Pretty stunned by counselor's reaction

[VIDEO: "What is parental alienation?"]

I went for my first counselor session yesterday. It was fantastic, I'm really looking forward to the future prospects with her and my other sessions. My counselor has great credentials and was extremely helpful.

What did surprise me though is, obviously, we talked about my past relationships and my ex-dBPD-friend and my non-ex.

Now when people would say counselors and therapist were quite wary about those with BPD and some would not even treat the disorder I personally thought it was an exaggeration. I am someone who believes in available help for all mental health problems for all persons and most counselors I spoke to, when decided who to go with for talk therapy, very much agreed. I thought that, surely, counselors would treat all mental disorders on a similar level.

But the moment I even mentioned BPD to my counselor her eyes widened and she actually gasped and looked at me with such empathy. We talked a bit about it and she did state how complicated a disorder it is, how with something like depression the chances of resuming normal life and coming out of it are completely possible and quite high, where as for BPD it's almost non-existent. She noted the manipulation I endured, the gaslighting and when I spoke about my ex-friend telling me I had BPD too she told me,

'I have only been speaking to you for 15 mins and I have already determined you don't have BPD'.

She noted how pwBPD can't identify their own destructive behaviour, which is why they rarely recover, so the idea they could identify it in another is impossible.

So it is true, even in the professional psychologist sphere, BPD is still a very complicated issue and one that rarely delivers hope or possibility to change/recover.

[Springle]

I went for my first counselor session yesterday. It was fantastic, I'm really looking forward to the future prospects with her and my other sessions. My counselor has great credentials and was extremely helpful.

What did surprise me though is, obviously, we talked about my past relationships and my ex-dBPD-friend and my non-ex.

Now when people would say counselors and therapist were quite wary about those with BPD and some would not even treat the disorder I personally thought it was an exaggeration. I am someone who believes in available help for all mental health problems for all persons and most counselors I spoke to, when decided who to go with for talk therapy, very much agreed. I thought that, surely, counselors would treat all mental disorders on a similar level.

But the moment I even mentioned BPD to my counselor her eyes widened and she actually gasped and looked at me with such empathy. We talked a bit about it and she did state how complicated a disorder it is, how with something like depression the chances of resuming normal life and coming out of it are completely possible and quite high, where as for BPD it's almost non-existent. She noted the manipulation I endured, the gaslighting and when I spoke about my ex-friend telling me I had BPD too she told me,

'I have only been speaking to you for 15 mins and I have already determined you don't have BPD'.

She noted how pwBPD can't identify their own destructive behaviour, which is why they rarely recover, so the idea they could identify it in another is impossible.

So it is true, even in the professional psychologist sphere, BPD is still a very complicated issue and one that rarely delivers hope or possibility to change/recover.

[Pingo]

Hi Springle, so glad you took so much away from your first session!  My T had a similar reaction, her eyes opened wide when I mentioned BPD and she told me that it's very difficult to treat and takes a lot out of the T, that is why they will often not treat more than one at a time.  It reassured me that there was nothing I could have done to save him and helped me then turn the focus on myself.

[Aussie JJ]

Define recovery... .

It's a complex disorder with many different perspectives.  

It is like us, we can stay stuck or we can work through our pain and recover from it.  For a pwBPD to recover the pain they have to work through is so immense.  They have a lack of insight, a lack of empathy all of those major things that are needed to do just that, relate to others and themselves.  

They cant see there own actions nor can they see how they hurt others.  There are some pretty powerful books out there that actually tell the story of pwBPD that have recovered.  Recovery is management of those symptoms for the rest of there lives.  

There is a lot of negativity around BPD here on these forums because of the experiences that we have endured.  I really would encourage borrowing "borderline and the budda" I think it is form the local library and reading it for so many people.  

It isnt an excuss as to how they act this way however it gives you an idea of the struggles that pwBPD have and the amount of work that is involved in managing the symptoms that they suffer from.  


AJJ.  

[Aussie JJ]

My P told me straight up as well and i didnt understand it initially. 

You can never have a forfilling or meaningful relationship with exBPDgf AJJ, I am so sorry to tell you this.  I know you love her it just cant ever be. 


AJJ. 

[clydegriffith]

I had a similar experience the very first time i went to therapy. In discussing everythign that was going on, i mentioned to him that i had done some research and she fits the description of borderline personality disorder to a tee. He just looked at me and smiled and said bingo. Unfortunatley i did not listen to him about them never getting better and he told me my life would continue to be hell as long as i was with her. I endured another year of a nightmare after that.

[Recooperating]

My T told me to forget about his BPD diagnosis but to look at his actions and behaviors. His actions are his, the way I respond belongs to me. She said to place the responsibility where it belongs what belongs to me I can change, what belongs to him I cant change.

Ive been in T quite some time now and during these sessions I learnt that I can not change his behaviour and I realized I had to let him go. My T never told me to leave him, she said to either accept it, deal with the behaviour or let go.

In the end she was happy to hear I choose me and let go... .

But she never went it to the BPD symptoms, she said it should be about me and my responses to the behaviour, my choices and my happiness.

She never jugded him, which annoyed me, but I understand now.

[fred6]

What are the specific reasons that therapists don't like dealing with pwBPD? I mean what happens? Does the pwBPD just go in there and tell the T what they want to hear, rage on them, or devalue them? Why does it take so much out of the T? What's the deal?

[Mr. Solo]

I worked at a local mental hospital for a while. We DREADED borderline patients. By the time they came to see us they were usually worked up to a point of unbelief. They tried to manipulate everyone and threw a fit if they didn't get what they wanted. One woman was on the phone and suddenly she screamed bloody murder and fell in the floor. She was rolling in the floor screaming, "Why God? Why?" She finally calmed enough to tell us her sister had just died in an auto accident. We had to put her in the padded room because she wouldn't stop going nuts. After about an hour of non-stop drama and acting like I have never seen another human being act like, one of the nurses came from the office and told us she called the patient's mother and she doesn't even have a sister. LOL! It was unbelievable that someone could fake what she faked. It was over a cigarette, by the way. She thought she would get to leave if a sister died and we were a no smoking facility.

[Louise7777]

LOL Solo. 

That´s why Im so cynical regarding people´s behaviours, I usually step back, take a deep breath and think "why?" "what for?".

Histrionics usually dont fool me, they just trigger me, I just want to run to the hills! 

Springle, Im glad for you. Having a T with vast knowledge in BPD must be great. 

[fred6]

I worked at a local mental hospital for a while. We DREADED borderline patients. By the time they came to see us they were usually worked up to a point of unbelief. They tried to manipulate everyone and threw a fit if they didn't get what they wanted. One woman was on the phone and suddenly she screamed bloody murder and fell in the floor. She was rolling in the floor screaming, "Why God? Why?" She finally calmed enough to tell us her sister had just died in an auto accident. We had to put her in the padded room because she wouldn't stop going nuts. After about an hour of non-stop drama and acting like I have never seen another human being act like, one of the nurses came from the office and told us she called the patient's mother and she doesn't even have a sister. LOL! It was unbelievable that someone could fake what she faked. It was over a cigarette, by the way. She thought she would get to leave if a sister died and we were a no smoking facility.

That seems like an extreme case though. I'm sure some of them act nutty like that. But I would assume that a lot of them lead somewhat normal lives and internalize things.

[Hope0807]

A vast number of psychiatric professionals will readily admit to either having been exhausted with trying to treat a BPD, have colleagues who have been over-extended by trying to treat a BPD, or flat out refuse to treat anyone with BPD.

I have read and heard first-hand that psychiatric efforts are all too often…futile.  The treatment that does show SOME promise (DBT, combined with other therapies) is extensive and requires a very, very diligent commitment from the pwBPD.  Even the very few who seem committed in the beginning to treatment often tap out and do not continue. 

What are the specific reasons that therapists don't like dealing with pwBPD? I mean what happens? Does the pwBPD just go in there and tell the T what they want to hear, rage on them, or devalue them? Why does it take so much out of the T? What's the deal?

[fred6]

A vast number of psychiatric professionals will readily admit to either having been exhausted with trying to treat a BPD, have colleagues who have been over-extended by trying to treat a BPD, or flat out refuse to treat anyone with BPD.

I have read and heard first-hand that psychiatric efforts are all too often…futile.  The treatment that does show SOME promise (DBT, combined with other therapies) is extensive and requires a very, very diligent commitment from the pwBPD.  Even the very few who seem committed in the beginning to treatment often tap out and do not continue. 

That's what I've read too. I was just wondering if anyone knew what specific traits or actions by pwBPD made them so exhausting to treat. I guess it's different for each individual.

[Hope0807]

Essentially they put therapists through a similar version of what they put us through.  The idealization, projection, raging, devaluing…

And what's more, apparently the intensively BPD-designed therapist sometimes require a plan for the therapist to be available by phone (in addition to sessions more than say once per week) and this excessive contact from the BPD wears thin on the therapist in a hurry. 

Just like anyone in the animal rescue community must come to the harsh reality…We can't save them all.  I'm going to stick to animals and small children.

A vast number of psychiatric professionals will readily admit to either having been exhausted with trying to treat a BPD, have colleagues who have been over-extended by trying to treat a BPD, or flat out refuse to treat anyone with BPD.

I have read and heard first-hand that psychiatric efforts are all too often…futile.  The treatment that does show SOME promise (DBT, combined with other therapies) is extensive and requires a very, very diligent commitment from the pwBPD.  Even the very few who seem committed in the beginning to treatment often tap out and do not continue. 

That's what I've read too. I was just wondering if anyone knew what specific traits or actions by pwBPD made them so exhausting to treat. I guess it's different for each individual.

[bungenstein]

I worked at a local mental hospital for a while. We DREADED borderline patients. By the time they came to see us they were usually worked up to a point of unbelief. They tried to manipulate everyone and threw a fit if they didn't get what they wanted. One woman was on the phone and suddenly she screamed bloody murder and fell in the floor. She was rolling in the floor screaming, "Why God? Why?" She finally calmed enough to tell us her sister had just died in an auto accident. We had to put her in the padded room because she wouldn't stop going nuts. After about an hour of non-stop drama and acting like I have never seen another human being act like, one of the nurses came from the office and told us she called the patient's mother and she doesn't even have a sister. LOL! It was unbelievable that someone could fake what she faked. It was over a cigarette, by the way. She thought she would get to leave if a sister died and we were a no smoking facility.

That seems like an extreme case though. I'm sure some of them act nutty like that. But I would assume that a lot of them lead somewhat normal lives and internalize things.

My ex ran at me once flailing her arms, I diverted her onto the bed rather take a full clash, she landed on the bed and then started hyperventilating, she then fell onto the floor screaming as loud as girl could scream and started "struggling" to breathe, she then started exclaiming that her ribs were broken and she needed an ambulance immediately. I ignored her and went downstairs, low and behold it all stopped within about 30 seconds and there was nothing wrong with her.

[Mr. Solo]

I worked at a local mental hospital for a while. We DREADED borderline patients. By the time they came to see us they were usually worked up to a point of unbelief. They tried to manipulate everyone and threw a fit if they didn't get what they wanted. One woman was on the phone and suddenly she screamed bloody murder and fell in the floor. She was rolling in the floor screaming, "Why God? Why?" She finally calmed enough to tell us her sister had just died in an auto accident. We had to put her in the padded room because she wouldn't stop going nuts. After about an hour of non-stop drama and acting like I have never seen another human being act like, one of the nurses came from the office and told us she called the patient's mother and she doesn't even have a sister. LOL! It was unbelievable that someone could fake what she faked. It was over a cigarette, by the way. She thought she would get to leave if a sister died and we were a no smoking facility.

That seems like an extreme case though. I'm sure some of them act nutty like that. But I would assume that a lot of them lead somewhat normal lives and internalize things.

Actually, at that hospital, it wasn't an extreme case but I am not saying all people with BPD are like that.

[outside9x]

Hi,

That's what I heard.  They, especially the highly functioning one's are master manipulators and start to weave stories back and forth and even fool the professional, and even come on to them.  Their stories are wrenching, and go back and forth.  I know, I heard her tale of woe, and felt bad.

And she was very intelligent and well read on many different emotional subjects and knew it inside and out but could never see herself in it.  Never. 

I agree, as they pushed us they can push them, and in the end, if they can't and they really don't believe there is anything wrong they will just leave and then get real ticked that they went and most likely rage at the SO, for even suggesting something was wrong with them and they will project on you.

[rosannadanna]

The therapeutic relationship is one that is framed as a formal delivery of a service, like a relationship you might experience with your medical doctor or dentist.  There is a code of ethics that should be adhered to to protect the client and therapist and prevent transference, countertransference, and therapist burnout.

BPD in most Mental Health communities is considered a "Severe and Persistant Mental Illness". What comes to most people's minds would be Schizophrenia but there are several that fit in this category.  These diagnoses tend to get treated by a team approach b/c of the severity of symtoms and low level of functioning.  This could be while they are inpatient or outpatient.  DBT consisits of a group therapist, an individual therapist and often a psychiatrist to prescribe meds.  This intervention method also reduces burnout.

As far as individual therapy, like I said before, it should be a formal delivery of service with boundaries in place to keep the roles of therapist and client clear  A PD tends to be a boundary crasher, so it is tiring to constantly restate and enforce boundaries.  I think it is also somewhat disturbing to a therapist to have a client take a formal interaction and push for quick and extreme informalness (just like we experienced in romantic r/s).

Just my opinion.

[Aussie JJ]

It all depends on the person going through therapy and how open they are to work through those issues. 

I choose to beleive recovery is possible and likely with work. 

I had one story told to me of a pwBPD still going to therapy for 5-6 weeks and sitting there telling the therapist they couldnt do anything and they didnt know why they hated the therapist but they knew they had to come to understand why.  When they were probed to find out why they would yell and say I DONT KNOW DONT TALK I AHTE YOU DONT TALK.  Kept comming back for 6 weeks to try and learn until one day they stopped hating the therapist... .

They kept comming back because they wanted to know why... .  Didnt want to hate them any more... .

It is possible.


AJJ. 

[rosannadanna]

Yes Aussie it does depend on how motivated the person is to do the work in therapy.  Also, there is more success if the person has the ability to have insight into their role in their life patterns and want to do something to change life patterns.

Many people, PD or not, just stay "stuck" in therapy, kind of sitting there session after session complaining about their life.  That is a sign of resistance to change and if the therapist points this out and the client is willing to process that, then change can occur, bringing satisfaction to therapist and client.  Many people do this "stuck" thing, but PD's probably do this with a twist:  dramatically and with a lot of transference (blaming the therapist) thrown in, which probably triggers countertransference in the therapist and bad feelings towards the PD.

[Aussie JJ]

The Psychologist I am seeing is pretty brutal with me at times.  I enjoy being challenged so it works.  I have been told flat out that I am wrong and then had it explained to me in detail at times, I have found these instances the most rewarding.  I have also been told that yes I am correct however I have come to the conclusion in the wrong way and had my thinking questioned and sort of broken down.  I don't understand it all, it doesn't add up however I work it out breaking it down piece by piece. 

He has also told me he always tells his BPD patients that they have BPD, when they start to get insight he leads them to the diagnosis themselves so they are telling him they have BPD.  I don't know how that works however if they don't have the insight they leave before they get to find out, get a bit of validation and move on. 

I can see if I wasn't willing to see my own flaws and behaviours, I would be screwed in therapy with someone questioning me.  Sometimes its me that points them out and they are getting smaller and smaller at present. 

IE: hold me accountable = I hate you = end of therapy. 

The story of going back for 6 weeks twice a week to sit there is one that will stick with me for a long time.  Imagine being in that situation where you knew you didn't want to be like "this" any-more, not having the insight to know why but having to put yourself through it for 6 weeks to just start working it out. 

[non_stuck]

My counselor won't discuss it with me. She calls the problem person in my life "very unhealthy" and tells me to stay away from her and try to deal with my own stress and the disapproval of my in-laws for not embracing the "new member of the family." (They aren't married yet, but I'm sure that will happen soon.)

My MIL suggested that I go to a counselor and she was sure that I had the problem. I guess she was hoping to hear that this was some sibling rivalry thing. The counselor said that when the "unhealthy" person starts to get on my nerves imaging that she's 5 years-old and has not being taken care of.

[ForeverDad]

Recovery is possible but only if the person wants to change.  And that's the problem, so many are in utter Denial of their issues, they're Blaming and Blame Shifting everything onto others.

Yes, it doesn't make sense, often they're actually causing themselves problems, you would think they could see it but that's mental illness, it doesn't make sense.  Experts can write books about it, categorize it, we can even predict some patterns, but it still won't make everyday common sense.

Some have thought, surely this time the person has hit bottom and is able to look up and out.  But as more time passes it then becomes clear there was no real insight, no real change.  A person has "hit bottom" only if you look back over time and see a real improvement.

Dialectical Behavior Therapy (DBT) and also Cognitive Behavior Therapy (CBT) have proven to be successful in many cases.  Marsha Linehan, a psychologist and author who developed DBT, only in recent years revealed she suffered with such issues when young.  Recovery is possible but guidance is necessary.  We who have or had relationships with them can't help them, however if they are on the path to recovery we can support them.  IF they are on the path to recovery.

Typically we can't help them.  We may think, I'm close, surely what I say will have an impact.  Well, that's precisely the obstacle, our closeness.  BPD is a disorder affecting close relationships, the closer you are, the worse it can get.  They can't really listen to us because all they see when looking at us is the immense emotional baggage of the relationship.  That is why it generally takes an emotionally neutral professional (psychologist, therapist, counselor, perhaps even a religious figure) to have success, maybe, if the person will stop the Denial, listen to the counsel, apply it diligently in perceptions, thinking and life, and stick with it long term.  A few visits are not enough.  Many visits but doing it for the wrong reasons won't work either.

How important is that emotional neutrality?  The anonymous author of "I hate You, Don't Leave Me!" wrote that she never once touched her therapist over the years of her therapy.  Not once.  Not until she 'graduated' and they hugged goodbye.  That's how important it is not to allow the emotions and emotion-based perceptions to get in the way.

It has been called the 'Perfect Storm' of Emotion Dysregulation.  The experts compiling the DSM V were actually proposing to change the name to something like "Emotion Dysregulation Disorder" but it never made it to the final stages.

All the professionals in my case didn't want to put a name to my ex's behaviors.  They followed the court's lead and limited themselves to the behaviors and behavior patterns.  So while it's nice personally for me to know my ex may have Borderline PD or Paranoid PD or some other co-morbid PD, I have to be satisfied with identification of the behaviors where it counted - my divorce and the related custodial/parenting issues.  Court wouldn't let me Play Doctor, so I just had to accept that, Let Go and Move On. 

[tim_tom]

My T, who is a PsyD, told me her firms policy is only 1 BPD at a time. They are too exhausting, require phone support and are very difficult to treat.

Not to make fun of them, but I do believe it helps counteract the gas lighting and was a bit relieved to hear this. Yes I have issues, but these are extremely difficult people to get close to.

[Turkish]

Dialectical Behavior Therapy (DBT) and also Cognitive Behavior Therapy (CBT) have proven to be successful in many cases.  Marsha Linehan, a psychologist and author who developed DBT, only in recent years revealed she suffered with such issues when young.  Recovery is possible but guidance is necessary.  We who have or had relationships with them can't help them, however if they are on the path to recovery we can support them.  IF they are on the path to recovery.

This thread has a link to Dr. Linehan's story, beginning with her rock bottom of being institutionalized and diagnosed as schizophrenic: https://bpdfamily.com/message_board/index.php?topic=236614.new#new

[Louise7777]

"The Psychologist I am seeing is pretty brutal with me at times.  I enjoy being challenged so it works.  I have been told flat out that I am wrong and then had it explained to me in detail at times, I have found these instances the most rewarding."

I believe this would be the "normal" approach to therapy. We "normals" dont go there to be validated over and over, without some "shaking up". A slap in the back of the head is necessary sometimes for some improvement. But to a uPD, thats the end of therapy.

I know (Im sure many of you do tpp) people that are in therapy for years and continue the same, there´s no improvement at all, in any field of life. I can only think they are there to play victim, to get validation or to learn how to change others.

[Infern0]

My counsiller was the exact same,  her advice to me was to get away and stay away.  She said that my ex would need to have years of therapy and that was only ever likely to happen if she had some major traumatic times and that if someone,  anyone like me was in her life that she would simply use me as a soother and never get better.

At the time I thought this damning verdict may have been overly harsh but recent events make me agree with that assessment.  Truth is I can't help her and in fact just me being around and offering support etc gives her just another reason to not put the work in with therapy.

[Infared]

I had a different experience with the whole T thing... .(I eventually sought a T for myself... .)... .but at the end of the relationship my ex had new supply and was running off to it and lying about everything.  I had no awareness of BPD... .or the other person other than my suspicions. I had a cute face innocently telling me that there was no one else.

Anyway... she started acting so erratic during the B/U that I actually called her step Mom (I was on good terms with everyone in her family), and suggested that she get a T... .even though she was leaving me I was worried about her. Her step Mom connected her with someone and she actually went... . So I did go to "closure counseling" with her T when she asked me... .and months later, when she is living with the person (right away they were together but she lied and said that they started dating 30 days later... yeah... right)... .she was cheating on me with (who she knew two years prior). I was in a bad way... .and not making good decisions so I went. This all REALLY destroyed me emotionally.  What a mistake. No BPD diagnosis or anything. I still did not know anything about it and apparently neither did her T.!  Of course my ex went into therapy and just weaved her web of lies and completely manipulated the T.

She sat there lying about the cheating and then I see that I was invited to these sessions so that the two of them could gang up on me and tell me what's what. It was unbelievable. Totally.  I am college educated, presentable and a decent looking guy... . I am upset no doubt... .as I am dumbfounded by what is going on and the T turns to my ex and says (like I am not in the room)... He isn't really marriage material. ... .This is after meeting me 15 mins prior. It was like a comment two drunks would make out of ear-shot in a bar. Right?... . I stayed for the session and had enough self-esteem to not go back for the other 5 sessions.  In a conversation my ex was repeatedly telling me the her T says that am insane? After meeting me for 40 mins... .where I did not raise my voice or act in any inappropriate way, which was huge for me considering the ambush that I walk into.  

I think that that T is a horrible person and clearly not suited for her profession. I felt like I was at some dating service or something. What the heck?... but what amazed me was all the lies and the manipulation that my ex had done when she went to this place to sort things out.  Later when I started to read about BPD... .everything started to make sense.   I went to therapy for two years and it was one of the most VALUABLE experiences that I ever had.  It changed my life remarkably and made me a better more aware person. Of course... .I went in telling and seeking the truth! LOL!

It is interesting to read all of the experiences here with T's when BPD is on the table.  WOW... .I understand why they stand back.

[ShakinMyHead]

And here are even more reasons, as pwBPD are the most litigious of patients. Remember, they project their behaviors on others, blame everyone else. If the therapy doesnt work, many practitioners can get sued, as well as many unpaid bills. If the therapy does actually start to work, things usually get worse before they get better. Why? Because in therapy we are typically focusing on removing mal-adaptive defense mechanisms. In a healthier person, when the defense begins to deteriorate, or fall away, we have worked to build up "The Self" in order to manage the psychic stress that the person experiences, relinquishing a whole defensive system. They will have an ability to self sooth in another way, while withdrawing, giving up a protective, defensive behavior. Alternately, when helping a borderline to not react defensively, to sit still, and not protect themselves, from a hell that already happened. That is emblazoned in their heads, we are essentially stripping away at a very integral piece of them, at their container. Healthier people are held together by the glue of the self within them, they can self sooth when they take a blow to the outside, or have to give up an addiction or behavior. A Cluster B is defined by what contains them on the outside, good or bad. This image, false self, is skin deep, and disregulated and chaotic below the surface, is what formed early on in them in order to just survive. Therapy asks that they give up a piece of their container, without anything very stable, more likely raging, underneath, and with no coping skills but the defenses we are removing. I'm not saying it cannot be done, there are many different types of BDL's, and some categories have better odds then others depending on where on the spectrum that person is, and how uncomfortable they are. As a practitioner, I'm thinking about how to help, how to figure out this puzzle, the BPD pt is very often thinking "How am I going to beat this shrink." I believe I invest much energy and passion into what I do, and there are so many people that actually want and can get better, and appreciate the help you give. Even though I work with a wide range of diagnosis in my practice, there are certainly certain cases that are more rewarding then others ….

[Hope0807]

It is startling to read (and I've read plenty of the same in recent months) that a disordered personality would sit across from a professional there to help them and think, "How am I going to beat this shrink?"

And here are even more reasons, as pwBPD are the most litigious of patients. Remember, they project their behaviors on others, blame everyone else. If the therapy doesnt work, many practitioners can get sued, as well as many unpaid bills. If the therapy does actually start to work, things usually get worse before they get better. Why? Because in therapy we are typically focusing on removing mal-adaptive defense mechanisms. In a healthier person, when the defense begins to deteriorate, or fall away, we have worked to build up "The Self" in order to manage the psychic stress that the person experiences, relinquishing a whole defensive system. They will have an ability to self sooth in another way, while withdrawing, giving up a protective, defensive behavior. Alternately, when helping a borderline to not react defensively, to sit still, and not protect themselves, from a hell that already happened. That is emblazoned in their heads, we are essentially stripping away at a very integral piece of them, at their container. Healthier people are held together by the glue of the self within them, they can self sooth when they take a blow to the outside, or have to give up an addiction or behavior. A Cluster B is defined by what contains them on the outside, good or bad. This image, false self, is skin deep, and disregulated and chaotic below the surface, is what formed early on in them in order to just survive. Therapy asks that they give up a piece of their container, without anything very stable, more likely raging, underneath, and with no coping skills but the defenses we are removing. I'm not saying it cannot be done, there are many different types of BDL's, and some categories have better odds then others depending on where on the spectrum that person is, and how uncomfortable they are. As a practitioner, I'm thinking about how to help, how to figure out this puzzle, the BPD pt is very often thinking "How am I going to beat this shrink." I believe I invest much energy and passion into what I do, and there are so many people that actually want and can get better, and appreciate the help you give. Even though I work with a wide range of diagnosis in my practice, there are certainly certain cases that are more rewarding then others ….

[Pingo]

Near the end of our r/s, my ex went to see two different T's.  One specialised in brain injuries, the other in PTSD and childhood trauma.  He only saw each one once so the session was him telling them his story.  He liked both of them because 'they both seemed to really feel compassion for him and his story'... .that was what he was focused on.  He described how they looked and sounded so sad about his story, how validating they were.  If they had been challenging he would have probably despised them, thought of them as heartless.  But since he only saw each one once they never got to the challenging part. 

My T told me she has had clients scream at her, storm out on her, etc.  She tells me that T's have to work very hard to maintain their own mental health when working with these types of clients.  I would imagine it would be overwhelming.  They are human after all, they react emotionally too.