could say "I can't do Wednesdays because I am seeing my therapist" This signalled to everyone who knew me that I was doing something about my behaviours and most people respected that.

kilted

Cecily
04-27-15, 11:20 AM
Remember that it's often chance that provides the impetus to growth, and this can be reaching rock bottom and realising the only way out is through ones own mental effort.

This is often the point of first "metacognition"



I'm getting conflicting advice throughout this thread. Not surprising since this is such a complicated issue, which is the very reason I haven't figured it out yet.

I hear the advice to support him no matter what. That this is what he needs from me most.

But then I hear (and have witnessed in other people's lives) that it often takes hitting rock bottom before the decision to truly pursue change and help is made.

I HAVE BEEN SUPPORTING HIM WITH EVERYTHING I HAVE. And in his own words he says that he is "comfortable." That he basically wants everything to stay the way they are (despite the fact that he is miserable half the time...).

He wants to change....
...but he doesn't know how to "choose" to change--to make himself truly "desire" to change.

He is NOT going to hit rock bottom if I am there for him and support him through everything.

If I withdraw loving support or give an ultimatum, he sinks into despair.

See my dilemma now?

daveddd
04-27-15, 11:40 AM
Wow true point i never thought of

Hitting rock bottom brought me to metacognitive awareness as well

kilted_scotsman
04-27-15, 11:52 AM
Yup...

This is where we enter the world of subconscious interactions. Something that transactional analyst psychotherapists call gaming.... popularised by Eric Berne in his book "Games People Play"

A guy called Karpman also wrote about this when he formulated the "drama triangle" where people in relationship more through three "positions"... victim, persecutor and rescuer. (By relationship we mean any relationship... work, family... and includes any number of people)

Though these are from the world of psychotherapy they are still relevant in neurodiverse relationships as they come from the environment we grow up in.....

"Rock Bottom" isn't the street... it's the place where the person has their situation made clear and unambiguous.... then they are in a place they have to make a choice..... hopefully this choice is made consciously as the process has been managed..... often it isn't.

In Game theory, Berne postulated that the first thing was to identify what kind of game was happening between the individuals...... then if one person played out the "antithesis"... the game stopped in it's tracks...... usually with angst and uproar.

Likewise with the Karpman triangle once even one person identifies their own pattern of moving between the positions.... if they stop doing that it forces the others involved to readjust their behaviours.

People in relationship.... any relationship move through levels of intimacy..... subconscious game playing is high up the level of intimacy.... which makes it v common amongst couples. As one moves up the intimacy scale..... RISK also increase.... risk of loss of relationship..... therefore to move from game playing to the higher level of true intimacy the people involved risk all. This is why confronting the game with its antithesis is often traumatic.... if breakthrough is obtained the relationship continues and is deepened.... however there is always the risk that one or more of the people involved refuse to budge.... in this situation the relationship breaks down and the individuals usually go off to find others who will play the complementary roles in their preferred subconscious game.

Ultimately it revolves around trust.... when subconscious gaming behaviour is identified and the antithesis behaviour initiated..... the decision to move to true intimacy is dependant on the individuals abandoning their defences and truly trusting the people around them.

In your situation.... this means your partner identifying that he has weaknesses at the moment..... and being prepared to trust you to make appropriate and mindful decisions for him.... in those areas..... It's very difficult for someone (particularly a man) with lots of fear and anxiety about other peoples motive's to do that..... a HUGE step..... and it takes the other person to work hard to be worthy of that trust.

This is the simplistic resume.... underneath this is a considerable amount of psychological depth... however Berne was good at taking academic theorising and putting in laymans language.... though that language is now a bit dated.

kilted

Fuzzy12
04-27-15, 12:27 PM
several people with add lack self help skills, interpersonal skills, emotional regulation skills

i know the 'doing not knowing disorder" is a common phrase but i think it really oversimplifies

add does not affect intelligence , but it can be pervasive otherwise

Yes, I know and I fully agree with you that it's not that simple. I do think though in my case and possibly the OP's husband case that this is relevant.

What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

Little Missy
04-27-15, 12:31 PM
Unfortunately, the only person you can control is yourself.

I'm still working on myself.

Fuzzy12
04-27-15, 12:42 PM
I'm getting conflicting advice throughout this thread. Not surprising since this is such a complicated issue, which is the very reason I haven't figured it out yet.

I hear the advice to support him no matter what. That this is what he needs from me most.

But then I hear (and have witnessed in other people's lives) that it often takes hitting rock bottom before the decision to truly pursue change and help is made.

I HAVE BEEN SUPPORTING HIM WITH EVERYTHING I HAVE. And in his own words he says that he is "comfortable." That he basically wants everything to stay the way they are (despite the fact that he is miserable half the time...).

He wants to change....
...but he doesn't know how to "choose" to change--to make himself truly "desire" to change.

He is NOT going to hit rock bottom if I am there for him and support him through everything.

If I withdraw loving support or give an ultimatum, he sinks into despair.

See my dilemma now?

I think, rock bottom is quite an elusive and subjective concept. Apart from death, there is no true rock bottom. You can always sink further and who knows what exactly the point is at which an individual decides that he absolutely must pick himself up? What if this point doesn't exist?

I don't think you have to wait for or should allow him to hit rock bottom. I could be wrong but I think that the damage and potentially irreversible damage that hitting rock bottom will cause, will just make it more difficult for him to pick himself up. Maybe this works for some people but for others (like me) every setback/failure, every additional problem adds to the feeling of being overwhelmed and out of control, which makes every task more difficult to deal with and ultimately reduces my ability to deal with anything. Also, considering that his well being effects your entire family, it's rather dangerous to seek rock bottom, I think.

What works for me is actually the exact opposite. Every bit of hope, every ray of light, every tiny little success and every additional pillar of support gives me more confidence and the motivation to improve myself.

The question though, I guess, is what kind of support is most helpful. Just doing everything for him might neither be feasible nor help him apply or develop any useful tools (nor would it be fair on or healthy for you).

Maybe you could ask him, what kind of support he thinks he might need to be able to function better.

Little Missy
04-27-15, 12:44 PM
Oh definitely, rock bottom can get even lower.

daveddd
04-27-15, 12:59 PM
Yes, I know and I fully agree with you that it's not that simple. I do think though in my case and possibly the OP's husband case that this is relevant.

I think people with adhd may have to learn one set of skills before being able to use simple life skills

Some therapists may look past this

Fuzzy12
04-27-15, 01:02 PM
I think people with adhd may have to learn one set of skills before being able to use simple life skills

Some therapists may look past this

Yes, that's actually a really good way of looking at it (if I understand you correctly). In a way being able to apply a skill is a skill in itself and there are tools that can help with that.

Ganjin
04-27-15, 04:11 PM
I HAVE BEEN SUPPORTING HIM WITH EVERYTHING I HAVE. And in his own words he says that he is "comfortable." That he basically wants everything to stay the way they are (despite the fact that he is miserable half the time...).

He wants to change....
...but he doesn't know how to "choose" to change--to make himself truly "desire" to change.

See my dilemma now?

I sure do see it. And it looks like a scary place for a wife and mother of children. You're strong to have come as far as you have on the journey that you've described.

You got lots of different advice from people here, and I don't think I have anything to add other than moral support and respect for what you're doing. And one more point of advice... Go hug your children. A depressed parent, even one that isn't abusive, can have a great impact on children. If they're old enough to begin to understand, then talk to them about their dad and encourage him to openly discuss it with them as well.

I have one question... Earlier in the thread, you mentioned ways you tried to "snap" him out of paralysis (think that's the word you used). Has he snapped out of this kind of slump in the past? Can you recall what snapped him? What were the circumstances? Did it seem random or triggered by something?

Sorry. That's actually a series of questions.

..namaste Cecily...

acdc01
04-30-15, 02:03 PM
Are you financially stable even without your husband's income? Can you really be the temporary full caretaker of your family without your husbands support? Sounds like the answer is yes - is that right?

If the answer is yes, I think you should do things in baby steps if your husband feels completely overwhelmed with all the changes and decisions he has to make.

I think you should tell your husband that there is only one step he needs to think about at all right now and he can clear his mind of everything else. The first step is the one that is statistically shown to help ADHDers the most (on average) - that's to get meds. And I'm not just talking about ADHD meds, your husband seems to have other issues too like anxiety or depression or something that will make ADHD meds not help at all if that's all you're treating him for.

Medication is just one tiny decision. Should I take meds yes or no? If he doesn't pull the trigger, tell him this isn't something that needs to be decided on cause his whole family needs him to do this, there is no question. You can even go get his meds with him. I would tell him how much you love him but if he can't do this for the kids and for you and for himself, then you can't survive like you are anymore. Say this only if you truly are willing to leave him though.

I would hold off on the moving for therapy. It is a lot of work to move and frankly success rates for therapy are low - medication is proven much more effective (though it doesn't work for some) so I would start with that and then think about therapy as a later step.

If you can't get him to even take one tiny step, I wouldn't feel bad for leaving him. He'll be miserable whether you stay or not. You and your kids are guaranteed to be miserable if you stay with him. Leave him, you and the kids have at least some chance for happiness. If your husband's bipolar can make him dangerous if you leave him, be careful in the way that you do it (sorry if this is an insult to bipolars, I'm not familiar with what it can make a person do).

Gina
05-17-15, 01:23 AM
Is this related to ADD?

My husband (ADD/bipolar) is a very stubborn man. For years, on one hand he has wanted help because he feels completely lost and overwhelmed and running his life into the ground, but he refuses most help offered him. He knows what he needs to do to get his life together, but strangely, he says that he cannot get himself to want to do what he's got to do. He is digging himself into a deep hole of depression and self-hatred, but he feels completely unable to change his own mind.

Is this ADD?? His therapist just keeps saying he's got to choose. It's all a choice. But he sits there with tears in his eyes saying that he does not know how to choose!

Any insight into what is going on with him? What is the real issue?

Most definitely, this could be ADHD. Can anyone here say for sure? No.

But you start off by saying he's "stubborn." And that he's "refused" most help offered to him.

His therapist lands some choice psychobabble that probably is the last nail in your husband's mental coffin.

Please, read some smart books on ADHD, watch some smart videos on YouTube, and try to understand what your husband is up against.

You cannot think in traditional mindsets about what constitutes "help" and "choice" if you don't understand ADHD.

I hope you both can find ADHD-informed help.

good luck,
g

Gina
05-17-15, 01:26 AM
What I mean that he refuses help is that he will not use the tools or skills to succeed with ADD. "Pills don't teach skills." Well, he does not implement the skills he's learned about. He has been given many tried and true ideas on how to organize his life and time and make the most of his strengths, but he does not implement these ideas. They are all "too hard."

He knows why he's about to lose another job. He knows he's wreaking havoc on his marriage and as a father. The stakes can't get much higher. And yet, he feels powerless to do what he knows he needs to do in order to keep himself and his family afloat.

ADHD is not about "not knowing what to do."

It's about trouble "doing what you know."

If it's "too hard," then maybe the "tried and true ideas" are bad ones. Or his medication needs re-assessing. Or he needs better sleep or diet or ....

It is not easy getting competent treatment. I'm extremely aware of that.

But I would try to optimize physical strategies first and try the other stuff after.