The Difference Between Conditions and Problems

A bipolar narcissistic father and his daughter finally get “religion.”

Posted Jul 15, 2019

What is the difference between conditions and problems?  "Conditions are relatively permanent and unchangeable situations over which we have limited control.  Problems, by contrast, are short-term and fixable.  Don’t confuse them.”  Said Dr. Loren Siffring, a retired medical doctor and now full-time pastor, author, and artist who understands both mental and medical conditions.  He has mentored and counseled hundreds of people over the past 40 years. 

For example, what if someone with permanent paralysis were to treat their medical condition as if it were a solvable problem?  They would be frustrated at best. Tormented at worse.  However, the condition of paralysis does create problems such as transportation, work, and even eating.  All of these are problems that the person with paralysis can and must solve with assistance on a daily basis.

Many Diagnostic and Statistical Manual (DSM) disorders are conditions, e.g., schizophrenia, paranoia, etc.  However, unlike permanent paralysis, disorders can be treated with varying degrees of success. Some cannot be eliminated but they can be managed with professional help, medication, self-awareness, determination, and support of family, friends, and community.

If you think you’re alone in dealing with the unhealthy conditions of family members, read Beth’s story.  A woman in her thirties, she suffered as a child with her father’s initially un-diagnosed bipolar and narcissistic personality disorders. 

A well-known professional in the community, her father engaged in what she described as Dr. Jekyll/Mr. Hyde behaviors: He could be both funny and engaging and then violent, controlling, and without empathy.  There were times of relative peace followed by terror. 

Throughout her entire childhood, she played the role of protector and confidante to her mother.  At age 32, she was getting married.  With her mother now deceased (from cancer), she asked her father to come to her wedding. 

She correctly anticipated that his conditions would produce problems.  Just before the big day, he told her he would not be coming to the wedding and would never see her again because she was not being married in his religion.  So, what did Beth do?

She walked down the aisle alone.  With the support of her new husband, Beth decided to take a counter-intuitive approach to her father and his condition.  For the first time, she accepted the fact that her father suffered from bipolar disorder and narcissism and that it was outside of her ability or responsibility to change it.  The acceptance of his condition increased her objectivity and gave her psychological relief about her father’s situation. 

Second, Beth reframed her own thinking by asking, “If my father were well, how would I treat him as a daughter?”  She decided to be her best self as a daughter and respect his position as her father while setting clear boundaries.  In the first month of her marriage, she wrote to her father, telling him only about her everyday affairs. 

Then a week later she called her father.  As expected, he became verbally abusive.  Prepared for this reaction, she responded by saying, “Dad, I look forward to talking to you when you are more able to have a civil conversation” and hung up.  Her second letter and phone call were the same.  

But by month three, her father was surprisingly civil on the phone.  In month four, he called to tell her that he was coming out to visit.  Understandably nervous but determined, she and her new husband invited him to come.  The visit was pleasant and there was no talk of the recent contentious past.

Over the years, Beth’s father continued to have bipolar/narcissistic-induced episodes, typically twice per year.  Each required hospitalization for about six weeks.  However, a major breakthrough came a couple of years after her wedding during one of his visits.  For the first time, he acknowledged that he had bipolar disorder and even described what it was like “to feel like God” during the manic phase. 

She also learned that her father’s mother had bipolar disorder and, at age fourteen, her father was suddenly sent by his parents to live with an older woman in another town so he could go to school. He was devastated. For both Beth and her father, this open understanding about his past was significant.  She had been forced as a child to pretend, hiding his condition from their neighbors, church members, and even his clients.  Now the “secret” was out.

Eventually, her father made a responsible choice to live in a nursing home where his medication could be regulated.  Now in his nineties, he spoke to Beth as a father to daughter.  He even said that he prayed for her and her family, the first real signs of empathy.  Yearly, Beth would receive a call from the nurse stating that her dad had been admitted to the hospital for treatment.  She developed a sense of humor about reports of his sometimes eccentric behaviors, knowing he was in a safe environment. 

One day, Beth received the call that her father had passed.  He ate his “last supper” with a smile, stood up, walked down the hallway and collapsed.

He died at 94 with the same conditions but with far fewer problems.  Beth’s response to her father was different and better.  Because she treated him as if he were well, it was this dose of reality therapy that challenged him to become a better father. 

Reflecting, Beth said, “Life is messy and it takes time.  On one hand, we accept our loved one's conditions. On the other, we set boundaries for ourselves and deal with the problems as they occur.” You might say, her father gained a new “religion” of responsibility and empathy that even led him to pray for his daughter.  And for her own peace of mind, she privately forgave him. It doesn’t get any better than that.

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