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Relationship Partner with BPD (Straight and LGBT+) => Romantic Relationship | Detaching and Learning after a Failed Relationship => Topic started by: Devaluedman on June 04, 2015, 03:31:48 PM



Title: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 04, 2015, 03:31:48 PM
    I'm new to this board.  Going through tons of pain.

I guess the big question I have is why therapists shy away from making a BPD diagnosis?  My ex was sent to DBT, though her therapist said she didn't have BPD.  I know DBT is used for more than BPD--yet, I feel that my ex did have BPD, or at least many of the traits.  Is it because BPDs are good at manipulating/lying to therapists about their condition?

Thanks!


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: strongerthanU on June 04, 2015, 09:20:33 PM
I can't say in general why a T is hesitant to diagnose BPD but in my h case his T informed me that anything greater than the PTSD diagnosis could really damage my h employment options. My h who had been high functioning all of his life most specifically in the work place not so much at home walked out of his job of seventeen years and took a disability stress leave. He had to do mandatory counseling to receive disability benefits and i was hopeful for the first time in many years that he would get the help he needed. He went to T for three years and when I was ready to join the counseling to unpack how all of this had affected our family h quit and refused to go back insisting I had betrayed his confidence with his T by wanting to discuss personal issues surrounding his breakdown. He took different work and our future was tragically impacted financially, emotionally and most definitely relationally as a result.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 04, 2015, 10:50:07 PM
One reason is BPD is a serious mental illness, and think about that: being told you have a serious mental illness would be very difficult to hear, for anyone, especially coming from someone who is supposed to know these things.  Plus, the traits of the disorder are on a continuum and we all exhibit at least some of them some of the time; a clinical diagnosis requires exhibition of several of them most of the time.  So it's possible for a therapist to think someone is borderline, not tell them that specifically, and focus on helping them.  Borderlines are also notoriously difficult to treat, and telling one they have a mental illness would probably trigger all the tools, the defense mechanisms, and the therapist would need to swim upstream against that while trying to help.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: once removed on June 04, 2015, 11:32:58 PM
hey devaluedman,

both replies to your post are correct, just thought id toss in that with a personality disorder, insurance frequently wont cover treatment.

"Is it because BPDs are good at manipulating/lying to therapists about their condition?"

its that too. BPD is sometimes referred to as "invisible" to anyone who isnt close to the person with it.



Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: enlighten me on June 05, 2015, 12:24:07 AM
hey devaluedman,

both replies to your post are correct, just thought id toss in that with a personality disorder, insurance frequently wont cover treatment.

"Is it because BPDs are good at manipulating/lying to therapists about their condition?"

its that too. BPD is sometimes referred to as "invisible" to anyone who isnt close to the person with it.

After something that I was told yesterday I wouldnt say BPD was invisible to proffessionals. My friend said another parent commented on her behaviour. The man asked whats her problem? My friend said she's mental. The man said is she boderline? This other man is a policeman andhe spotted it after five minutes so a good psychiatrist should spot it. I have heard how some can tell just by the way they enter a room.

I think some psychiatrists shy away because theyre scared to commit to a diagnoses so will diagnose something milder. How many of us here have flip flopped between BPD and something else?

FHTT I think this not telling them the full diagnoses is dangerous. If a doctor found you had tuberculosis but told you you have a cold then you would walk away thinking you just had to rest a few days. If you have BPD and are told its depression then you would look for an external cause for your depression. You may get some pills but the underlying problem is not getting faced.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 05, 2015, 12:34:07 AM
FHTT I think this not telling them the full diagnoses is dangerous. If a doctor found you had tuberculosis but told you you have a cold then you would walk away thinking you just had to rest a few days. If you have BPD and are told its depression then you would look for an external cause for your depression. You may get some pills but the underlying problem is not getting faced.

Tuberculosis is a fatal disease, BPD is not.  And it's not about lying to the patient, it's about addressing symptoms without assigning labels that don't really help.  My understanding is many borderlines abandon therapy early, and of course blame the therapist, some present with comorbid issues and need to be institutionalized, and a small percentage are in it for the long haul and want to do the work and improve.  At some point in the proceedings, once a strong patient/therapist bond has been formed, it may be appropriate to reveal what the diagnosis is, at a point in therapy when it can help and not hinder the recovery, and of course every case is different.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Turkish on June 05, 2015, 12:41:17 AM
My Ex and I have Kaiser (a Health Maintenance Organization/non-profit insurance org). I asked a T there if they diagnosed BPD. She said no, but if they thought so, they would refer a patient to DBT. Perhaps this can shed some more light;

Why are therapists hesitant to give a BPD diagnosis? (https://bpdfamily.com/message_board/index.php?topic=68149.0)


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: enlighten me on June 05, 2015, 12:53:48 AM
FHTT I think this not telling them the full diagnoses is dangerous. If a doctor found you had tuberculosis but told you you have a cold then you would walk away thinking you just had to rest a few days. If you have BPD and are told its depression then you would look for an external cause for your depression. You may get some pills but the underlying problem is not getting faced.

Tuberculosis is a fatal disease, BPD is not.  And it's not about lying to the patient, it's about addressing symptoms without assigning labels that don't really help.  My understanding is many borderlines abandon therapy early, and of course blame the therapist, some present with comorbid issues and need to be institutionalized, and a small percentage are in it for the long haul and want to do the work and improve.  At some point in the proceedings, once a strong patient/therapist bond has been formed, it may be appropriate to reveal what the diagnosis is, at a point in therapy when it can help and not hinder the recovery, and of course every case is different.

I agree that it is a case by case basis and yes my tb is a bit extreme but BPD can be fatal too. Not just for the sufferer but for SO too. I suspect my exgf was the catalyst in one of her exs suicides. Yes he had depression but her role in things has made me wonder. She will go through life in denial and who knows how many more people will get hurt.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: neverloveagain on June 05, 2015, 01:23:30 AM
Excerpt
Is it because BPDs are good at manipulating/lying to therapists about their condition?"

A massive chunk of the problem is they don't believe or see they have a problem.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 05, 2015, 01:59:29 AM
FHTT I think this not telling them the full diagnoses is dangerous. If a doctor found you had tuberculosis but told you you have a cold then you would walk away thinking you just had to rest a few days. If you have BPD and are told its depression then you would look for an external cause for your depression. You may get some pills but the underlying problem is not getting faced.

Tuberculosis is a fatal disease, BPD is not.  And it's not about lying to the patient, it's about addressing symptoms without assigning labels that don't really help.  My understanding is many borderlines abandon therapy early, and of course blame the therapist, some present with comorbid issues and need to be institutionalized, and a small percentage are in it for the long haul and want to do the work and improve.  At some point in the proceedings, once a strong patient/therapist bond has been formed, it may be appropriate to reveal what the diagnosis is, at a point in therapy when it can help and not hinder the recovery, and of course every case is different.

I agree that it is a case by case basis and yes my tb is a bit extreme but BPD can be fatal too. Not just for the sufferer but for SO too. I suspect my exgf was the catalyst in one of her exs suicides. Yes he had depression but her role in things has made me wonder. She will go through life in denial and who knows how many more people will get hurt.

Fair enough enlighten, and do you think telling her she has a disorder would change anything?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: enlighten me on June 05, 2015, 02:25:16 AM
For her no as she isnt self aware enough that she has a problem. For others though that realise something is wrong then yes.

I truly believe that if handled correctly and given the right support then diagnosing BPD would be healthier than pussy footing around it... .

I feel this is the failing with mental health as diagnosing isnt a problem but once diagnosed there isnt the support. We see this with veterans and PTSD all the time. They are diagnosed. Told they have it and then cut loose. Some are lucky enough to be treated but for a lot the bare minimum is done.

Most pwBPD are fairly competent. A lot are intelligent with good jobs. These are people when they put their mind to it can be driven. Its just a matter of guiding them along the right path.

One of my favourite sayings is that theres no such thing as a bad student there are only bad teachers. I feel this applies with mental health. Its about understanding how a person is stimulated and using that to teach them.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 05, 2015, 03:48:31 AM
This is the world we live in.

Where professionals do not honestly diagnose someone because of "monetary" concerns, and how it might "appear" to society if the person is diagnosed properly. That is what I am reading here is many of the posts, and this is what I experienced.  So the truth is not told, causing more suffering for all the people around the sick individual. Their lives are never validated with the TRUTH of how this person behaved and how sick that they actually are  What about their lives and how this person's real sickness has destroyed them?  

Welcome to life in the US, where the dollar is KING.

That's just the reality sometimes, not always, but boy oh boy it happens so often.

It's interesting how often the truth can be discarded, by everyone, when there is money involved.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 05, 2015, 07:30:21 AM
Thank you for all your thoughtful comments. I sent an email to the couples counselor we had worked with, telling her I believed my ex had BPD. She had represented me as verbally abusive and angry, after I got upset she abandoned our marriage after a few weeks. Literally a few weeks! She did this, apparently, because I disagreed with how she was treating me and sulked. (She refused to visit me in another state, since it was LDR. Mind you, she's a professor and had sabbatical and could have stayed with me for months). She said I hurt her for getting angry about this obvious betrayal. I knew this couldn't be normal behavior. Anyway, I related this to the T and she sent me back a cursory reply. I know she couldn't respond, as that would show bias, but I had to get the truth out.

Anyway, thank you for being here. All of you. I am in so much pain right now.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 05, 2015, 07:52:04 AM
I begged my ex to go to therapy where she just lied  to and manipulated the T. How do I know? I was stupid enough to go to a beat down session where my ex had told all these lies about me to the T who insulted me and did not let me speak... .she just passed judgement on me based on my ex's lies. It was surreal and bizarre.  

My ex was cheating on me and she told the therapist she met the guy after she left me?

I think in her sick mind,by manipulating the therapist and having her on her side to demean me validated her running off?  I sense that I got that part right.

It was just so bizarre, surreal and one of the top ten worst experiences of my life.

I thought I was in an episode of The Twilight Zone!


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 05, 2015, 08:22:43 AM
Infrared:

I totally sympathize. The triggering behavior was me getting upset about an obvious slight, something that would cause hurt in anyone. Think about it: you marry someone and vow to be in a committed, loving relationship, and this person decides they don't want to see you after a few weeks after the marriage, and then blames you for this outright selfishness. Over and over, I tried to explain why what she did cause me hurt. But she'd never take responsibility. In fact, she blamed me--saying I had freaked out after we married. The thing is this distancing behavior occurred before we even had a formal argument. This is just abnormal behavior, straight up. And yet, I am the bad guy, the abuser who needs mountains of therapy.

Yes, I am bitter. Sorry folks


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 05, 2015, 08:45:09 AM
Infrared:

I totally sympathize. The triggering behavior was me getting upset about an obvious slight, something that would cause hurt in anyone. Think about it: you marry someone and vow to be in a committed, loving relationship, and this person decides they don't want to see you after a few weeks after the marriage, and then blames you for this outright selfishness. Over and over, I tried to explain why what she did cause me hurt. But she'd never take responsibility. In fact, she blamed me--saying I had freaked out after we married. The thing is this distancing behavior occurred before we even had a formal argument. This is just abnormal behavior, straight up. And yet, I am the bad guy, the abuser who needs mountains of therapy.

Yes, I am bitter. Sorry folks

Well this is the kind of treatment many/most of us got. Do not apologize, please, you are not alone.  BPD's take responsibility for NOTHING. They blame any and everyone.  I know that mine/they are mentally ill, but the behavior still hurts... .dramatically.

DeValued... .read as much as you can here... .understanding the sickness of the mental disorder helps to take the edge off of the pain.  Also, talking here let's you know that you are not the only one who has gone through this insanity.  That is a comfort in itself.  I had to learn to have NO expectations about my ex... .and just watch the circus unfold... .and boy, oh boy... .was it a three-ringer... .maybe could have used 4 rings under her big top! 

I under stand how you feel. Truly.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 05, 2015, 09:05:47 AM
Thanks infared. That makes me feel a lot better.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 05, 2015, 09:20:21 AM
This is the world we live in.

Where professionals do not honestly diagnose someone because of "monetary" concerns, and how it might "appear" to society if the person is diagnosed properly. That is what I am reading here is many of the posts, and this is what I experienced.  So the truth is not told, causing more suffering for all the people around the sick individual. Their lives are never validated with the TRUTH of how this person behaved and how sick that they actually are  What about their lives and how this person's real sickness has destroyed them?  

Welcome to life in the US, where the dollar is KING.

That's just the reality sometimes, not always, but boy oh boy it happens so often.

It's interesting how often the truth can be discarded, by everyone, when there is money involved.

Yes, the health care industry is an industry just like any other, and as with any industry, there are folks who focus on what's best for customers and folks who focus on making money, for a number of reasons, and it gets skewed a little in that industry because the customer is also the patient.  There are civil rights issues too; labeling someone with something potentially derogatory can stigmatize them, and in the case of a borderline, broadcasting that they are 'sick' can add to the massive shame pile that is already there.

The answer is to focus on what's best for the patient.  Unlike physical ailments like cancer, mental and behavioral issues are touchy; you could say that someone with cancer screwed up because they ate crappy food, didn't exercise, exposed themselves to toxins, and had a lousy attitude, but we don't do that in general, we treat them like victims and heap sympathy on them, what a terrible thing.  It's easier to blame someone with a mental issue like BPD or alcoholism, since they are responsible for their behavior, but they are not responsible for their condition.  Or are they?  Some see alcoholism as a disease that is a bummer and needs to be treated, other people see alcoholics as weak people who need to get their sht together, there's that stigma again, and navigating that is not straightforward like a physical ailment.  So what's best for the patient?

So going back to a diagnosis, telling someone they have a personality disorder like BPD won't necessarily help the patient, and could potentially hurt if done too early, and at the least it could rupture the therapist/patient bond.  With mental issues and focus on the patient, it's important to disclose a diagnosis at the right time, since there is no cure and 'illness' is complex.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 05, 2015, 01:47:00 PM
This is the world we live in.

Where professionals do not honestly diagnose someone because of "monetary" concerns, and how it might "appear" to society if the person is diagnosed properly. That is what I am reading here is many of the posts, and this is what I experienced.  So the truth is not told, causing more suffering for all the people around the sick individual. Their lives are never validated with the TRUTH of how this person behaved and how sick that they actually are  What about their lives and how this person's real sickness has destroyed them?  

Welcome to life in the US, where the dollar is KING.

That's just the reality sometimes, not always, but boy oh boy it happens so often.

It's interesting how often the truth can be discarded, by everyone, when there is money involved.

Yes, the health care industry is an industry just like any other, and as with any industry, there are folks who focus on what's best for customers and folks who focus on making money, for a number of reasons, and it gets skewed a little in that industry because the customer is also the patient.  There are civil rights issues too; labeling someone with something potentially derogatory can stigmatize them, and in the case of a borderline, broadcasting that they are 'sick' can add to the massive shame pile that is already there.

The answer is to focus on what's best for the patient.  Unlike physical ailments like cancer, mental and behavioral issues are touchy; you could say that someone with cancer screwed up because they ate crappy food, didn't exercise, exposed themselves to toxins, and had a lousy attitude, but we don't do that in general, we treat them like victims and heap sympathy on them, what a terrible thing.  It's easier to blame someone with a mental issue like BPD or alcoholism, since they are responsible for their behavior, but they are not responsible for their condition.  Or are they?  Some see alcoholism as a disease that is a bummer and needs to be treated, other people see alcoholics as weak people who need to get their sht together, there's that stigma again, and navigating that is not straightforward like a physical ailment.  So what's best for the patient?

So going back to a diagnosis, telling someone they have a personality disorder like BPD won't necessarily help the patient, and could potentially hurt if done too early, and at the least it could rupture the therapist/patient bond.  With mental issues and focus on the patient, it's important to disclose a diagnosis at the right time, since there is no cure and 'illness' is complex.

Well... .I am coming from this place... .I AM a (recovered- not cured) alcoholic. 13 years. I make my condition a priority in my life. My top priority. I go to 3-4 meetings a week. I help others get sober... .alcoholism is a disease of self-centeredness (just like BPD). ... .and guess what... .I could not address the problem until "I" stood in front of a mirror and said the words:"I am an alcoholic".

BPD's don't have a chance unless they do the same thing, in  my opinion, and experience. No healing or change can begin without it. Straight up. So... .can you tell me again how a "responsible" health-care professional avoids the diagnosis. That is if that professional actually wants the person to improve and can treat them for what ails them? Anything less is dancing around the actual issue, so... .NOTHING CHANGES.

The truth is the truth. One of my favorite sayings early on in my recovery was: "You have to name it to tame it".  I got responsible, I got healthier... .not perfect... .but LOTS. Better.

Wouldn't you agree, that a person cannot address a problem unless they face it? Let's not make excuses here... .that does no one any good, does it?

Pussy-footing around the issue is wasting everyone's time. No?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 05, 2015, 02:38:58 PM
In a way, doesn't a therapist have a professional responsibility to diagnose the problem accurately like any medical doctor ostensibly would?  The problem I see is that this is a growing problem in our modern age, these destructive character traits, harming people irrevocably. There is something about our fragmented way of life that produces these broken individuals. Some say BPD is a spiritual disease, at least some have proffered that explanation in our forums. I agree. As our society becomes more and more narcissistic and individualistic--and materialistic--it stands to reason that more people will develop these anti-social behaviors as a response to the breakdown in social values. So, when a T refuses to diagnose BPD he/she is really exacerbating an already out-of-control problem.   


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: enlighten me on June 05, 2015, 02:47:17 PM
I dont think that society is creating these dissorders. I do think that in modern society they can yhrive. There is a lot more acceptance of narcisist. Just look at the reality shows and they are full of them. The same with BPD. Our societies have far more relaxed morals. In olden times they would have been shunned as harlots or rogues but now theyre just having fun. The same with psycopaths whole sectors such as banking are a hot spot for them where they can thrive and be succesful.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 05, 2015, 03:00:08 PM
Well... .I am coming from this place... .I AM a (recovered- not cured) alcoholic. 13 years. I make my condition a priority in my life. My top priority. I go to 3-4 meetings a week. I help others get sober... .alcoholism is a disease of self-centeredness (just like BPD). ... .and guess what... .I could not address the problem until "I" stood in front of a mirror and said the words:"I am an alcoholic".

BPD's don't have a chance unless they do the same thing, in  my opinion, and experience. No healing or change can begin without it. Straight up. So... .can you tell me again how a "responsible" health-care professional avoids the diagnosis. That is if that professional actually wants the person to improve and can treat them for what ails them? Anything less is dancing around the actual issue, so... .NOTHING CHANGES.

The truth is the truth. One of my favorite sayings early on in my recovery was: "You have to name it to tame it".  I got responsible, I got healthier... .not perfect... .but LOTS. Better.

Wouldn't you agree, that a person cannot address a problem unless they face it? Let's not make excuses here... .that does no one any good, does it?

Pussy-footing around the issue is wasting everyone's time. No?

Because think about Infrared, and congrats on the 13 years BTW.  And before you quit, before you hit your bottom as it's termed in the rooms, if someone had told you you were an alcoholic, you might have said "fck off and hand me a beer", or something to that effect.  Alcoholics have to hit bottom to become humble enough and teachable enough to decide it ain't workin' and look for answers, and then phrases like "denial ain't a river in Egypt" start making sense in the rooms.  But before that?  Hell no, let's go drinking... .

So is it any different for a borderline?  And in a sense alcoholism is simpler: you either take a drink or you don't, there is no gray area.  But borderlines don't need an external substance to trigger them, and since they've been working at it for a lifetime the defense mechanisms are highly refined and strong; the disorder exists to deny itself.  So does a borderline need to hit bottom, and what does that look like?  And I still contend that blurting out a diagnosis of a mental illness before someone is ready to hear it is just going to alienate them from the person trying to help them, and that doesn't move the process of recovery forward.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 06, 2015, 12:25:38 AM
And what about a person in recovery from alcoholism who also has the traits? This person is seeking answers but still may not be ready for that kinda news?

I know of one person who had the diagnosis and it didn't make a diddly squat bit of difference, went to therapy for less than 6 sessions... .Left her fiance overnight to go back to her ex whom she claimed had been physically abusive! By the way, on a side note,  she only ever referred in female company to her fiancé as her 'friend'! Mind blowing... .I think that's the problem it's like trying to pin the tail on a moving donkey... .


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 06, 2015, 07:00:54 AM
And what about a person in recovery from alcoholism who also has the traits? This person is seeking answers but still may not be ready for that kinda news?

I know of one person who had the diagnosis and it didn't make a diddly squat bit of difference, went to therapy for less than 6 sessions... .Left her fiance overnight to go back to her ex whom she claimed had been physically abusive! By the way, on a side note,  she only ever referred in female company to her fiancé as her 'friend'! Mind blowing... .I think that's the problem it's like trying to pin the tail on a moving donkey... .

Yes... .pwBPD never have to face themselves because they can just latch onto a new (or recycled old), willing victim. Doing that validates them and they never have to take a look at themselves. Their needs are being met.

They are not the kind of people who seek therapy to help themselves. They never see any problem with themselves. That's the tragedy.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Devaluedman on June 06, 2015, 07:46:10 AM
Yes, they do latch onto old flames. After I broke up with my ex, she went out with an ex for dinner. But according to her, she's not dating. Nothing came of this interaction, apparently, but who knows for sure? These people have an amazing capacity for lying. I'm sure at some point when she's horny she'll be ringing me up for a booty call--if she can't find a wiling victim. That's how these people work. There's an incapacity to get close in a real way. And if you do get close, as I did, they eject you unceremoniously. That's how I know in my heart this is BPD. To go through the motions and get married and then devolve the "relationship" into a booty call is narcissism on steroids. Who does this sh$&&t?

I feel I have been wronged tremendously. I gave everything to this woman, and I was discarded like trash. Again, this is the impulsive BPD behavior we all know. It is so anti-social! And yet more and more this behavior is accepted by society at large, making trying to find a mate like WW3. 

I have no relief. No one understands what happened. Not my friends, family, etc.  And the therapists willingly participate in this, causing great harm to so many innocent nons.  The pain is unbearable. I don't know what to do with it. I truly don't.



Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 06, 2015, 08:08:57 AM
Yes, they do latch onto old flames. After I broke up with my ex, she went out with an ex for dinner. But according to her, she's not dating. Nothing came of this interaction, apparently, but who knows for sure? These people have an amazing capacity for lying. I'm sure at some point when she's horny she'll be ringing me up for a booty call--if she can't find a wiling victim. That's how these people work. There's an incapacity to get close in a real way. And if you do get close, as I did, they eject you unceremoniously. That's how I know in my heart this is BPD. To go through the motions and get married and then devolve the "relationship" into a booty call is narcissism on steroids. Who does this sh$&&t?

I feel I have been wronged tremendously. I gave everything to this woman, and I was discarded like trash. Again, this is the impulsive BPD behavior we all know. It is so anti-social! And yet more and more this behavior is accepted by society at large, making trying to find a mate like WW3.  

I have no relief. No one understands what happened. Not my friends, family, etc.  And the therapists willingly participate in this, causing great harm to so many innocent nons.  The pain is unbearable. I don't know what to do with it. I truly don't.

I think everything you just said is right on the money. ... .at least this is just what I experienced.  My situation was different in that my expwBPD was cheating on me while living with me. She then just ran out of our home and in an instant discarded me. I did not know about BPD or that she was cheating on me. Of course she told everyone a ton of lies. And yes, society and apparently therapists want to believe all those lies of the poor, fake female victim? Unfortunately there is not much that we can do about any of it. All we can do is pick up the pieces and love ourselves. I understand your pain and it is unbearable.  Just try to keep things in the moment or in one 24-hr. period.

Stay away from the past and the future.  I had to stay away from any contact of any kind with the ex.  It's just more damage. It's hard to do, but when I could do all these things  I was a little better.

You can get through this. Just be easy on yourself and take small steps forward, away from the car crash.



Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 06, 2015, 08:14:39 AM
And what about a person in recovery from alcoholism who also has the traits? This person is seeking answers but still may not be ready for that kinda news?

Impulsive behavior is a trait of the disorder, including substance abuse, so in the case of a borderline alcohol may be the solution, not the problem, although anyone can drink themselves into alcohol dependence if they drink enough.  The good news is sitting in an AA meeting sober and listening, talking and connecting with people who are getting real about their lives is always a good thing.

Excerpt
I know of one person who had the diagnosis and it didn't make a diddly squat bit of difference, went to therapy for less than 6 sessions... .Left her fiance overnight to go back to her ex whom she claimed had been physically abusive! By the way, on a side note,  she only ever referred in female company to her fiancé as her 'friend'! Mind blowing... .I think that's the problem it's like trying to pin the tail on a moving donkey... .

A diagnosis of BPD is helpful to therapists because it provides a framework for treatment and they can talk to each other about issues and know what they're talking about.  And although we can't diagnose here, learning about the disorder and seeing so many similarities between our stories and every else's helps make sense out of nonsense, which can be very healing.  But telling a borderline they have a disorder?  As you mentioned disillusioned, telling a borderline they have a personality disorder won't necessarily change anything, and could actually hurt the recovery process if done at the wrong time.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 06, 2015, 08:23:34 AM
I feel so angry today so bear that in mind with what I'm saying... .Knowing this stuff,  having this insight is liberating and validating but so effing painful! Like there is no where to go with it when the world doesn't see it,  like sheep following the charismatic,  funny one! A part of wants to scream "can you not see?,  there is no self... .Telling you what you want to hear... .saying all the right things... .Aarggh!" my heart is so broken and my head is so wrecked I cannot be around even a whiff of it! I wont even get into the crazy-making with therapists! I thought I would combust looking for validation, let's just say I can totally relate... .


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 06, 2015, 08:25:23 AM
In my experience the truth is the best route. It my be disregarded or rejected... .but if at least said, at some point down the road it may be revisited and accepted. Coddling  just enables for a longer period of time.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 06, 2015, 08:45:39 AM
I feel so angry today so bear that in mind with what I'm saying... .Knowing this stuff,  having this insight is liberating and validating but so effing painful! Like there is no where to go with it when the world doesn't see it,  like sheep following the charismatic,  funny one! A part of wants to scream "can you not see?,  there is no self... .Telling you what you want to hear... .saying all the right things... .Aarggh!" my heart is so broken and my head is so wrecked I cannot be around even a whiff of it! I wont even get into the crazy-making with therapists! I thought I would combust looking for validation, let's just say I can totally relate... .

Yes, what we need coming out of these relationships is validation, compassion and empathy, and it's very frustrating when we talk to friends and family who may want to help but just don't fully understand.  That's what this site is for, we all get it, we've been there.  And the feeling that we've been duped when we were all-in emotionally is sobering and very difficult to accept.  That can be the good news too though, because the pain can motivate us to look deeply into our own stuff, and the growth that inspires can deliver us out the other side as a revised, better version of ourselves, wise enough to never, ever let that happen again yes, but also as preparation for the relationship of our dreams, some point in our bright future.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 06, 2015, 09:00:58 AM
Thanks HtH,  I hadn't seen your previous post when I posted.  I got so much from that one statement  "alcohol being the solution" alone. I have found it hard to get this aspect validated also... .

Its so true about well meaning friends and family, I was mostly getting a ' I wouldn't like to take sides'  type of response.  It felt further invalidating,  like there are two sides so to speak.  Thank God I found this place,  as tough as it is now,  I have some hope reading others accounts,  cannot imagine what I'd be like without it,  still confused I guess.  On that note thanks to all here. 


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Reforming on June 07, 2015, 05:39:50 AM
Hi all,

Good thread. I'd just like to chime in with Heeltoheel

Infared I understand your point about facing the truth and taking responsibility for our actions and choices. I think we should all strive to do that, but I think that it be challenging even for people who don't have PDs.

My understanding is that therapists work with pwBPD over an extended timescale to help them develop the resources and skills to take responsibility for themselves.

As many here can attest encouraging someone with a PD to commit to and stay in therapy can be enormously challenging for both partners

As Heeltoheel says I think there are many therapists who believe that confronting a pwBPD with a diagnosis in the early stages of therapy is counterproductive because they either feel stigmatised (shame) or use the diagnosis as another way of deflecting responsibility for their behaviour elsewhere.

I asked my Schema therapist about this and she felt that labelling a patient was often counter productive. She felt that many therapists feel that effective treatment is more important than sharing a diagnosis - though as Heeltoheel says they may share a diagnosis later when the patient developed the resources and coping skills to deal with it.

I realise how traumatic and confusing these relationships can be. Understanding and making sense of your experience can be such a huge relief, but I think the question here is whether an accurate diagnosis is more important to us NONs, who want our experience validated with the certainty of a diagnosis (we did everything we could - it was their fault) than to someone with BPD where effective treatment is the priority.

Does it really matter what the label as long as the condition / disorder is being treated effectively?

I think there there are also other reasons why therapists are wary of black and white diagnosis. Diagnosing a PD can be hugely challenging, even for a highly trained and experienced professional

Joan Lachkar, a highly regarded psychologist and author has worked and written about borderlines and narcissists.

In her book the Narcissistic Borderline Couple https://bpdfamily.com/message_board/index.php?topic=56788.0 she says

"I have come to recognise the ever-changing states of narcissistic and borderline vulnerabilities. These disorders are not clear entities, rather narcissistic/ borderline states, traits and characteristics tend to vacillate"

She also notes "diagnosis can be elusive"

I think a PD diagnosis can also bring another layer of complexity for couples

If one partner is diagnosed with a PD, there's a danger that the other partner can conclude that all the relationship problems are caused by the pwBPD.

I'm not defending BPD behaviour or excusing them of responsibility for their behaviour. I know how profoundly destructive and hurtful it can be, but both partners play a role in these relationships and unless both understand their own part it's hard to move forward and heal.

Reforming


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 07, 2015, 01:02:23 PM
Hi all,

Good thread. I'd just like to chime in with Heeltoheel

Infared I understand your point about facing the truth and taking responsibility for our actions and choices. I think we should all strive to do that, but I think that it be challenging even for people who don't have PDs.

My understanding is that therapists work with pwBPD over an extended timescale to help them develop the resources and skills to take responsibility for themselves.

As many here can attest encouraging someone with a PD to commit to and stay in therapy can be enormously challenging for both partners

As Heeltoheel says I think there are many therapists who believe that confronting a pwBPD with a diagnosis in the early stages of therapy is counterproductive because they either feel stigmatised (shame) or use the diagnosis as another way of deflecting responsibility for their behaviour elsewhere.

I asked my Schema therapist about this and she felt that labelling a patient was often counter productive. She felt that many therapists feel that effective treatment is more important than sharing a diagnosis - though as Heeltoheel says they may share a diagnosis later when the patient developed the resources and coping skills to deal with it.

I realise how traumatic and confusing these relationships can be. Understanding and making sense of your experience can be such a huge relief, but I think the question here is whether an accurate diagnosis is more important to us NONs, who want our experience validated with the certainty of a diagnosis (we did everything we could - it was their fault) than to someone with BPD where effective treatment is the priority.

Does it really matter what the label as long as the condition / disorder is being treated effectively?

I think there there are also other reasons why therapists are wary of black and white diagnosis. Diagnosing a PD can be hugely challenging, even for a highly trained and experienced professional

Joan Lachkar, a highly regarded psychologist and author has worked and written about borderlines and narcissists.

In her book the Narcissistic Borderline Couple https://bpdfamily.com/message_board/index.php?topic=56788.0 she says

"I have come to recognise the ever-changing states of narcissistic and borderline vulnerabilities. These disorders are not clear entities, rather narcissistic/ borderline states, traits and characteristics tend to vacillate"

She also notes "diagnosis can be elusive"

I think a PD diagnosis can also bring another layer of complexity for couples

If one partner is diagnosed with a PD, there's a danger that the other partner can conclude that all the relationship problems are caused by the pwBPD.

I'm not defending BPD behaviour or excusing them of responsibility for their behaviour. I know how profoundly destructive and hurtful it can be, but both partners play a role in these relationships and unless both understand their own part it's hard to move forward and heal.

Reforming

You bring up a lot of thoughtful and valid points, Reforming.   There are no blanket answers that work in all situations... .and especially with BPD... .the symptoms vary, change and are hard to nail down.  My observation in my situation would be that ... .she thinks no therapy is required... .she sees nothing wrong with herself and her actions. So there will be no change there in that instance.  For me... .if I never have to spend one second in the presence of a pwBPD, I will be a better person.  Too much damage was done (I had no idea I was dealing with a personality disordered person until well after the abandonment)... .I am not sure if I will ever heal all of it... .but, for this guy... .I do not ever want to get near the flame again... .let alone stick my hand in it!   *)

Her sickness is her problem... .thank God its not mine any longer.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: once removed on June 07, 2015, 06:03:15 PM
i think its also worth noting that if it were easy, more pwBPD would start googling symptoms, self diagnose as BPD, and presumably then seek treatment.

some of them have even done so, but still not sought treatment.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 06:33:02 PM
Reforming,  would you explain what you mean by "but both partners play a role in these relationships" for me please?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Invictus01 on June 07, 2015, 06:36:43 PM
Personally, I don't care if a T officially and formally diagnoses a pwBPD, but from the human point of view, I think a T would do a huge favor to a non by pulling the non aside and kinda explaining what he thinks he is dealing with and the options the non has. Would a non stick around if he or she knew that his/her life partner needs 5-7 years of intense therapy with little chance of doing too much good and during those years the non should expect to be treated like an emotional tampon, to be cheated on, to be a parent in the relationship? Forget that, what if the T sees that it's not a BPD he is dealing with, that he is dealing with a flat out sociopath or narcissist? Simply from a human point of view, how do you NOT pull the other half of the relationship aside and say "GET OUT! RUN!"?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 06:44:16 PM
Absolutely.  Doctors have an oath,  first do no harm,  and therapists are sworn to confidentiality except when there is a danger to self or others... .Surely all the stories here on the LEAVING:DETACHING (not the staying board) are evidence enough of real and present danger to others?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 07, 2015, 06:58:24 PM
To respond to several posts, we were all willing volunteers in these relationships and could have walked away at any time.  For some everything was completely rosy for a while and then they were blindsided by dysfunction, but for most of us, myself included, there were red flags I ignored from day one, and eventually plenty of abuse and disrespect that I tolerated and shouldn't have.  And my needs were never met more than at a very low level.  So does it really take a mental health professional to tell us that?  Would labeling the set of behaviors as a personality disorder have changed those behaviors?  We were as complicit as what we put up with, and to be fair, I was far from perfect myself, I triggered her abandonment fears without knowing it more than once, but I did the best I could in the face of chaos, and it's probably safe to say we all did.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 07:25:45 PM
I dont really see how if you were groomed to accept more and more abuse,  it can be said that you are complicit in it? It has become a power greater than you no?


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 07, 2015, 07:38:44 PM
I dont really see how if you were groomed to accept more and more abuse,  it can be said that you are complicit in it? It has become a power greater than you no?

People will only treat us as badly as we allow them too, and sure, borderlines with their need to attach and conviction that everyone will eventually abandon them get very good with the manipulation and control to prolong or avoid it, because they don't see another choice, plus the attachment provides a place to off emotions they can't deal with, projection.  All of that wears on our self esteem, which is why it's so painful and sites like this exist, although think about it, a totally healthy person would walk away at the first sign of dysfunction, abuse or disrespect, and we stayed, some far longer than we should have.  So it's a combination of what we bring to the relationship, experience, maturity and mental health-wise, along with our attachment style that determines our complicity.  And that's actually where the growth is after these relationships end; what if a borderline entered our lives for a purpose, because there were lessons we needed to learn, and striving to get out of our own pain is a great motivator?  At some point it's helpful and necessary in detachment to shift our focus from our ex to ourselves, so that in the next relationship we enter our partner gets a better, wiser version of ourselves, on our way to creating a truly healthy one.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 08:03:55 PM
I get all that and I am committed to that I just think it's a bit if a myth that 'a healthy person would have walked away'. I often say this but my ex was like Jesus of Nazareth when he came back, he was so shiny,  full of wonderful stories about his growth,  his evolvement,  he had been in this group and that... .I regularly used to say to him actions speak louder than words.  I confronted my ex on his behaviours,  I articulated my feelings,  I gave him my terms and conditions,  I insisted we see a counsellor together and then later than he get a psychiatric evaluation.  He convinced me and several therapists he was trying... .his attendance,  financial investment in therapy matched that... .I thought he was a little misguided on certain things,  I didn't know he was delusional and possibly a pathological liar until I came here and I certainly had no idea how futile my forgiveness was.  I understand attachment,  we were working with an Attachment therapist.  In the absence of a label and factual knowledge about BPD it was nuts going along with all the traditional couple advice that counsellors give,  it's good to argue,  it clears the air! God help me.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Infared on June 07, 2015, 08:04:47 PM
I dont really see how if you were groomed to accept more and more abuse,  it can be said that you are complicit in it? It has become a power greater than you no?

In the end it is our responsibility to recognize this and do something about it for our selves.  We are responsible for ourselves in the end... .no one else.  We cannot control another's words or actions. Only our own.   That is why many of us coming out of these relationships took responsibility for ourselves and went and found a therapist, self help groups, this forum, etc... .to work on ourselves.  We recognized that we had a part in the dysfunction.  My exBPD blames everything on anyone. She is incapable of self-introspection. She just seeks out another "vulnerable" victim, like ourselves or the way I "used" to be.  They are experts at picking us out to manipulate.  I do not know if they do it consciously or sub-consciously... .but boy... .oh boy... .are they good at it.


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: once removed on June 07, 2015, 08:13:24 PM
if you want to focus or learn about your role in this relationship i recommend the posts of 2010

https://bpdfamily.com/message_board/index.php?action=profile;u=38193;sa=showPosts;start=0


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: fromheeltoheal on June 07, 2015, 08:14:15 PM
I get all that and I am committed to that I just think it's a bit if a myth that 'a healthy person would have walked away'. I often say this but my ex was like Jesus of Nazareth when he came back, he was so shiny,  full of wonderful stories about his growth,  his evolvement,  he had been in this group and that... .I regularly used to say to him actions speak louder than words.  I confronted my ex on his behaviours,  I articulated my feelings,  I gave him my terms and conditions,  I insisted we see a counsellor together and then later than he get a psychiatric evaluation.  He convinced me and several therapists he was trying... .his attendance,  financial investment in therapy matched that... .I thought he was a little misguided on certain things,  I didn't know he was delusional and possibly a pathological liar until I came here and I certainly had no idea how futile my forgiveness was.  I understand attachment,  we were working with an Attachment therapist.  In the absence of a label and factual knowledge about BPD it was nuts going along with all the traditional couple advice that counsellors give,  it's good to argue,  it clears the air! God help me.

Yeah, me too disillusioned, I ended up finding this site by Googling "psychopath" after I left her.  I didn't even know what a psychopath was, turns out she's not one, but that search led me to something that described her to a T, BPD, and this site, where we read story after story we could have written.  So we didn't know, and all of our own stuff kicked in in the face of dysfunction, but I'll bet that never, ever happens to us again, at least those of us who stick around here long enough to learn the lessons and grow.  I'm sorry you went through that, it sounds very painful, and let's keep creating our bright futures.  Take care of you!


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 08:16:18 PM
I did that single handedly.  No therapist led me there... .But they kept taking my money, I could still be there trying to implement their stupid advice except that I was relentless in looking for answers.  At no stage was I not looking at myself,  I knew I was unhappy,  getting exhausted and truly fed up with the unresolvable nature of the conflicts,  I was setting more and more boundaries,  I was detaching and working on getting out.  I just couldn't understand how something so promising,  with all the help we were getting could be going so wrong... .


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: once removed on June 07, 2015, 08:19:38 PM
and by the way, i agree with all three of you:

"People will only treat us as badly as we allow them to"

"So it's a combination of what we bring to the relationship, experience, maturity and mental health-wise, along with our attachment style that determines our complicity.  And that's actually where the growth is after these relationships end; what if a borderline entered our lives for a purpose, because there were lessons we needed to learn, and striving to get out of our own pain is a great motivator?  At some point it's helpful and necessary in detachment to shift our focus from our ex to ourselves, so that in the next relationship we enter our partner gets a better, wiser version of ourselves, on our way to creating a truly healthy one."

"I just think it's a bit if a myth that 'a healthy person would have walked away'." i dont think its a myth per se, but i dont believe theres such thing as a totally healthy person, in the sense that we all, not just members here, have our issues, and life is kind of a lesson in self improvement.

"In the end it is our responsibility to recognize this and do something about it for our selves.  We are responsible for ourselves in the end... .no one else.  We cannot control another's words or actions. Only our own."  |iiii


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: disillusionedandsore on June 07, 2015, 08:33:33 PM
Oh it will never happen to me again because everyone that I like I will be running a lie detector on, hiring a P. I. and doing some serious personality profiling! I am only joking,  no I've learnt the hard way to listen to my Gut! No that is not something I ate it's a warning signal something is off.  Yes pain is very curative. Thanks for your contribution guys


Title: Re: Why do therapists shy away from making a BPD diagnosis?
Post by: Suzn on June 07, 2015, 09:48:24 PM
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