Need advice regarding most effective Therapy for my spouse who has BPD

[Titainium2]

My wife has BPD.  Medication has helped some.  She is on Lamictal for mood stabilization and Lexapro for depression and anxiety, currenlyt gradually increasing  her doses.  I am a pharmacist so well informed with respect psychopharmacology and therapeutics.  However, I am not well versed in what is the most effective non-drug therapy for BPD.  She reports a year "Talk Therapy" was NOT effective.  She recently has had  a few sessions preparing for EMDR but is NOT comfortable with the therapist so has declined to proceed.  When she is calm and in her right mind she acknowledges she needs help and treatment.  However, when she is "tripped off" which can happen in a split second there is no helping her and she becomes quite emotionally abusive.  I am a very calm, strong and mentally healthy individual but am finding it more difficult to recover after every episode and I have lost too much of myself accommodating her mood swings and she is reacting quite strongly to me taking some of that back.

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[walkinthepark247]

Titainium2, welcome.

You are somewhat ahead of the game of others here in that your wife acknowledges from time-to-time that there is some problem. In my situation, I fully believe that my wife is seeing an unqualified therapist. I truly believe this therapist is making the situation worse. Unfortunately, it seems to me that the bar for "therapist/counselor" is set quite low. When my wife comes home from her sessions, she is more keyed up and on edge. The therapist has also convinced her that she only needs to get out more and "get a hobby". It's so much more than that! Lately, I've been convinced that some counselors are only a pit that you continuously throw money into.

What I have learned, and others will chime in (I suspect), is that we truly cannot steer the therapy for them. If they are looking for a therapist to help with BPD issues, that's amazing!

If it were up to me (which it isn't), I would get my wife to someone qualified who could do diagnostic testing. I would also want someone qualified and experienced dealing with BPD. The main therapy is DBT: https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/

To reiterate, I truly believe that the wrong counselor can make the situation worse. It also seems that many of them are ignorant of BPD.

[Enabler]

Unfortunately, it seems to me that the bar for "therapist/counselor" is set quite low. When my wife comes home from her sessions, she is more keyed up and on edge.

Since your wife has self awerness she my fair better, however my uBPDw sees a therapist who constantly tells her to focus on her inner voice... .this is the same inner voice that would tell her I'm abusive, I've been unfaithful, she's not been unfaithful... .it's the same inner voice that tells her she needs to get drunk, the same inner voice that tells her she's not responsible for anything and the same voice that says she deserves special treatment. But then neither my wife nor the therapist are exploring BPD therefore they're not looking for the inconsistencies in the narrative with which to open up the cracks to get to the truth... .or I suppose in fairness the truth that I think I know from experience and evidence as an intimate partner.

[walkinthepark247]

... .my uBPDw sees a therapist who constantly tells her to focus on her inner voice... .this is the same inner voice that would tell her I'm abusive, I've been unfaithful, she's not been unfaithful... .it's the same inner voice that tells her she needs to get drunk, the same inner voice that tells her she's not responsible for anything and the same voice that says she deserves special treatment... .

Ughhh. What does this even mean? I'm trying to think of how that would work in my household. My wife's inner voice tells her that she is no good, I'm no good, no one loves her or cares about her, her kids don't love her, I'm trying to steal the kids away from her. Lately, there has been a lot of paranoia as well.

Do these people not remotely get how destructive their position can be if misused? I'm not saying they don't mean well. Rather, how is that even remotely ethical? Shouldn't you rule out diagnostic testing first? I'm in a profession where we are CONSTANTLY told that you do not take on a job unless you are fully fit and qualified for that position.

Sorry for the semi-rant, this has just been on my mind a lot lately. I get all tense because I have to drive by the T's office every day. When I think of all the money we have dumped into that place... .We've spent thousands of dollars and my wife has just determined that she needs to play more tennis. Meanwhile, she seems to be dysregulating more than ever. As I said in another post, she doesn't even look well (I'm genuinely saying this out of concern). Oh, it's also my fault that she doesn't play enough tennis. Everything would be a-ok if she just played more tennis. Because, well, the therapist (with a shiny new diploma) knows best.

The way I understand it, the therapist even encouraged my wife to discount diagnostic testing and mental health treatment and just get more hobbies. That seems just plain reckless to me.

[walkinthepark247]

Titanium,

Have you thought about going to see a QUALIFIED (do extensive research) therapist of your own? I have been looking lately for someone qualified and extremely experienced with mental illness and "Marriage and Family Therapy". https://www.aamft.org/iMIS15/AAMFT/Content/About_AAMFT/About_Marriage_and_Family_Therapists.aspx

Mostly, I have been concerned about how to address concerns regarding my young children.

[Enabler]

Re the tennis... .endorphins = feel better. It's also advised as an alternative to self harm and advised in DBT. I don't believe my uBPDw has ever had DBT but she seems to do many pf the anti self harm things it suggests. It used to be a continual frustration for me that she was running/cycling rather than doing house wife things as agreed when she gave up work... .but now I kinda get it. The exercise serves a purpose and even if she doesn't consciously know it, it does something for her. Also, it's hard to ruminate when you're exercising or working. My wife was infinitely better when in full time employment.

High functioning BPD is tough to spot, my uBPDw's description of her reality is VERY clear and complete. It's a world where she has done nothing wrong and o am the baddie. No information to contradict that will pass her lips... ., but she has been seeing a therapist since Jan every week and her T wants to maintain that rate... .I'm down to once every 3 weeks and I basically have to beg to see mine as I like the chit chat, he keeps telling me I'm fine and lengthening out the periods I see him. Fwiw I don't freak out, I just feel empoweeed when I see him.

[believer55]

Hi Titanium

I think loving someone with BPD is less about finding them help - more about finding yourself help.

She is the only one who can find what is right for her - DBT? Mindfulness? etc whatever she is willing to try and stay committed to.

In the meantime you will need help to work with your feelings and the impact the relationship will have on you. What I am slowly learning is that I can do all the research in the world and change my communication with H to help him, but none of that addresses how I am coping. Helping your pwBPD will be draining and the help coming back the other way will be minimal if at all. So you need to set support up for you if you are committed to this journey. The more you understand what it is like to live with BPD (as a person with BPD) then it will help you to see how she sees the world (lots and lots of fear). It will not change the way she behaves, but it may help you.

Keep posting.
B.