Rappler’s Life and Style section runs an advice column by couple Jeremy Baer and clinical psychologist Dr. Margarita Holmes.

Jeremy has a master’s degree in law from Oxford University. A banker of 37 years who worked in three continents, he has been training with Dr. Holmes for the last 10 years as co-lecturer and, occasionally, as co-therapist, especially with clients whose financial concerns intrude into their daily lives.

Together, they have written two books: Love Triangles: Understanding the Macho-Mistress Mentality and Imported Love: Filipino-Foreign Liaisons.

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Dear Dr Holmes and Mr Baer,

I have been married for 17 years. I am 51, my husband 52. My problem concerns my husband, a bank manager based in Indonesia. When he drinks, his courage goes up; he says things that are below the belt. Our first big fight was way back in 2013.

He went drinking with his friends and when he came back he kept on asking me who the other men in my life were. In my anger, I kicked him and left the house with my children. He didn’t know where we were and it took 3 weeks before he found us. He apologized and promised he would never do this again. In 2018 I was chosen as ambassador in my company, a big one working with agriculture.

Because of this, I was always in the company of technicians and my bosses. Sometimes, when he is on vacation, I take him with me on these trips, to the extent that my bosses and technicians now know him. His anger has no basis. But never has he hurt me physically.

Last week, we fought again (through video) with him saying words like: “You are a whore; unlike other whores who are paid, you are the one who pays those men”. Or “Your mother has a lover”.

My mother is dead; he has never met her. When he becomes sober, he apologizes and says he does not know what came over him. I have wanted to leave him for a long time, but I am of two minds, because of my obligations to him as a wife and as a human being who made promises to honor and obey him.

My husband and I fight whenever he gets drunk and accuses me of things I have never done. My children are distant from him because they see how he treats me and hear the terrible things he tells me.

My eldest (a boy, 23 years old) has been diagnosed as bipolar with paranoia, and is undergoing therapy. My son remembers all the harsh discipline my husband (his father) has done against him, even if this started when he was 6 years old.

I need advice because I cannot bear it if my son’s life is destroyed if I leave my husband. I have tried to several times, but my son’s life becomes a shambles when I do this. I do not know if my feelings are valid because of his treatment of me.

He is a good provider and a good man, But he changes when he gets drunk or I do not feel like having sex with him. Please help me? How can I clear my mind and make the right decision? – SARA

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Dear Sara,

You say that you have a husband (“Jim”) who is only a problem when drunk or deprived of sex and a son (“Bob”) who is bipolar with paranoia, distant from Bob because of Jim’s behavior towards you yet acts up whenever you leave Jim. 

I wonder if you and Jim have discussed his drinking and the problems it causes. If he apologizes and promises not to reoffend, then perhaps he has an issue with alcohol and should consider something like Alcoholics Anonymous. Alternatively, if his promises are just pro forma and so easily broken, then he really has very little respect for you which is not the best foundation for a marriage.

However, his behavior appears to affect your son Bob in two contradictory ways. You say that because of it Bob is distant from his father yet his life becomes a shambles whenever leaving Jim is in the cards. This seems contradictory but perhaps it is related to his schizophrenia which is after all a thought disorder.

Dr Holmes may comment further on this and any commonality between the behavior of father and son.

As for the future, you seem to have two obvious choices. You can soldier on in the marriage and try to sort out Jim’s drinking or if/when that doesn’t work you can leave him, having prepared Bob as best you can.

Finally, while trying to balance the competing priorities in your life, do not lose sight of your need to consider your own wellbeing which is vital to your future as well as that of your family.

All the best,

JAFBaer 

Dear Sara,

Thank you very much for your letter.  Yes, your feelings are absolutely valid and I hope some of the information I will share with you below will help you deal not only with your feelings, but equip you with knowledge that will help you deal more effectively with the problems with both your husband “Bob” and your son “Jim.”  

Because bipolar disorder has genetic components, it is possible that Bob may also be suffering from a mental disorder that has been untreated.  According to a study funded by the  NIH (National Institutes of Mental Health) people with disorders like depression, ADHD, bipolar disorder, schizophrenia and autism are more likely to have genetic variation at the same four chromosomal sites.

You write that your son has been diagnosed “bipolar with paranoia.”  The fact your son has been diagnosed with a mental disorder (Bipolar disorder) with the accompanying symptom of paranoia is, in a sense, good news in that paranoia is not psychosis.  

True, paranoia involves distressing suspicions (which schizophrenia—a psychotic mental illness may also include as a symptom) , but paranoia can  still include some degree of insight.  Paranoia can still include questioning these beliefs and thus be helped by cognitive behavior therapy.

In contrast, psychosis includes a deeper, more powerful disconnection from reality. It can be accompanied by delusions or hallucinations and usually needs a more intensive, more detailed plan to manage its symptoms.  

You also mention that Jim remembers all the “harsh discipline…that Bob (your husband and his father) has done against him… even if this started when he was 6 years old.”

However, this harsh discipline may, in fact, have started much earlier than when Jim 6 years old, even if that is as early as he can remember.  Usually, the earlier the childhood trauma is, the more severe its impact may be. Severe abuse during childhood is particularly linked to experiencing paranoid thoughts and even hallucinations.

I hope, therefore, that Jim is being treated also for his trauma and not just for his bipolar disorder and the paranoia that accompanies it.  There are lots of  evidence-based somatic therapies that work.  All forms of somatic therapies incorporate the body and body sensations in treatment.  Somatic therapy deals more with the body than traditional therapy does.  

Somatic therapies prioritize “embodied awareness” — how a client notices, identifies and responds to body sensations that emerge in session — and uses this awareness as a lever in the healing process.”   There are several professionals in the Philippines that have been trained in different somatic therapies. Please contact Two Pronged if you would like more information on this.

In other words, dearest Sara, in addition to medication and talk therapy your son is receiving, he might also benefit from somatic therapy. Jim would also benefit from some sort of therapy.  

A person cannot help having bipolar disorder and whatever disorder Jim and most  likely, Bob may have, and should not be blamed for it. 

However, a person can be judged if he doesn’t do things to help himself: being compliant with his psychiatrist’s suggestions and committing to lifestyle changes proven to help manage these difficulties.  

Two examples are exercising regularly and abstaining from drugs and alcohol. If Jim and Bob refuse to-do either, then perhaps you can  clear your mind and make appropriate decisions regarding how you want to live the rest of your life. 

It is time to put yourself first, as this will also help you be a better mother to Jim, and a partner for Bob.  Whether you remain Bob’s wife or separate  (if he refuses to go to a psychiatrist or do what will make him better) depends on him.

It is time to put yourself first for a change.  You do not do this selfishly or self “absorbedly,” but in a mentally healthy way, as all of us should. All of us should because of  self respect and boundary setting (distinguishing between what is ok for someone to do or what is not ok). Because it is “sobra na” (too much). 

Oh, Sara, please forgive me for bombarding you with information. Please write us again should you need further help. 

All the best,
MG Holmes 

– Rappler.com