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She will ask me a question but when I answer casually, she twists my words as an attack on her. She's OCPD which I've diagnosed. She won't go to doctor, won't take any medicine. She's more paranoid. As an only child, she's put me down not believing she does. Attacks me but feels attacked herself. How do I deal with this?

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Harvey,
What do you mean when you say you answer "casually"?

Sometimes with enough information, we can figure these things out.

Not doubting she puts you down and attacks you. This must be devastating in your own home. Can you elaborate how the two of you came to live together?

Can she at all live alone? I find it unusual that her routine is to leave everyday as if she is required to, just to do non-employment related activities, and, has friends who share this activity. And, she is driving to do this?
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Harvey you say she's high functioning and appears friendly to outsiders, but you also mention that she's had outbursts in public to which the police have been called.

So, I have to wonder. With no family to share her care, who do you talk to about how she's getting on and what sort of help might work for her? It just crosses my mind that people might have been being too polite and not wanted to interfere.

What about people who have daily contact with her, such as neighbours and the friends she goes shopping with: are you sure they think she's fine? Sure they're not waiting for you to speak up?

At some point, a line will be crossed where the situation becomes unsustainable. You know it's coming. Wouldn't it be better to go out and meet it, by consulting - for example - an older age psychiatrist and asking for professional guidance?
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Harvey218, if possible have Mom tested for an Urinary Tract Infection. Such an inflection can cause such screaming outbursts, etc. This can be treated with antibiotics.

Time to use a "therapeutic fib" to get Mom to the doctor. Make an appointment for her, but tell her the appointment is for yourself and you want her to come along as moral support.
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Do you have help?
Usually when someone is like this the best thing you can do is leave the room. Go for a walk, Go into another room anything to get a way for a bit.
If she has any understanding at all can explain to her that you can not tolerate the way she is talking and the next time she does this you will walk away.
Do not respond to the attacks.
Are you POA for Health? If so despite what she says it might be time for you to step in and make an appointment for her to see her doctor and get what ever referrals you need for her to see possibly a neurologist or a neuro-psychologist and or psychiatrist .
Also if she can comprehend your conversations explain to her that if this continues you will not be able to care for her for your own mental and possibly physical health. Every one has a breaking point...and another fact about care-giving..often the caregiver dies before the one they are caring for.
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Harvey218 Feb 2019
Thank you for your answer. My mom is high functioning in that she's been driving everyday. She is out every am by 6:20. 365. She meets a friend or two and they hang out until the stores open. Then she goes to at least 2 stores, sometimes several, where she buys things such as groceries and clothing and household items that are marked down. She does this 7/365. She buys things we already have multiple of. She won't get get rid of anything. She brings straws, napkins home despite the places she keeps them overflowing. She saves all plastic store bags. She's very clean but hoards. I'm a nurse, retired. My son's an attorney. Nobody in family will deal with her. She has been this way ever since I can remember. Over this past year I see her becoming forgetful and having trouble feeling she is "following the rules" which means her incorrect understanding of certain forms she fills out yearly. But along with this she is even worse in how anything I say seems to immediately throw her into terrible verbal abuse toward me. She WILL NOT STOP SCREAMING long enough for me to complete a phrase let alone a statement. This isn't new but it's worse. Her words are terribly abusive. I do leave but I'm tired and just want to rest. My entire life was difficult being raised by her being this way. I had no brothers or sisters to talk to to understand she was ill so I had major struggles feeling so unhappy and inferior. I'm finally mostly emotionally healthy now, finally. She has no trust. She preached to me since childhood to never trust anyone but I'm trusting and joyful. She appears friendly to all outsiders. She will never consider POA of any kind. She needs me now but she's making it so much more difficult. Thanks again.
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