1st counseling appointment - Goals of therapy?

[goodintentions]

My uBPDw has finally made it a priority to get marriage counseling. We are going to a counselor together this week. I could use advice on what goals to discuss so that therapy can hopefully be productive for us.

Selfishly, my goal would be for her to get a diagnosis! (I know people w/ BPD often don't react well to that... .however historically that type of 3rd party straight shooting has been motivating for her).

But clearly I can't state that as a goal, right? Or even couch it in observations, such as abandonment fears, black/white splitting, raging, dependency, anxiety, helplessness, etc? I hate to "lead the witness," but I've felt pretty strongly that BPD is the issue, since the moment I first read about it on this site. Still, it's not my place to make that call.

We've been to marriage counseling in the past; it was actually incredibly validating for ME. But after numerous sessions, our therapist concluded my uBPDw needed to get individual treatment (past trauma, etc.). Problem is, she doesn't like homework - she didn't go through the materials and didn't begin individual therapy.

Obviously if we start fighting (for lack of a better word) in front of a therapist some of those things may surface. But the T she agreed to see (her/our religious qualifications) doesn't appear specifically trained in personality disorders or the related therapies.

I would appreciate any advice for this first session (or new round) of counseling. How can it be productive? Thanks!

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[waverider]

Hi goodintentions

I haven't experienced marriage counceling myself, but the experiences reported by our members seems to bear up what your previous counselor says.

This type of therapy is to help clarify and negotiate your differences to provide a healthier RS. How a pwBPD has compromised acceptance and negotiation abilities as they are overruled by denials, delusions and defensiveness. The common outcome of this is that these traits sabotage all attempts at mediation.

Dealing with the core issues of BPD is above and beyond the scope and ability of marriage councelling sessions. Refusal of your partner to follow up on information and recommendations for specific individual therapy is normal. this is what makes dealing with BPD so difficult and frustration.

So what to do in this appointment? First off stay away from the defensive blame game, and don't expect a diagnosis or any magic result to come from it. Be aware of your partner steering it away onto side issues and not making best use often session.

As a couple I attend most of her therapy sessions, but not as marriage counselling, but it does help to keep things on topic and not allow complete fantasy to take over.

[Ceruleanblue]

I totally agree with Waverider. I've attended quite a bit of co therapy with BPDh, and with his therapist, it was actually quite validating at times. But did that do me any good with BPDh? Heck no! And for me, it almost made it worse, because then I knew I wasn't crazy, and had a right to feel, and see the things I do in him. His T just doesn't know the extent, or I actually think he's done such a good snow job of convincing her a LOT of this is me, and having him come weekly for four years, that's a pretty good racket.

Now, his psychiatrist, who doesn't get sucked into all the small stuff, put him on meds, and put him in DBT, even if I don't know is "official" diagnosis. It took me four years to get here though, and BPDh doesn't seem to be fully immersing himself in the DBT therapy. He likes venting, activities, and learning, so I think for him, this is more social, because he doesn't seem to be doing the actual work.

I hope you have better luck than I have had in marriage therapy. I'm giving in one last try myself, and if we get nowhere, I'm done with marriage therapy until he'd completed his DBT and learns to not be so judgemental(was glad to hear that was part of DBT... . because blame and judgement, and never believing me is a HUGE issue). It's so hard when we love these people so much, and just want them to be happy, but they do so many things to US, and to themselves that make it so hard to love them, or stick it out with them. The thing about those with BPD, is most of them do denial and projection, so how can marriage therapy really work, when they take no real responsibility? They think they are fine, and WE are the sole problem.

In fact, my last session in "marriage therapy" that T asked BPDh what his biggest stress was, and he pointed to ME. Yep, I'm the sole problem, in his view. Not his stressful job, not his kids who won't see him, not the fact we just moved, nope, it's ME. It's funny now, but it was not funny when he said it last week. I guess hindsight, you really can see just how ridiculous some of their black/white thinking is.

Keep us posted on how your marriage T goes. I'm going back in very cautiously optimistic... .

[goodintentions]

Thanks waverider and ceruleanblue. Our first appointment was today. The therapist seems a bit young, and based on specialties/modalities/issues I'm not confident in his ability to help us long-term, but maybe I'm wrong. I was encouraged that he did push back on some of my wife's comments -- and I tried to focus my concerns around splitting/black and white thinking, and her abandonment fears, trying whenever possible to use her own words to demonstrate those.

She did get argumentative in the meeting, and of course brought up each of the 5 worst things I've ever said to her in our 7 year marriage (as examples of "how I treat her" - but without any context around those horrible situations of course!).

I'm always the optimistic one so maybe I'll get a dose of reality soon. I could certainly see it ending much like our last series of counseling appointments did. With the therapist telling her she needed individual treatment, which of course she didn't pursue. But the good news is that 2 therapists have now pointed out that she's not communicating well or fighting fair.

I think "cautiously optimistic" is probably a good mindset to be in. It felt validating for me at least.

Good advice to not play the blame game. Give me some great things to think about. Thanks!

[formflier]

 

Focus MC on treating the r/s... . changing things to help it heal... . make it better

It is likely they may refer either of you... . or both... .for IC. 

BPD is an individual issue... . yes it affect the r/s.

The traits are what the counselor will most likely focus on.

So... . for instance... . what to do when there is blaming or name calling.

How to take a time out... . that kind of thing.

Those are valuable skills to learn.

FF

[Ceruleanblue]

Glad your session wasn't a total bust. Time will tell if the T is up to actually being of help to the relationship. I think MC in most cases doesn't help when there is a serious PD factoring in. I pretty much had a T tell me that in a call back this week. He doesn't do MC when there is an addiction issue or personality disorder, is I think what he said(plus, he wasn't taking new patients). I'm glad I found a T who does, but that also made sense to me. I mean, both people have to have the maturity to work the issues, and the desire to, and both can sometimes be lacking when BPD is present.

At least your attitude about it is good, and maybe if another counselor suggests individual therapy for her, the BPD might eventually get diagnosed? For us, it was my husband finally seeing his psychiatrist, and allowing me to come, and him finally admitting how severe his issues really were. I guess I caught him at a good moment, when he wasn't transferring all blame onto me, as he seems to be back to doing. It's all just so hard, because a huge trait of BPD is the denial. My husband has hurt so many people in his life with his behaviors, mostly those closest to him, but also co workers, and old bosses. I always wonder how they can continually think it's "everyone else", and not THEM?

Keep us posted on how your sessions go. I have a first MC session Monday, and like you, I just want some help knowing how I can deal with all this. How I can stop the bleeding, and not trigger it(as much as that is possible).