My former partner is having Transference Based Psychodynamic Therapy on the Nhs.
Wow that is amazing. That is the first time I've heard of the NHS paying for any course of therapy other than counselling or CBT. I've had bad experiences of the NHS and mental health in general. As a family we've had to fight for adequate treatment for my dad who is schizophrenic - he is on drugs which control it now, thank heavens but GPs have got things really wrong in the past because they have tried to treat him themselves rather than let him have regular access to specialist care.
Mum is probably BPD/NPD and has never been diagnosed with anything. She was prescribed tranquilisers in the 70s and 80s 'to help cope with my dad' - she has only ever been diagnosed with anxiety. When she developed ME/CFS in the 90s she was referred (I believe inappropriately) to a CBT therapist to deal with (as far as I know) the physical symptoms. What happened after that was a long story, but basically the therapist told the GP she could not deal with my mum's aggression towards her anymore. My GP told me this when I was 18. I think the GP sensed something was very wrong with her as he was always advising me to leave home as soon as I could.
I am now 38 and spend approx £200 per month on private therapy (I have masses of emotional issues and BPD 'fleas' after being 'brought up' by the pair of them) - I can just about afford this and am grateful that I have a job that pays well. In fact the therapy helps me hold down my job, and has saved my relationship with my partner. If I lost my job (I escaped redundancy in November) I have no idea how I would get the help I need.
I have never heard an NHS professional suggest my mother may have a PD (she has never self-harmed and is very high-functioning so maybe she doesn't fit their stereotype). One of my struggles has been that doctors hear the word 'schizophrenia' and assume all my issues stem from my dad whatever
I tell them. Some of them have implied I have 'bad genes' and have said I am 'lucky' to have escaped schizophrenia myself.
Sorry I have gone off-topic slightly but it is such a relief that someone has raised the UK situation on the board. My experience is that PDs are not in many UK GPs' clinical vocabulary. And my guess is that they are reluctant to refer to community psychiatric teams and psychiatric consultants (who can
potentially diagnose) because of NHS resourcing issues. Instead they hand over (cheap) SSRIs to their patients like sweets and if you're lucky you'll get a few sessions of CBT from an NHS support worker who is very well-intentioned but has minimal training.
My grandmother was severely BPD (again I am guessing) and it got worse as she aged. At one point in her 80s, she was put on SSRI anti-depressants, anti-psychotics and
tranquilisers - it appeared her GP had simply run out of options and just kept adding to her prescription. That in my opinion is potentially clinical malpractice and it was my mother of all people who had to point that out to him and suggest that she might need a visit from a CPN. When he heard someone use professional jargon he suddenly 'woke up' and realised we could not be fobbed off.
Now the government are planning to get GPs to commission services rather than PCTs - I don't understand the politics of this at all - but I am worried this situation will get even worse. I have a lot of respect for the GP profession but they are generalists
not specialists and they are not equipped to diagnose and treat complex mental health disorders. Yet often they do not
and will not
refer to secondary care and do not acknowledge when they are out of their depth when 'the drugs don't work'.
Please by all means challenge me if I have got some of this wrong and the picture I am painting is overly bleak. I would love to be wrong.