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Psychiatry & Psychology--General/Paranoid boyfriend ruining our relationship

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What do i do?
My boyfriend has always been paranoid type but lately its insane. He is obsessed with illuminati and freemasons, he think that they are out to get him. Specifically because he knows too much and he is on a much higher level than anyone else. He says things like " you and people like you are going to pay, you will suffer for a long time and burn" he has previously, when drunk told me that he needs to drown the devil in me.
Every sign for a business or anything on tv we see he points out illuminati symbols and tells me how these people have given up their lives for this stuff (?)
Any time i scratch or rub my eye he freaks out telling me i know thing, im part of "them" and im lying to him.
He said to me tonight i must be the worlds best liar to pretend not to know for 5 years. I dont know what this means. He also talks about magic and spells and putting a hex on people  ( i feel as if this is directed at me) and also asks me how much i got paid for doing what i did ( apparently in conjunction with masons or some other secret group im part of?)
Everything is negative, he refuses to work, constantly puts people down, including myself, his friends, my family and his own, claiming that we are out to get him.
He says "she" is coming and we will all get what we deserve, and that the cowards will burn. I have no idea what started this and no idea how to stop it.
He will wake me up in the middle of the night because he has been watching youtube and the guy in the video halfway around the world knows what he (bf) knows, and is going to get him for it so he cant tell anyone else.
When i ask what he is talking about i get told that he has already said too much and that i cant understand because I'm not high enough to see what he sees, or know what he knows.
I cant deal with much more of this, i have to watch my step and what i say, because anything can trigger a rant, which then triggers verbally abusive behaviour.
Emotionally its taking its toll, i feel drained, tired, unloved, confused. I have to work 50 hours a week just to scrape by on bills while he refuses to work, and he just belittles me for not doing anything, or alternatively, being stupid enough to work for the man.
Ive asked him to come and see someone with me, told him this isn't normal and that he scares and upsets me, but he just laughs at me and tells me ill see the truth soon enough.
I need advice, i love him, i dont want to leave, but i cant keep going like this. Its draining me to the point im not the person i used to be and its affecting my job and my friendships. Help...

Answer
Hello Cassandra,

I am not going to focus, for now, on your boyfriend's maladies. I am going to focus on yours because that is who I am most worried about.

You tell me that your boyfriend is acting quite "insane" and you gave some pretty good examples of very pathological behavior. He has threatened you, he said you and people like you will burn, suffer, and he has stated he needs to "drown the devil in you." And not once in all this do you say or recognize that you are afraid of him. If you are not afraid...oh my goodness! Why not? I am afraid for you.  You say he doesn't work, you are struggling, working 50 hours per week to pay the bills. Then he rants and raves about your worthlessness and how you are so far below his extreme level of intelligence. And you take it all in and act as if it is true. And then you wonder why you are drained, feeling unloved, and confused. There is little that is confusing except how you have managed to stay in this unbearable, painful relationship for so long. That is terribly concerning. To make matters worse, this situation is not only mentally draining, I believe you might be in physical danger.

So...the worry is for you. You need to get some help and get it ASAP. There is a reason why you are inclined to remain in what is an abusive, explosive, and unrewarding relationship...a relationship that might prove to be not only mentally abusive but physically dangerous for you. What happened in your childhood that might have allowed this situation to be created and fester? What were the relationships like between yourself and your parents that might have fostered in you a sense of yourself as deserving such abuse and behavior? These would be serious questions for consideration if you were my patient. And we would consider them only after you have found a safe place, away from the danger that your boyfriend poses for you.

So my advice is...do not expect nor wait for your boyfriend to seek therapy. I do not believe that will happen soon enough if ever. Although I would not make any diagnosis from such a distance, I will tell you he is exhibiting behavior that would define a serious mental illness. He seems to be exhibiting a grandiosity that suggests an extreme form of narcissism, megalomania. However, you also describe breaks with reality that suggest a severe paranoid psychosis. His mind, therefore, does not function correctly and he sees the world quite differently. In that world, he is being persecuted and he has said he will right that world by making those in it suffer. In this mentally ill state, he could be extremely dangerous.

I strongly suggest you remove yourself from the situation IMMEDIATELY. Go to a trusted friend, a trusted family member; do not stay in the house. If you can be any help at all, you must be that from a distance. I would contact his family members, if there are any available and tell them what is happening. You need help. If you cannot get it then, by all means, your main concern is your safety. The situation, as it stands now, is volatile and dangerous.

Next, once you have done this, you need to get to a good, caring psychotherapist. One that can help you explore and work through why you have allowed yourself to be abused and put in danger and not even recognize the threats that swirl around you. Something just as worrisome is going on in you, that would allow you to continue on in such an abusive and unsatisfying relationship.

I hope this helps. Above all, keep yourself safe and get some help.

Psychiatry & Psychology--General

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Jacquelynn Cunliffe

Expertise

I would like to answer under the category of Psychiatry and Psychology. However, I would like to see a separate category for Psychotherapy/Psychoanalysis. I do not answer questions about medications as I do not prescribe. My expertise is in psychotherapeutic treatment.

Experience

I am a psychotherapist and psychoanalyst who specializes in the treatment of mental health issues caused by childhood trauma, domestic abuse, eating disorders, relationship difficulties, and a wide variety of psychological disorders. The kind of therapy I do is often referred to as deep therapy, talk therapy, or psychoanalytic therapy. Please note that I am not against medications and when managed well, medication can be an adjunct to psychotherapy intervention. I think it is important for the public to realize that psychodynamic or psychoanalytic psychotherapy DOESmake changes not only in people's minds but those changes can also be detected in their brain structure. Psychotherapy and psychoanalysis are powerful interventions to help people change their lives from the inside out.

Organizations
American Psychoanalytic Association American Psychiatric Nurse Association Member of Psychoanalytic Center of Philadelphia Member of National Eating Disorder Association

Education/Credentials
Ph.D.-University of Pennsylvania, Psychology and Education, Division of Human Development M.S.N. and R.N.-B.C. Board Certified Nurse in Psychiatric and Mental Health Nursing. 2-Year Adult Psychotherapy Program graduate 2-Year Child Psychotherapy Graduate Current: Candidate in Psychoanalytic Training at the Psychoanalytic Center of Philadelphia

Past/Present Clients
I have worked with clients who have experienced significant childhood traumas. These patients come with a variety of mental health issues, including anxiety, depression, suicidal ideations, relationship difficulties and diagnoses such as Personality Disorders, Adjustment Disorders, and, though rarely, Dissociative Identity Disorder (formerly multiple Personality Disorder)

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