Should I stay here or should I go?

[oakland2021]

I've just spent the past 2 hours browsing the many different sections of this forum. I feel so at home and so seen. I felt this way when I read the assessment which accompanied my husband's BPD diagnosis a few months ago. Finally, I'm not crazy and I'm not overreacting.

However, since then, my husband's new psychiatrist (as recommended from his assessing and diagnosing doctor) has since told my husband that she doesn't think he has BPD; that she doesn't like diagnoses like that.

Now we're back to square one. And even beyond that. Now my husband has said that he agrees with his new therapist. That there's nothing wrong with him, that all of our relationship problems stem from my inability to meet his needs and more specifically my intentional desire to hurt him. And now he's resentful that I made him go through the evaluation in the first place... it was just another way to hurt and judge him.

I know that personality disorders are on a spectrum but I I still think that my husband displays certain behaviors and certain thinking patterns that are in the BPD family. I'm not a professional so what do I know about diagnosing someone but I do know what I see and experience every day.

My challenge now - how do I find better ways to communicate and interact with my husband and how do I try to repair our relationship? My only tools have been within the BPD framework. They feel right, they make sense to me.

But I am no longer bringing up the BPD diagnosis with my husband. I know it was a very painful period to learn that he has a "disorder" plus his current therapist says he doesn't have it. It doesn't serve me in any way to talk to him about it. But should I still be digging into BPD resources? Is that a losing strategy for me? I'm not sure where else to turn especially when the shoe fits so well.

[PLEASE - NO RUN MESSAGES]

PLEASE - NO RUN MESSAGES This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members may appear frustrated but they are here for constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[Cat Familiar]

Did you hear this directly from the psychiatrist? Or from your husband’s interpretation of what she said?

BPD is an onerous label and one that many mental health professionals would prefer to avoid, as it carries a stigma and much of the literature indicates little hope for improvement.

The skills you can learn here will serve you well in all relationships. Please check out the Tools section near the top of this page.

[oakland2021]

We are going to attempt couple's therapy with her so I've had a few one on one sessions with her. I have not heard her say this to me though. I didn't even think to ask her; I've just taken his word on what was said.

I have another session with her this week so I should ask. I guess I'm afraid to directly ask her.

But as you've said, I hope that the skills that I learn through this process will help me either way. I know that I have certain predispositions that I can improve on in order to be a more compassionate person.

[Rev]

I know that personality disorders are on a spectrum but I I still think that my husband displays certain behaviors and certain thinking patterns that are in the BPD family. I'm not a professional so what do I know about diagnosing someone but I do know what I see and experience every day.

My challenge now - how do I find better ways to communicate and interact with my husband and how do I try to repair our relationship? My only tools have been within the BPD framework. They feel right, they make sense to me.

But I am no longer bringing up the BPD diagnosis with my husband. I know it was a very painful period to learn that he has a "disorder" plus his current therapist says he doesn't have it. It doesn't serve me in any way to talk to him about it. But should I still be digging into BPD resources? Is that a losing strategy for me? I'm not sure where else to turn especially when the shoe fits so well.

Hi there,

Just wanting to reframe this incursion into your own coping mechanisms and encourage you to stay.

1) You have the right to seek out help that helps you. There's a reason that therapy is meant to be confidential.  For those around you, therapy should be about outcomes - ie - they see you feeling better, more confident, etc...

2) So along those lines, lets make the distinction between root causes and traits.   A psychiatrist or MD or diagnostic psychologist would be interested mostly in root causes to seek out treatment. But treatment of a root cause - ie clinical depression - will not necessarily change character traits. Treatment of a root cause is about improving the chances problematic character traits can be tempered.

Which  leads me to three -

3) No - your eyes to not deceive you. And here, you will have all kinds of support dealing with borderline traits of your partner's behavior. Here, you will get the emotional support to stay that course. BPD and Bipolar disorder look very similar on the surface - for example.  At the base, if your partner has been told he is not borderline, then that improves the likelihood that he will benefit from medication - whereas, medications by and large do not appear to be effective with BPD/NPD.

Stay - you will benefit from the acceptance.

Rev

[oakland2021]

2) So along those lines, lets make the distinction between root causes and traits.   A psychiatrist or MD or diagnostic psychologist would be interested mostly in root causes to seek out treatment. But treatment of a root cause - ie clinical depression - will not necessarily change character traits. Treatment of a root cause is about improving the chances problematic character traits can be tempered.

I believe his psychiatrist is mostly interested in root cause work right now. I don't know, I'm not in the sessions. I can only gather from what he shares... that his childhood trauma has led him to seek out partners who are "less empathetic" to him, recreating his unmet needs from his mom when he was younger.

I'm trying to look at his doctor objectively but since he's started seeing her my life has been even harder. Her lack of support of his diagnosis plus her assertion that he seeks out women to recreate the trauma from his childhood have both been extra support of his most recent attacks of me.

He will now have to find a new doctor though as I was uncomfortable with having him continue to see her one on one while also having her as our couples therapist. He of course twisted that against me and said that my request was another way to control him.

[Evenodds]

If you recognize many of his behavioural traits from you have read here, then stay until you find out from his psychiatrist what his diagnosis actually is (I am assuming he has been diagnosed with something).

You say that his psychiatrist 'doesn't like diagnoses like that'. Does that mean she is doing what Car Familiar described and avoiding labelling?
My own experience was that my pwBPD's psychiatrist made no reference to BPD in her diagnosis. Instead,  she listed the problematic behaviour that would be the focus of treatment. The description of these were similar to the DSM criteria for BPD.

But I was still puzzled and unsettled to find no reference to BPD in the written diagnosis.
My pwBPD had given her consent for me to talk to her psychiatrist and when we did, she explained that she avoided using the DSM's titles headline for any condition whenever she could. There no therapeutic value to be gained from labelling a patient. In fact it was more likely to trigger a negative reaction and hinder progress.

So in my case, the lack of any reference to BPD did not matter as the end result was the same. I know my pwBPD was pleased that label was missing but she still followed the advice and started DBT sessions.

That might be how your husbands psychiatrist is approaching  things. The only way to find out for sure is to speak with her. When you do, describe the specific problematic behaviours you have to contend with and what her treatment plan is.

Don't give up the resources here now. They could be of help whilst you are trying to get more clarity. 

[Rev]

I believe his psychiatrist is mostly interested in root cause work right now. I don't know, I'm not in the sessions. I can only gather from what he shares... that his childhood trauma has led him to seek out partners who are "less empathetic" to him, recreating his unmet needs from his mom when he was younger.

I'm trying to look at his doctor objectively but since he's started seeing her my life has been even harder. Her lack of support of his diagnosis plus her assertion that he seeks out women to recreate the trauma from his childhood have both been extra support of his most recent attacks of me.

He will now have to find a new doctor though as I was uncomfortable with having him continue to see her one on one while also having her as our couples therapist. He of course twisted that against me and said that my request was another way to control him.

Hi Oakland,

So I would follow your intuition on this one.  BPD / Bi-Polar disorder is one of the toughest, if not the toughest conditions to treat. Often, therapists of treat people in this condition for any length of time are recommended to be in therapy themselves at the same time - albeit in a less intensive way - to maintain some sense of stability.

That your partner's doctor is also your family therapist is a major conflict of interest. No wonder you are feeling what you are feeling.

In the part of North America where I am completing my Master's in psychotherapy, this would never be permitted by the college of physicians.

I can really sense that you are feeling cornered, or something close to that. My suggestion would be to go see someone yourself, on your own, to get a sense of where you will draw your boundaries, what it will take to make them stick, and what to expect in terms of acting out from your partner.

Without that, your mental health will continue to take a hit.

I hope that doesn't sound too heavy. It's hard in writing. If we were in person, I would likely invite you to take a walk with me and talk it through together. I think physical movement helps clear the mind with situations like this because so much of it is so hard to pin down.

Hang in there.  It's clear you have a good heart. Do what you need to keep it strong. The best of us always comes from there. It will help to prevent you from second guessing yourself in the future, if that hasn't happened yet.

Write anytime.

Rev  

[oakland2021]

You say that his psychiatrist 'doesn't like diagnoses like that'. Does that mean she is doing what Car Familiar described and avoiding labelling?
My own experience was that my pwBPD's psychiatrist made no reference to BPD in her diagnosis. Instead,  she listed the problematic behaviour that would be the focus of treatment. The description of these were similar to the DSM criteria for BPD.

But I was still puzzled and unsettled to find no reference to BPD in the written diagnosis.
My pwBPD had given her consent for me to talk to her psychiatrist and when we did, she explained that she avoided using the DSM's titles headline for any condition whenever she could. There no therapeutic value to be gained from labelling a patient. In fact it was more likely to trigger a negative reaction and hinder progress.

So in my case, the lack of any reference to BPD did not matter as the end result was the same. I know my pwBPD was pleased that label was missing but she still followed the advice and started DBT sessions.

That might be how your husbands psychiatrist is approaching  things. The only way to find out for sure is to speak with her. When you do, describe the specific problematic behaviours you have to contend with and what her treatment plan is.

Don't give up the resources here now. They could be of help whilst you are trying to get more clarity. 

This was really helpful. Thank you, Evenodds.

I'm not too clear on what the psychiatrist is thinking or what she actually even said. I've only heard this from my husband so it's all from this view point, which can be twisted as I am well aware of.

I will raise this in my next session with her this Friday.

I also understand the need not to label. At this point I care less about the label and more about the cycle of behaviors that is making our lives unstable. I now better understand the "root cause" work as something that is vital to unlocking these patterns of thinking and resulting behaviors. I believe that he and his psychiatrist have been doing this. I have yet to learn about what the resulting treatment plan is though, besides couples therapy. I will also ask more about this.

I will definitely not abandon the immense resources on this site and from the many kind and caring people that have already given me so much great advice. Thank you.

[oakland2021]

Hi Oakland,

So I would follow your intuition on this one.  BPD / Bi-Polar disorder is one of the toughest, if not the toughest conditions to treat. Often, therapists of treat people in this condition for any length of time are recommended to be in therapy themselves at the same time - albeit in a less intensive way - to maintain some sense of stability.

That your partner's doctor is also your family therapist is a major conflict of interest. No wonder you are feeling what you are feeling.

In the part of North America where I am completing my Master's in psychotherapy, this would never be permitted by the college of physicians.

I can really sense that you are feeling cornered, or something close to that. My suggestion would be to go see someone yourself, on your own, to get a sense of where you will draw your boundaries, what it will take to make them stick, and what to expect in terms of acting out from your partner.

Without that, your mental health will continue to take a hit.

I hope that doesn't sound too heavy. It's hard in writing. If we were in person, I would likely invite you to take a walk with me and talk it through together. I think physical movement helps clear the mind with situations like this because so much of it is so hard to pin down.

Hang in there.  It's clear you have a good heart. Do what you need to keep it strong. The best of us always comes from there. It will help to prevent you from second guessing yourself in the future, if that hasn't happened yet.

Write anytime.

Rev  

Hi Rev - wow, so much to unpack here (as they say). How much I'd give to go on this walk you speak of. I haven't been able to go into depth like this recently with anyone. Even therapy feels so short and time-bound. Ok, clocks ticking to the 45min mark. And then it's 6 whole scary and isolating days until my next session. 

I am seeing an individual therapist. Mine is actually our last couple's therapist. (We've had 2 other couples therapists so maybe the third time's a charm?) 

Before I started to see him again (his name is Dan), I asked my husband if he would be ok with it. Husband said yes but now he throws it back in my face that I'm deliberately choosing to hurt him by seeing Dan again. Dan was one of two people (my other was my other individual therapist, who I had been seeing separately while we were going through couple's therapy with Dan) who suggested a personality disorder assessment, based on several explosive and impulsive things my husband did around that time. So I think there's definitely resentment there. I should have known better than to trust his acceptance of me seeing Dan again. Now he using it to say I'm hurting him. I think the best thing for me to do is to ask for a recommendation and start to see someone else. I don't want to give my husband any more ammunition. BUT it does help to have someone who's seen us together, who's seen us interact. Am I being hypocritical for continuing to see Dan? It's not like he's still our couple's therapist. 

Onto the other matter of having husband's new psychiatrist as both his individual therapist and our couple's therapist. I spoke to his therapist about it, she's a psychiatrist and she said that there was nothing wrong with that setup from her perspective but she did understand my concern. My therapist, Dan, said that it could lead to some uncomfortable situations for therapist and for patients (like disclosing things in individual sessions that have not be disclosed in couple's sessions) so he and his colleagues typically advise against it. I'm in the US. I googled a bit about the topic and it's a mixed bag. I don't know. At the end of the day I think that I should be able to make a request like that and not have it used against me as "here I am again trying to control everything". 

I've said this directly to my husband that I know he really likes his new psychiatrist and that I'm thankful that he's willing to "give her up" so that she can be our couple's therapist. But that's not enough for him. And he accepted to do this but still throws it in my face. Damned if I do, damned if I don't. 

[Rev]

BUT it does help to have someone who's seen us together, who's seen us interact. Am I being hypocritical for continuing to see Dan? It's not like he's still our couple's therapist. 

Damned if I do, damned if I don't. 

Hi Oakland,

These are really great questions.  And I hear you about the 45 minute clock. Therapy can be a pressure cooker. I think the real learning happens between sessions.

As for your questions - and what seem to be your concerns - about the boundaries around therapy, what does your intuition tell you?  Are you able to really hear it right now?  So often therapy acts as a parallel process to our real lives.

Here's one thing that comes to me from your writing. You seem to be struggling to have yourself heard for any length of time.  The goal posts seem to keep moving - both in your personal life and in your therapy life.  Am I on to something here - AND - if I am wrong, which is understandable based on the fact that we're writing and not talking, what parallels do you see in your life and therapy?

Finally, based on what you write here, it appears that your partner is wanting therapy and life to unfold on his own terms. This is common for people with any personality challenge. They don't tend to pivot very well. So they control, and then project their feelings onto the person closest to them that they feel will pick it up. People with BPD traits live in a world of what I call "feelings based facts" - which basically means if something over there made me feel bad, and now I am feeling those feelings here with you, then it must be your fault. In the moment of being flooded by those feelings, I lose my ability to have perspective.

Does this sound familiar?

I would encourage you, for the time being, to let go of wondering when your partner is "going to get better" and focus on what you can learn about managing the volatile situations you seem to be involved in.  And by that, I don't mean blame yourself for what he's doing or saying. I mean learning to know when it's time to keep your distance and detach from the drama.

Somewhere here I think there's a resource about the Karpman Drama triangle. If not, Google it. You'll see where you might be unknowingly drawn into something that's going to back fire. In the future, you'll be better able to avoid these situations altogether and protect yourself.

Stay safe. And remember - whenever you are having a conversation with yourself, be polite!

Rev

[Evenodds]

So I think there's definitely resentment there. I should have known better than to trust his acceptance of me seeing Dan again. Now he using it to say I'm hurting him. I think the best thing for me to do is to ask for a recommendation and start to see someone else. I don't want to give my husband any more ammunition. BUT it does help to have someone who's seen us together, who's seen us interact. Am I being hypocritical for continuing to see Dan? It's not like he's still our couple's therapist. 

Onto the other matter of having husband's new psychiatrist as both his individual therapist and our couple's therapist. I spoke to his therapist about it, she's a psychiatrist and she said that there was nothing wrong with that setup from her perspective but she did understand my concern. My therapist, Dan, said that it could lead to some uncomfortable situations for therapist and for patients (like disclosing things in individual sessions that have not be disclosed in couple's sessions) so he and his colleagues typically advise against it. I'm in the US. I googled a bit about the topic and it's a mixed bag. I don't know. At the end of the day I think that I should be able to make a request like that and not have it used against me as "here I am again trying to control everything". 

I've said this directly to my husband that I know he really likes his new psychiatrist and that I'm thankful that he's willing to "give her up" so that she can be our couple's therapist. But that's not enough for him. And he accepted to do this but still throws it in my face. Damned if I do, damned if I don't. 

Hi Oakland
I feel for you. I really do. It is so hard giving up trying to reason with and persuade your partner with logical, factual, truthful words but the truth is they are unlikely to cut through and register in an emotionally charged discussion such as the one you are having now. And you are not giving him ammunition. He will always create plenty of that all by himself. So if you feel Dan is the best choice for you, state that, once,  and try and stick to it. If you haven't done so, read through the Setting Boundaries piece in the Tools section above . Better yet, read through the 'Eggshells' book (if you are still fighting to stay in the relationship. I felt  'Stop Caretaking the BPD' was more aimed at stiffening the resolve of those edging towards moving on)
You need to look after yourself and conserve your mental and physical reserves and the techniques described really do help.
When I finally twigged there was this thing called BPD that explained many of the mysteries of my pwBPDs behaviour, I read everything I could about the condition. I read absolutely nothing on how to look after myself. So of course I did all the things you are advised not to. I burnt up huge amounts of energy discussing, debating, cajoling, bribing, threatening, trying again and again to find the right form of words that would instantly persuade her to abandon some totally illogical view. Of course none of this made it better. It just raised the emotional temperature and prolonged the arguments. After nearly two years of my delusional behaviour, I seriously started to wonder if the gaslighting wasn't gaslighting and that I might be the one with the problem. Just as she had always said. From there  it was a short slide to the bottom, severe depression and anti depressants for the first time in my life. Only then did I start speaking to a therapist about BPD and start reading Eggshells. Drawing boundaries and not engaging in debate has made a huge difference to me now, although I'm still struggling with the listening with real empathy bit.

Forgive me if you've already covered this ground. It just sounded like you might not have done so and it is so important not to burn yourself out engaging in endless debate. As I said, I really feel for you but you must make sure you are looking after yourself.