What to Do with an Emotionally2
or Physically Disabled Spouse

Letter #1

Dear Dr. Harley,

We've been together for 20 years, happily married for 17, and have two teenage sons. Since I returned from a 3 day business trip 5 weeks ago (my first in 4 years) my wife has accused me of 1. having an affair, 2. trying to hide assets, 3. threatening her, 4. wanting to hurt the children, 5. tapping her phone, 6. bugging the house, 7. not loving her. 8. planning on leaving her for a younger woman, etc. I haven't done any of these things.

I love my wife with all of my heart. She has now locked me out of the house and gotten a restraining order preventing me from contacting her or my kids. She has always been slightly paranoid, and now she has gone off the deep end (At least with respect to me. She is still fairly rational and normal with everything else). She will not talk to me at all, she throws away my letters and she accuses the counselor we were seeing of lying to her and now she won't go to a counselor either.

What should I do?

B.R.

Dear Mr. B.R.,

Your wife is probably suffering from a paranoid disorder. It is usually a problem that gets worse over time, since in many cases its underlying cause is damage to the brain which, itself, deteriorates over time. Most people who are known to have a degenerative neurological disorder are somewhat paranoid.

Some people are paranoid at an early age, which could reflect an early brain injury. One of my clients that I saw for the first time at the age of 16 had a serious head injury when she was 6. She is now 38 and on rare occasion manifests some paranoid symptoms, but is married with three children and has steadily improved throughout her lifetime. It's a rare but encouraging example.

Some of my clients with serious paranoid disorders have eventually divorced their spouses, with everyone who cares for them, including their loving spouses, trying to stop them. I have gone to extraordinary lengths to try to prove that their paranoid fears are unfounded, but rarely does "proof" have any effect.

Sometimes medication can control paranoid thinking, particularly when the person is experiencing schizophrenic or manic symptoms along with being paranoid. But you describe a pure state of paranoid thinking in your letter, and medication has not been very successful in treating it. Psychotherapy is also somewhat unsuccessful, although there are instances of full recovery.

As you discovered, after taking your 3 day business trip, people that suffer from paranoid thinking don't like their spouses to leave them alone. I believe that your wife may eventually let you back into her world again. If she does, don't ever leave her again overnight. The more time you spend with her, the less chance she has to imagine what you could be doing behind her back. Also, stress clearly increases paranoid thinking, and when you're with her she will be less anxious.

For a while, you may suffer stress from all her accusations, and it may even make you very angry. But I would not argue with her. Simply reassure her that you love her, and promise you will never leave her overnight again. That may settle her down. Also, call her regularly throughout the day. The more of your time you give her, especially when she has your undivided attention, the fewer symptoms you are likely to observe.

People with a paranoid disorder imagine all sorts of plots designed to do them in. Some are dangerous to live with because they are convinced their spouses are planning to kill them. I have counseled paranoid clients that have tried to kill their spouses in what they think is "self defense." Whenever I have a client who threatens to kill their spouse, I advise a separation until there is evidence of remission.

In your case, there does not seem to be any danger, so I would encourage you to make every effort to reunite with her. I think she will probably respond to you efforts within a few weeks, or at the most, a few months.

Make several efforts each day to talk to her, and when you can, tell her that you love her. Tell her the truth, never go along with one of her fantasies just to try to get along with her. If she demands that you confess doing something she imagined, gently tell her that you would never do anything to hurt her. Give her regular reassurance that you care about her and don't let yourself become so frustrated that you end up saying something that would hurt her feelings.

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