Should I call the therapist about this?

[justhope]

This is a very long story, but I will skip the long history and background and just try to outline the current issue. I need help with my husband's therapist.

A few months back, I figured out that my husband of 22 years probably has BPD (along with previous confirmation of PTSD, suspicion of ADD, depression, anxiety, paranoia and more).

In a conversation with my SIL (my husband was there), I brought up my suspicion of BPD in as gentle of a manner as I could, thinking I would get a lot of pushback. I hadn't even finished the word ":)isorder," and she was saying it at the same time, stating that she recently discovered that it ran in their family. I was relieved and distraught all at the same time.

Fast forward to a month ago. My husband started seeing a therapist-we do not have any psychiatrists in our area that can diagnose and will accept our insurance, nor are there any therapists that specialize in BPD in this state.

I have not been to the sessions, all I have is the information he tells me afterwards. He told the therapist that BPD runs in his family. He in turn told me that the therapist "does not see any indications that he has BPD." He gave me the run down of the session, and he's shockingly honest about some things, while distorting or only half-truthing other things. (I am used to this.)

Here lies the issues. Because the therapist has told him certain things, one example: #1 indicator of BPD is rage that cannot be controlled in private, or public (which he denies he has), he is doubting more and more that he has anything more than ADD and PTSD, which the therapist suspects.

Issue 1: I know you understand when I say that this is held against me, and I am looked at in an even more negative light bc I think he does have BPD tendencies.

Issue 2: I don't agree with some of the therapists comments, based on what I have read, but I cannot disagree with the therapist-I do not have the credentials to back me up.

Issue 3: I also don't want the therapist to look bad or not be trusted (if I were to disagree) bc I want him to get help, and we don't have a lot of options in our area.

After today's session, I'm a wreck. I want to call the therapist and tell them not to even discuss the BPD with him, unless they have been trained to diagnose it and INTEND to diagnose it. This constant speculation, in my mind, and commenting about it, is making it even more difficult to live with him and keep my sanity.

I need advice. Should I call the therapist about this, make my own appointment, ignore it, or what? What should I or shouldn't I do? All assistance is greatly appreciated.

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[Skip]

 

ADD and/or PTSD can look a lot like BPD when it comes to interpersonal relationships.  

There are a lot of people with experience with therapists here in the community that can help.

Stand by!

[DaddyBear77]

Hello justhope, and welcome!

As Skip said, there are many folks here who have gone through a very similar experience. I am one of them.

When I learned that my wife's therapist was unwilling / unable to diagnose BPD in my wife, I was shocked! To me, it was so clearly obvious! My wife had a very similar combination of confirmed diagnosis as your husband (PTSD, depression, anxiety, etc) and according to my wife, I should stop trying to "pin BPD on her". In fact, it got turned around so much that my wife said *I* was the one who had BPD and NPD so I should take care of my own problems before I go around trying to pin it on her!

Unfortunately, this reaction is VERY common.

Here are a few things that I've learned and read along the way.

First and foremost, a therapist cannot help someone if they don't stay in therapy. That might seem basic, but with many pwBPD or pwNPD, it's the number one challenge. Building trust, communicating difficult truths in a loving and validating way - these are REALLY hard skills. You've got to give credit to any therapist that can manage to engage for a long period of time in a meaningful way.

The second thing I learned is that it's actually a very difficult thing to clinically diagnose "full blown" BPD or NPD. The criteria are very strict and professionals have high standards to uphold when it comes to meeting those criteria. The diagnosis of BPD from a professional can be very stigmatizing. Most patients can't handle this and so I think most therapists will settle on working the other similar issues of PTSD and ADD.

And the third thing I learned is that many times, the most effective modes of therapy like mindfulness and DBT, or certain anti-anxiety or anti-depression drugs, can be effective at treating PTSD and anxiety as well. Whether or not there's a suspicion of BPD, a confirmed and accepted diagnosis of anxiety and PTSD provide an easier pill to swallow (pun intended) as a path to treat the underlying symptoms and behavioral and thought patterns of all of the above.

Everything I just said is from a completely non-professional point of view, by the way - I just want to make that clear. I am not a professional in any sense.

I'll pause here and ask, does any of this make sense?

Also, I'm sure there are many others who can share similar stories so I'll ask them to chime in as well!

[justhope]

Thank you so much for replying. I really appreciate you commenting. I have been traveling, and just got the chance to check here, again.

Thank you for validating and reinforcing my thoughts about the therapist. Yes, she may not be able to diagnose, but at least she is helping. He is building trust in her, and it appears that she's attempting to tackle one issue at a time, which is good for him because he gets so overwhelmed. That just makes your second point more important for him. After going to his PCM, we had a conversation about diagnosing and it was even more clear that it's the name BPD that scares him more than anything. He is trying a therapy for PTSD, which is an acceptable stigma in his mind, this week.

He's had enough time, now, to turn what he told me a few weeks ago about the therapist saying he wasn't showing signs of BPD into "she is totally convinced that I don't have BPD." I know that it is basically his coping mechanism, but that doesn't make it any easier to hear. Plus that's what he told the PCM, and since I wasn't in the session, I can't dispute it.

Side note: at a recent appt with the PCM, he told the doctor that when his meds wear off, I get really irritable and hateful, and he thinks that I should need to be on some meds, too. PCM smiled and said he felt it was his perception of the situation, and he totally agreed. I've said this many times and he always says I'm way off. Anyway, his view of my behavior and assessment that I needed meds sounded even more ridiculous in that room (I actually laughed and he didn't kind of laughed, too), and that was the first time that he had ever said anything like that in front of someone; just wish it had been the therapist.

Baby steps. Miniscule. Baby. Steps.

[Notgoneyet]

  Welcome justhope, 
  Just a quick comment or two. After 35yrs married to my uBPDw  ,more therapists, marriage counselers then I can even remember we've finally found one that has begun to REALLY help my SO as well as myself. 
   If it's helping at all I would stick with it while looking else where if you feel like it.
   Lots of info on this site to help with that as well as many other things. You are in the right place.
   Best of luck with everything & keep up the good fight!
 Notgoneyet