Don't know how to help a friend, ideas welcome

Applecore

Gold Member
Please: no Artificial Intelligence responses. My friend has been unemployed for four years, living on savings that are about to run out. That means she can't afford psychotherapy and she says the government in her jurisdiction isn't going to help. No support from her family. She's had hundreds of hours of therapy and consultations with doctors. She's been diagnosed with chronic systemic inflammation, Hashimoto's disease, endometriosis, tetany. Doctor suspects Chronic Fatigue Syndrome or ME (myalgic encephalomyelitis) without formal diagnosis yet. Attacks of exhaustion (needing immediate sleep in the middle of the day), insomnia at night, brain fog (takes a day to write a short email), some verbal disorganization (her sentences are sometimes incomprehensible), extreme absent mindedness (losing important things like phone, laptop, wallet, keys, several times a week), irritability including fits of rage (verbal not physical), general sadness, negativity, pessimism, listlessness/inaction, complaining, blaming, despair, horror at her worsening condition, regularly talking about euthanasia. Extremely stubborn and hates "unsolicited advice". It started with an unhappy childhood and developmental trauma. Angry with her parents, especially with her father. She has decades of bulimia behind her, I suspect not entirely recovered, and I suspect it has caused brain damage. She tried MRI three times to check but had too much anxiety or claustrophobia to go through with it. She has on one occasion after a panic attack said she thinks she has a psychiatric disorder. I suspect Borderline with traits of vulnerable narcissism. Spends a lot of time checking the mirror, finds it hard to say sorry and can't handle criticism. Naturally very physically attractive, turns heads in a room and on the street. She is clever, funny and can be logical in spite of everything has a rock of resilience inside her. In public, people find her charismatic, intelligent, charming, sweet, kind and beautiful and can't understand that there could be any trouble whatsoever.
 
You sound like a lovely and supportive friend to want to seek help for her, but as others have already highlighted make sure first she wants the help, and what that looks like to her. If she has difficulty in being hyperindependent (eg stubborn as a mule, a trait many of us share as a result of trust being impossible) coming in and offering her lots of suggestions may well make the symptoms worse. Think about your boundaries too, no one is superhuman and you can't take the weight of this on your own without being hideously burnt out.

Practically it sounds like affording to live is a big priority. MH stability is very hard to achieve if the basics aren't there as a nice secure base. If her needs and medical conditions prevent her from re engaging with work, looking at whatever the welfare system is where you are seems like a pretty urgent need. Maybe her T is aware of the process and can offer some signposting, or government website/ charity info that can give a breakdown of what help might be available and how to access.
 
Thank you all.

I can provide more context that she was my life partner for many years, she moved out in December into her own place nearby. In fact it was her decision taken a very long time ago, confirmed several times, and which I had agreed was for the best. She took two or three years to actually get round to the move. Although she lived in my property for many years rent-free while renting out her own for supplementary income, she contributed to my bills and groceries and I did not give her money.

We remain close friends, meeting every two or three days and emotionally sharing a great deal. I can therefore admit that in terms of what are seen as conventional relationship norms there might be seen as something unusual here:

(1) We were once co-habiting monogamous life partners much like a wife and husband who had love and sex and expected to grow old together.

(2) We are now best friends who neither live together nor have sex yet nor do we date anyone else, and we continue to make platonically loving gestures and it's a sort of celibate exclusivity that remains. Both of us tell others when asked that we remain in a certain kind of relationship, and yet live apart. There are far more atypical relationships out there, to my mind.

Yes she says she wants help. She specifically said, with regard to generating income: "Without somebody's help I won't manage. I need somebody who will be eager to help me."

My reading of this is that she wants charity not employment, or some easy employment where dysfunction and incapacity is not a problem for the philanthropic provider. She seems to want the kind of help that is financial dependence.

Given my opinion that she has traits of vulnerable narcissism, I fear what she might be meaning between the lines the classic: "I need your help and you are going to fail."

And of course, maybe saying she wants me to bankroll her because she is incapacitated. But yet she has spent a huge amount of her own money on seeking change, therapy and medication, so I can't believe that this is simply all she wants.

She specifically asked me what to do about her situation and I replied that I am not going to give a spontaneous answer but I am going away to think about it and will get back to her.

What I want first if all is to find a way of persuading her of my opinion that financial independence is what is going to be most helpful for her in the long run. If only she could start small, say work for an hour a day (she has some tutoring ability) and make money from that, it would be a good start.

At the same time, I am asking my fellow community here for advice as I am seeing a drowning person and I am on the shoreline, not knowing what to do. Simple humanitarian response. I genuinely fear her suicide or incarceration in a psychiatric ward that would make things worse (they are very bad, more like jail in this country which is not part of the Anglophone world).

I have thought many times about going to her brother and her father (despite her telling me not to) to tell them my honest opinion that they are risking a suicide in their family if they don't show her that she is loved, wanted and needed at least. They're unable to help her financially because, perhaps by no coincidence, they are financially incapable.

She can no longer afford therapy. In her last session, she explained this and asked her therapist where she can go, whether there is a state-funded dorm she can stay at due to her conditions. She said the therapist said he is unable to help her and unable to give her any further advice.
 
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I have thought many times about going to her brother and her father (despite her telling me not to) to tell them my honest opinion that they are risking a suicide in their family if they don't show her that she is loved, wanted and needed at least.
Why do you think that they are capable of this? If they were never able to do this before, what's changed that would make them able to do this now?

And why do you think it is a loving act to do something she has specifically told you not to do?
 
to tell them my honest opinion that they are risking a suicide in their family if they don't show her that she is loved, wanted and needed at least
Ah. If only it were to simple that a conversation will make people behave differently.
I think you would be going down a road best avoided here. If they could behave the way she needed, they would. If they haven't, they either can't or won't. No amount of wisdom from you is going to make any difference. In fact, it's likely to cause disruption especially if she's explicitly told you not to.
If my partner went to my family I would be very angry. I know she has wanted to buy I've told her not to.
. I can therefore admit that in terms of what are seen as conventional relationship norms there might be seen as something unusual here:
Why? I always think that remaining friends or part of each others family makes sense. The friendship and deep connection doesn't need to disappear just because the intimate relationship has ended. Love can morph into a different type of love.
My ex is my best friend. So I get it.
Without somebody's help I won't manage. I need somebody who will be eager to help me."
Maybe a social worker?
so I can't believe that this is simply all she wants.
Doesn't sound like it is. She moved out. So she knew that would mean being financially independent?
persuading her of my opinion
This is also best avoided.

It's incredibly hard to see someone you love struggle. And sometimes there is nothing you can do but witness it and be there for them.
Is there no adult services or a charity or a community place that would help? Religious group? Community group?
 
Why do you think that they are capable of this? If they were never able to do this before, what's changed that would make them able to do this now?

And why do you think it is a loving act to do something she has specifically told you not to do?

Thank you for the great questions. They are constructively challenging and succeed in making me think.

I doubt her brother is aware of just how unwell she is. In my experience I can see that he does love her; it is my opinion that he is unaware about how much demonstrating his love to her may help her. I believe it will.

It so happens that she has several times told me that I should have ignored what she told me not to do to, because she hadn't realized that telling me not to do something was not in fact in her own best interests.

She gave the example of Michael Mosely, the British celebrity doctor who died of heat exposure on a hike in Greece, who she said should have been stopped by her family from walking in the summer sun alone, no matter what he told them.

For 11 years that I have known her, I have never done something she has specifically told me not to do, and the situation is now extremely desperate - I gave the example of the person drowning above.

I may be able to find a middle way and modify my approach to her brother. She specifically told me not to speak about her illnesses with him; she didn't specifically tell me not to give him my heartfelt opinion that his demonstrations of love right now may stop him from having a suicide in his family - which is what I sincerely believe to be true.

To extend the principle to an extreme degree: if she told me not to stop her from committing suicide, I would do something she has specifically told me not to do.

You raised a good point, and thank you again.
 
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It sounds like she needs a social worker to start with.

And like a drug addict, she may have to hit her version of "rock bottom" before she is willing to make the changes necessary to get any improvement happening.

If it's an option for you, it might be worthwhile sharing what country/ state she lives in, in terms of what resources/ help/ support is available in that area, as it differs so wildly from country to country and sometimes even from state to state.
 
It sounds like she needs a social worker to start with.

And like a drug addict, she may have to hit her version of "rock bottom" before she is willing to make the changes necessary to get any improvement happening.

If it's an option for you, it might be worthwhile sharing what country/ state she lives in, in terms of what resources/ help/ support is available in that area, as it differs so wildly from country to country and sometimes even from state to state.

Thank you for the questions.

It's a European country. I am not from here and I don't know how social services work, but it's not one of the wealthy ones with exemplary social services (i.e. it's not Scandinavia). I have never heard of social workers in action here, but I will now Google it and get back to you. I have heard that there are some 'National Health Service'-equivalent options for psychiatric treatment. But as I mentioned in an earlier post getting sent to the local psych ward is apparently a total nightmare. I consulted a wealthy friend yesterday who's son is schizophrenic; he can afford private care and said the public services would be utterly useless if not detrimental. He described the local psych ward as like something out of One Flew Over the Cuckoo's Nest. This is partly why I think about her bother - at least he is local and has the language better than I do, possibly better contacts too. I agree with you about rock bottom and I think she is there right now. At the same time, her issues are not purely psychological but neurological and endocrine also. That requires a sophisticated holistic approach, not just getting drugged and locked up with psychotics.
 
If you need good advice about what resources are available locally, then self-help groups are a fantastic place to start. You can go to all the ones that sound vaguely relevant and explain your friend/ ex's situation there and get feedback from the locals who understand the medical/ support system there and know what helps and what doesn't. Self-help groups are an amazing resource for getting that kind of information.
 

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