prepare for psych evaluation

[Family Court Strategies: When Your Partner Has BPD OR NPD Traits.]

Our doc and my psychologist have strong concerns about him having BPD. I've given him enough evidence to see that it's worth evaluating with a professional. Our doc referred him to a psychiatrist for evaluation next month. He's agreed to let me participate in the appt. Is there anything I can do to prepare for the appt? I am thinking about making some notes but I don't want him to feel uncomfortable.

[needsupport6]

Our doc and my psychologist have strong concerns about him having BPD. I've given him enough evidence to see that it's worth evaluating with a professional. Our doc referred him to a psychiatrist for evaluation next month. He's agreed to let me participate in the appt. Is there anything I can do to prepare for the appt? I am thinking about making some notes but I don't want him to feel uncomfortable.

[Want2know]

Did the doctors tell you what they expect from you during the evaluation?

[needsupport6]

We had a short 15 min appt together with our family doc and got the referral for the evaluation. That's it. At that time, he was very uncooperative so I was thrown off and didn't get a chance to ask. Maybe I should phone the psych's office and ask? Not sure they will tell me anything but I can try... .

[Want2know]

Maybe I should phone the psych's office and ask? Not sure they will tell me anything but I can try... .

That sounds like a good start. 

[Matt]

I don't think you can be involved directly in someone else's psych eval.  You can go along if he wants you to, but the psych eval is between him and the professional.

One thing to be aware of is whether the psych eval will include objective testing like the MMPI-2.  If it does, it will accurately find if there is BPD and/or some other disorder.  But if there is no objective testing - if it's just a psychologist interviewing him - it may do more harm than good.  Someone can just act right for a little while, and the psychologist may or may not diagnose accurately.

Have you filed for divorce, or do you plan to?  If so, you can file a motion for objective testing.

[ForeverDad]

I don't think you can be involved directly in someone else's psych eval.  You can go along if he wants you to, but the psych eval is between him and the professional.

It is normal for a person to avoid looking bad.  That feeling is amplified to an extreme in someone with a personality disorder such as BPD or other acting out PDs such as Narcissistic, Histrionic, Paranoid, etc.

What that means is that what he tells the evaluator may be overly slanted and minimizing, even blame-shifting, to an extreme.  While it is good to get outside observations and comments from those around him such as yourself so the evaluator isn't fooled, sometimes that is hard to do.  Let's hope the psychiatrist is both perceptive and experienced, something a degree alone cannot guarantee.

[Matt]

I don't think you can be involved directly in someone else's psych eval.  You can go along if he wants you to, but the psych eval is between him and the professional.

It is normal for a person to avoid looking bad.  That feeling is amplified to an extreme in someone with a personality disorder such as BPD or other acting out PDs such as Narcissistic, Histrionic, Paranoid, etc.

What that means is that what he tells the evaluator may be overly slanted and minimizing, even blame-shifting, to an extreme.  While it is good to get outside observations and comments from those around him such as yourself so the evaluator isn't fooled, sometimes that is hard to do.  Let's hope the psychiatrist is both perceptive and experienced, something a degree alone cannot guarantee.

Yeah - exactly - this is the problem with subjective psych evals.

The professional (psychologist or psychiatrist) is ethically obligated to focus on the individual being evaluated, and not to be biased by inputs from others.

But if that individual doesn't tell the truth, or misleads the evaluator, intentionally or not, it may not be possible for the professional to do an accurate evaluation.

The only way a person like this can be accurately evaluated is by using an objective instrument like the MMPI-2.  (In my humble, non-professional opinion.)

My wife and I went to four marriage counselors, and she misled them all.  The fourth one - who my wife picked - perceived that she probably had BPD, and told me about it - I'd never heard of it.  She said that only a court-ordered objective psych eval could say for sure.  So when I gave up on counseling and decided to move ahead with the divorce, I filed a motion - based on advice from others here - to have a Custody Evaluator appointed - a Ph.D. psychologist who could administer objective tests to both of us.

We both took the MMPI-2 - about 500 items you rank from "Always true" to "Never true" (or something like that).  It's designed to be hard to fool, and to identify when someone tries to fool it.  It has three "truth scales" - sets of items which together rank whether you're answering honestly.

My results showed that I was answering honestly and had no psychological disorders, though I was surprised to learn I am at some risk for substance abuse.

My wife's results showed "multiple psychological disorders" including BPD.  They also showed that she "presented falsely", which means she tried to fool the test.  But the test is designed to give accurate information anyway.

$500 for each of us - well worth the money.  Make sure both parties will have access to both results.

[scraps66]

I would want no parts of being involved in SO's psych eval.  You an review and have the results reviewed if there is a question.  By the sounds of it this is not a psychologcial evaluation but more of a screening.  Anything short of peforming the MMPI-2 will be uselss in diagnosing BP or anything else.  The MMPI-2 is a first step.  with results in hadn the Dr. may say he needs more time to accurately diagnose if that is the end goal.  Also, my Dr. told me that the MMPI-2 alone is not necessarily credible standing on it's own and that additional tests, I think I took three others are suyed to corroborate the results fo the MMPI-2. 

What happened to me was that I went and spent the money and used the Dr. my L told me to use.  Respected in the courts and a straight shooter.  My ex - she avoided it all becasue the court order did nto stipulate using a partiualr document - a mistake.  After me spending more money and two more trips back to court my ex did get a "psych eval" but it was bogues.  she picked a Dr. that didn't know what she was doing, fed her a line, and the report came out wrought with lies.  I have not yet gone back to court to correct this but it still does not sit well with me. that was over two years ago.  Vent.

So, since you may not get another shot at this - do it right the first time and the only time.  Make sure there is a report issued and sumbitted to both sides, make sure the Dr. is credible, make sure there is somethign written about what tests are tob e done.  Leave nothing to chance.  My one motivation for going back to court - I will likely have to pay $2k for her real psych eval - is that is is an insuracne policy of sorts.  I have suspected my ex is trying to lure me into an altercation in recent months and without something that says she has severe mental health issues, she could be successful in accusing me of false allegations.  I think if I have this on file it could help me refute anything she says or does down the road.

So again, make the most of your opportunity. 

[ForeverDad]

If this matter may possibly end up in domestic or family court... .

Be aware that most if not all courts accept people as they are.  Court's are not in the business to force people to change.  Typically, courts are only prepared to order a small set of things such as Anger Management classes.  Even that, once completed, ends the matter.  If there is abuse, neglect or endangerment of the children then supervised visitation might be ordered.  But even with that the court will be looking for ways to phase that out over time.

My point?  If you're expecting a diagnosis to resolve all issues and give you clear sailing to resolve every issue simply and cleanly, odds are that won't happen.  So ponder your goals and expectations.

At that time, he was very uncooperative... .

Would it give your spouse incentive to seek therapy and recovery?  Maybe, anything is possible but - reality check - this site is filled with spouses, ex-spouses, BFs, GFs, siblings, parents, children who never managed to get the disordered one to make positive changes in their lives.

Would it give you leverage in court regarding custody, etc?  Maybe.  But probably not nearly as much leverage as you might think.  A diagnosis does not necessarily correlate to the behaviors.  Courts go more by behaviors than by a diagnosis.  And even disordered people have rights and boy oh boy do the courts help protect those rights.

What I've written here applies more to the long term view.  You're right at the beginning, so it's good that you try every option possible.  But consider a "decision tree"... . ponder your options if things don't work out as you hope... . What if a diagnosis isn't made or is vague enough to drive a truck through it?  What if your spouse rejects it?  What if ex starts but then stops or claims doc said he was cured with a couple quick visits?  What if... . you get the idea.  Think a few steps ahead.  And if you do get some leverage, don't gift it away, you need every little bit of advantage you can manage to get.

[Matt]

Court's are not in the business to force people to change.

My wife was diagnosed based on the MMPI and other evidence, and the psychologist appointed by the court recommended "psychotherapy".  That was written into the court order.

But I don't think my ex took it seriously or has ever seen a therapist.  The court has taken no steps to enforce it, and my lawyer told me not to bother with it, unless she acts out in a serious way, or we find ourselves back in court.

My view is, if our shared custody doesn't work out, I could go for full custody, and I could show that the other party hasn't obeyed the court order, and that is part of the problem.  But things are working out OK, so we probably won't go back to court.  So that therapy requirement imposed by the court will probably never be enforced.  I think this is common - the courts don't enforce stuff like this.