Hi Pook075 ,
Here's the thing though from your wife's viewpoint. For someone with mental illness, they will take your statement of "You need to make more effort in getting treatment" to mean "You're nuts and you'll never be good enough for me."
Based on the EOS theory, I believe the distortion you described is made "unconsciously purposeful" so that they can feel rejected and therefore release endorphins. Therefore, you have a good point.
However, this distortion does not always happen. In my case, she didn't react at all when I communicated the four conditions. Because we were together and she was feeling good with my presence. She even asked me to stay for the night in her home. As I denied, she asked why, a bit angry, but as I gave logical reasons, she accepted them. I think it went well simply because she was interested enough in closeness to ignore the opportunities to pick up a fight.
You can hire the best psychiatrists in the world and it honestly wouldn't make a bit of difference if your wife isn't ready to accept that she's mentally ill and put in the work to actively change.
I disagree. Unlike NPD, people with BPD do know that they are mentally ill, even if they deny it to others. And if, for whatever reason, they accept to do DBT with a good therapist, then it is very likely to work, but still it depends on them liking the professional. For instance, my wife does not like male professionals. But once they feel comfortable (which is the goal of DBT), they will begin to like the sessions (because of the validation they get). As a result, they will gradually become more motivated to put up some effort. After all, they are aware of their problems and failures.
My wife never denied being mentally ill, and as soon as she was diagnosed, she shared it with close family the same day.
Think of it this way. Someone is deathly afraid of spiders. You tell them that they have to walk through a room packed full of spiders, and they must stop and talk to each one of them along the way.
That's probably how your request "feels" to your wife...for her it's unthinkable due to past traumas and mental illness.
You correctly pointed out one of the reasons that makes her resistant to treatment. The other reason is that she has never done DBT, and regular therapy (such as CBT) doesn't work for her (makes her feel invalidated). But I am quite sure that this will be overcome once she starts actual DBT and the therapist match is good for her.
I'm not trying to take her side here, I just want you to realize how much of an ask you're placing on her by making that a condition of reconciliation (really, it's the top 2 conditions). It's just a lot to ask and the chances of success are very slim without some compromises in there. Many people never recover and even those who do show significant progress still face major obstacles.
I think that only item 1 is the hard one. Because specific phobias (item 2) are considered the most treatable of all anxiety disorders, with a treatment success rate of 86%. Because they only need to treat one specific thing, such as the fear of heights, and do not necessarily need to treat the original trauma when there is one.
Also, I believe that this phobia is a byproduct of her BPD, and she unconsciously cultivates it. I say this because it's clear that she unconsciously took steps to traumatize herself and then always sabotages her treatments. But maybe if medication and DBT are capable of reducing her need for opioids, then any specific phobia treatment will be effective. Many people even cure themselves through gradual exposure, without the support of any professional.
I'm just trying to be honest here because if you do want to save the relationship, this doesn't feel like a sustainable goal at the moment.
Yeah, I know it seems difficult. However, in my priorities, the peace in my house comes first, and the relationship comes second.