BPDFamily.com

UBPDw is seeing T to get a diagnosis. 

Last night was the fourth session to date & he tells me that he has not much of a dialogue with the T & that the sessions consist of my H relaying his thoughts, experiences, etc.

There doesn’t seem to be much dialogue between them.

Does anyone know if this is a customary diagnostic approach of BPD?

Diagnosing a PD may take some time. This is especially true of the client/patient does not open up and a sense of trust is not established by the therapist.  Trust issues are really common amongst pwBPD.  Also, many pwBPD have a hard time expressing feelings/emotions. Finally, a diagnosis is reliant on what type of diagnostic tool a therapist uses.

I think this is typical that a T will spend the first few sessions getting a feel for the patient.  That means more listening and less diagnosing.  And if the T suspects BPD, I would guess the T would tread carefully.   Better to take things slow than to make a wrong early diagnosis. 

One thing to keep in mind here - that just him going to T is a good thing.  Everything beyond that is beyond your control and should be beyond your control.  If he wants to talk about it, fine, but be careful to not get too involved - you aren't his caretaker.  That's the only way to regain sanity through all this - let his emotional issues be the realm of him and his doctors, and that frees you up to take care of yourself.

My anxiety about his possible reaction to a diagnosis is getting the better out of me.

I know he has spoken about his tumultuous r/s with women and has bundled me in with all the 2 yrs r/s he had in the past... .that threw me over the edge... .so I stopped asking about the particulars.

I am also anxious of his reaction once he is diagnosed

I can understand how that may give you anxiety.

He may react in a negative way. That mainly has to do with a pwBPD having a hard time accepting their flaws. Honestly, many people have problems accepting that there is something wrong with them.  Being supportive and using communication tools and validation will help with an adverse reaction to a diagnosis. 

My pwBPD has a hard time with "labels," which is understandable. He told me that he thinks he has a PD. He seemed upset and I explained a PD is just a name for a grouping of maladaptive behavior. 

Also, I tend to not ask my pwBPD about his therapy. If he wants to tell me about something in particular, I just listen  and do not say anything. I found it is best to not involve myself in his therapy.

Do you have anxiety about the possibility that your SO may not be diagnosed?

Yes!  I do.  It's been 10 years of magic/fog/tears/confusion/anger & I am afraid that if he doesn't get diagnosed that we will not ever deal with deep issues that brew the rages and illogical thoughts.

I have also had seen my share of incompetent therapists... .and I fear getting shammed by a person who earned his degree from a on-line diploma producing school (we had 3 sessions) and the other T who complained about his wife and told us that we needed to break up since we could not "see eye to eye". 

Diagnosing BPD can be sometimes difficult. BPD is a spectrum disorder, which means there are variations with the intensity/range of behaviors. The variability of behaviors can fit criteria for other disorders.  Many therapists/psychiatrists tend to start focusing on less stigmatizing disorders, like bipolar (which is a common misdiagnosis for BPD) and try to distinguish the behaviors and rule disorders out.  Whether or not your SO is diagnosed with BPD should not be a focus, since it is only a label. The most pertinent thing is working on maladaptive behaviors and the origin of behavior.

I am sorry you had such a difficult time with finding a therapist.   Finding the right psychiatrist/psychologist is really important. It truly is not a "one size fits all" type of thing. It may take a couple of different therapists to find the "right one." Most therapists have their background listed on their website or another website that has a review. You can look at their credentials and the focus of their treatment (CBT, DBT, Psychodynamic, etc.) and make a decision on tailored on that.     

 

Focus on the traits... .the actual behaviors... .don't worry about diagnosis.