Is it unethical to call my brother's (with BPD) psychiatrist

[Sherzade]

I feel stuck and need some advice.

My brother has a borderline personality disorder and he is at times very violent, especially to my mum who he loves and hates. My other brother died 2 months ago and it has been difficult to mourn him as my brother turned everything to him and I get so worried that all my attention goes to him.

He’s having murderous feelings towards specific people and he verbalizes it with so much rage. I tried to understand whether he could distinguish between fantasy and acting it out in reality but I think it’s quite unpredictable. One minute he seems more insightful, next minute he is completely irrational and enraged.

My question is should I get in touch with his psychiatrist (private) and tell him about his murderous feelings as I fear that he may hurt someone, especially my mum? Or am I over dramatising and playing the role he wants me to play in his manipulation? He is in denial and never did any kind of psychotherapy. He takes his medication, including anti-psychotics, but that’s about it. I’m trying to convince him that he has a problem and needs psychotherapy. There isn’t really much happening in Portugal,where he lives,regarding borderline. No support groups, no information and perhaps no one with experience in treating borderline personality disorders. And he doesn’t speak English or any other language.

I remember when I was 16/17 being so afraid that he killed my mum. I would get to school and go back home straight away fearing the worst. There was no support and even the police said that they couldn’t interfere in family problems. 20 years later I feel the same. Completely isolated and not knowing what to do and where to turn to for help. Is it ok to call his psychiatrist and tell him this?

Thank you. Any comment to help me think is welcome.

[Symora]

Hi Sherzade, It sounds like your family is going through a lot. It appears that your brother's death has triggered your other brother...rage is often part of the grieving process and it sound like he is right in there.

If it were me, I would contact the psychiatic to inform him or her about his erratic and highly agressive compulsions. It seems to me that family members should have input into the recovery process, especially if the psychiatist does not spend much time with him - he may not actually know or understand where your brother is at right now. I'm assuming your mother is not able to help you decide this? Do you have other members of the family you can discuss this with? It a lot to put unto your shoulders alone, it's always nice to be able to make a decision as a family.

I'm sorry your family is going through such a hard time.... It's never easy watching the people we love reek such havock in their lives and dragging others into the maelstorm. Hope things settle down soon!

[Sherzade]

Thank you Symora.

It’s true that the death of my other brother is triggering a lot of difficult feelings. But my brother (BPD) always had crisis of rage, which he deals with by attacking my mother. For him someone has to be blamed if anything goes wrong in his life or if he thinks that is anything wrong in his life. He then calls or goes to my mum’s house and he’s abusive and violent towards her. This is his way of (not) dealing with his difficult feelings or any kind of feelings. For him they all seem to be difficult. He throws them forcefully and violently towards my mother and in the past towards me or the other brother. This is a dysfunctional family, in which I as the youngest played the role of the father that left when I was 5 and simply disappeared in the world. My mother failed by not providing boundaries and not being able to recognize and respond to our emotional needs… My brother was the first to understand this and to express it in this way. But he’s stuck in that mode of functioning. He was never challenged, except by me and I obviously failed. Then I kind of quit, moved to the UK and I tried to rework the dynamics of our family by changing my own behaviour. I now feel that I have been dragged into it again. It all seems so extreme in one minute and the next minute it all seems pointless. Like if I had had a nightmare and it wasn’t real. But then the danger seems real again and the cycle continues.

I think that my question is also how to not get too involved in his mode of functioning and how to take care of myself.

Do not have more family.

Thanks a lot. What a release to write in here. I’m so tired that my friends always know me worried and with problems… I fear that I don’t know how to live differently anymore.