How do I find a counselor specialized in personality disorders like Borderline?

[O'Maria]

I am talking to a counselor after my shocking relationship with a man who has 9 out of 10 traits of BPD, comes from a family with a mother hospitalized for mental illness and a grandfather who committed suicide. The counselor said that BPD is less common and thinks it was anger outbursts from a man who lost his job. This sounds like my ex who defended himself saying that he went a little overboard and wouldnt do it again and that it only happened during stress.

Maybe my ex had more than one illness. I read a book about verbally abusive relationships and he happened to look at the list of traits for both BPD and NPD. Then he said he didnt think he was narcissistic, and that he had heard of borderline but didnt want to comment any further. 

I have so many questions although I feel I learn every day. Its hard to explain to the counselor what went on inside our home, all the abuse that I still suffer from. I want to get treated for my nightmares and start over with a normal partner. What if I got damaged by the abuse. How do I find a counselor specialized in personality disorders like Borderline? Why is it not the first choice they think of?   

[LOAnnie]

According to this excerpt in a sub-article on BPD in the larger article on personality disorder:

"Standardized criteria were developed[87] to distinguish BPD from affective disorders and other Axis I disorders, and BPD became a personality disorder diagnosis in 1980 with the publication of DSM-III.[82] The diagnosis was formulated predominantly in terms of mood and behavior, distinguished from sub-syndromal schizophrenia which was termed "Schizotypal personality disorder."[86]"

Here's the link:

www.en.wikipedia.org/wiki/Borderline_personality_disorder#History

So, its a fairly new category of mental illness, and the way the symptoms are being re-grouped now will mean yet more changes in the way the disorder is categorized and diagnosed in the DSM 5.0.  The way the disorder is even thought of keeps changing.

The way to find a psychiatrist or psychologist who has experience with treating patients with borderline pd, who has training and experience using dialectical behavioral therapy (or the newer schema therapy) to treat BPD and who is willing to take on a new BPD patient... . is to do a lot of phoning and interviewing of those who are within your area.  

You have to hunt for them and interview them.  

From what I've read, there aren't a great number of psychiatrists or psychologists who are willing to treat patients with BPD.  But if you find one who is willing and who is trained in dialectical behavioral therapy and willing to take new patients, then, jackpot!

Here is a link to a site that does list a few therapists who treat BPD patients, organized by state:

www.borderlinepersonalitytoday.com/main/BPDlist.htm

Keep in mind that the person whom you suspect might have BPD has to be willing to accept that he or she may have a personality disorder, has to care very much that his or her behaviors are hurting their spouse and/or their kids, has to want to change his or her behaviors very much, and has to be willing to undergo what might be years of therapy.  Its an uphill battle, but it can happen.

-LOAnnie

[O'Maria]

Its the endless projection which prevents awareness. Also, there seems to be "forgetfulness" once the rage outburst is over, to minimize the need for therapy. How can they not remember what happened even when no alcohol was used? I remember every word that was said.

My experience is that even when the "patient" knows something is wrong there is resistance to treatment. If I start with family therapy its easier to accept but I already know it won't help cause medication alone has not helped. Even if all other family members know its a mental illness the patient "wants to be left alone". Its the fear of rejection of somebody who is sick, and a fear of getting the diagnosis. 

[SeaCliff]

I agree with this point. I have spoken with numerous therapists (psychologists and psychiatrists) over the past year about BPD, and most of them aren't that familiar with the Borderline behavior. For those who had a brief experience in treating a Borderline patient, they didn't seem all that motivated to try to treat another Borderline.

For those therapists who consider themselves Borderline experts, there still doens't seem to be one DEFINITE way to improve the Borderline behavior. For every positive article or book which I read on DBT, I then read a negative one which notes that many Borderlines don't finish the DBT treatments very often. What are the absolute best and most consistent treatments out there which may overcome the Borderline's layers of defense barriers such as Blaming and complete denial?

[LOAnnie]

Successful therapy seems to be more about tailoring the therapy to the individual patient's needs than it is about relying on one specific form of therapy because BPD (plus frequently present co-morbidities) is such a complicated disorder.

Here's an excerpt from an article discussing treatment of BPD patients:

"Clinical guidelines for psychotherapy for patients with borderline personality disorder."

Psychiatr Clin North Am. 2000 Mar;23(1):193-210, ix.

Stone MH.

Department of Psychiatry, Columbia College of Physicians & Surgeons, New York, New York, USA.

"In planning a course of psychotherapy for borderline patients, clinicians must take into account the heterogeneity of the clinical presentation in the borderline domain. Borderline personality disorder is usually accompanied, for example, by one or several "symptom disorders," such as an eating disorder, depression, posttraumatic stress disorder, premenstrual tension, dissociative disorder, or anxiety disorder--not to mention one or more other personality disorders. The nature of the "comorbidity" in each patient will determine which medications, if any, are applicable. The accompanying personality disorders will have an impact on amenability to psychotherapy. The main forms of therapy currently in use are supportive, cognitive-behavioral (including dialectical behavioral therapy) and psychodynamic (including transference-focused psychotherapy). Group therapy is often used adjunctively with any of these approaches. The main question is no longer, Which of these approaches is best, overall? but rather, Which approach is best for which type of borderline patient? Contemporary research is addressed to this latter question."

***

-LOAnnie

[atwittsend]

Its the endless projection which prevents awareness. Also, there seems to be "forgetfulness" once the rage outburst is over, to minimize the need for therapy. How can they not remember what happened even when no alcohol was used? I remember every word that was said.

they cant remember cause they are dissociating when they rage.  they arent grounded in reality. 

[SeaCliff]

Thanks, LOAnnie. Is there an experienced BPD (with possible PPD tendencies) specialist in the West Los Angeles region who you may recommend (or anyone else here on this site)? Does the removal of a potential pituitary or adrenal gland growth (typically a benign tumor as suggested by several medical experts familiar with my situation) potentially improve their personality disorder somewhat in the short term prior to the start of any long term BPD therapy?

Thanks for your help. I do appreciate it.

[atwittsend]

www.borderlinepersonalitytoday.com/main/states/california.htm

thats where id start Rick... .

[SeaCliff]

Thank you, "Atwittsend". I do appreciate the list of L.A. doctors. Your website name describes my situation exactly due to my absolute shock and complete disbelief in regard to my current relationship situation as I, too, am completely at my "wit's end".

[atwittsend]

yep when I came here I was a disaster!  that was July 09.  there was no room for my own identity in that relationship!  I just put out fires for the girl 24/7.  it was killing me. 

[LOAnnie]

I haven't come across any studies at all regarding pituitary gland or adrenal gland tumors in relation to BPD symptoms.

But if I do I'll post the links.   Sorry, but I have no links to psychiatrists who treat BPD other than:

www.borderlinepersonalitytoday.com/main/BPDlist.htm

By the way, if you'd care to share, is your BPD ex left-handed, and did she or does she have any dyslexia?  That is a correlation I am curious about (and posted on an earlier thread) as a possible physical marker,  based on my BPD/NPD mother, having to do with the possibility of left-brain damage in BPD.

-LOAnnie

Thanks, LOAnnie. Is there an experienced BPD (with possible PPD tendencies) specialist in the West Los Angeles region who you may recommend (or anyone else here on this site)? Does the removal of a potential pituitary or adrenal gland growth (typically a benign tumor as suggested by several medical experts familiar with my situation) potentially improve their personality disorder somewhat in the short term prior to the start of any long term BPD therapy?

Thanks for your help. I do appreciate it.

[SeaCliff]

Thanks, LOAnnie. My ex-BPD is right handed, and she is an avid reader herself with no dyslexia problems. She has perfectionist artist traits as that was her backgroud. She has always been too hard on herself. Sadly, I saw more good in her (as did her friends and family) than she did in her own self.

As she was certain that I stopped loving her, she completely "split" as severe as possible. Yet, I keep trying to show my love and support for her if only for the sake of our children at this point.

[O'Maria]

Very interesting comment about therapists' unwillingness to treat Borderline. I understand now from what I have learned that its a hard illness to treat. Maybe because there are so many tragedies in early childhood that shape the person. My ex didnt even touch the childhood issues before I asked about his constant irritation, anger, instability and jealousy. It was so obvious to me that he needed treatment.

I have not found an expert in central Florida yet. There are several counselors interested in family therapy, trouble with relationships but not too many who are willing to treat any personality disorders. I read that all PDs are hard to treat and from experience I can tell that I didnt even succeed in talking about it, I was accused for being Miss Perfect, or Crazy B, or something similar.

How can a therapist know whats going on between BPs and non-BPs if they don't ask us, the victims? A therapist can easily be mislead to think that a functioning, nice looking, polite (outside home), educated guy has some temporary stress issues.

[O'Maria]

What were your experiences with dissociation during rage? How do you treat such a misbehavior?

I was totally confused, never prepared for the sudden anger. It could happen in the middle of an everyday conversation, during a TV program, in the traffic, in the store, in the restaurant. Just one "wrong" look from somebody could trigger impulsive behavior. I still don't understand the sudden adrenaline rush and how you could ever treat such a hormonal imbalance in a guy.

[LOAnnie]

Here's a link to an article on why a lot of therapists do not choose to treat borderline pd patients.  I get the impression that its because most therapists just aren't prepared for how incredibly difficult, hostile, negative, uncooperative, manipulative, blaming, and irrational BPDs can be. We adult kids of BPDs have been putting up with their crap our whole lives. 

We're used to it; they're not.

www.psychcentral.com/blog/archives/2008/04/02/why-do-therapists-stigmatize-people-with-borderline/

-LOAnnie

[O'Maria]

LOAnnie,

They are incredibly HOSTILE and behave like monsters, at home.

Loved ones get the worst treatment.

But I guess seeing the same therapist for a while makes them less shy to act out.

[LOAnnie]

Here's an excerpt that I think explains really well why it is that those closest to the BPD/NPD get the worst of their behavior:

--- In WTOTransition@yahoogroups.com, "scrambled75" <stujwils@... .> wrote:

"I have posted this before but it may be worth saying again. It is something I read in Richard Skerritt's book 'Meaning from Madness'.  Basically, borderlines and narcissists live in great fear of being negatively judged by others so they project an image they feel will be acceptable (i.e. mirroring). But they will only do this so long as you fall outside their definition of 'self'. Once you fall within their definition of 'self' (i.e. through marriage or the like) they are no longer motivated to impress you, but to control you so that you ALSO project that image to those outside. All perceived flaws must be eradicated.

I don't think it is a case of them consciously choosing when to be nice and when to be nasty. In general, they will appear to be nice so long as you are on the outside."

This explanation works for me because my BPD/NPD mother actually told me on more than one occasion that I "had to love her."   So, in her mind, she could do or say anything at all to me, anything she felt like, because I had no choice; I had to love her.   Its that "treating other people like objects or possessions without feelings" thing, that narcissistic component to BPD that is so damned horrid to live with and so incredibly damaging to children.  

Anyone who is suspected of having BPD should really be very thoroughly examined and assessed and monitored closely if she has children; its just unconscionable to allow little kids to be raised by a mother who is incapable of relating to her child as anything more than a possession or an object without feelings.

Its a recipe for tragic emotional damage to the child.

-LOAnnie

LOAnnie,

They are incredibly HOSTILE and behave like monsters, at home.

Loved ones get the worst treatment.

But I guess seeing the same therapist for a while makes them less shy to act out.

[O'Maria]

Whats dissociative disorder?

I remember my ex in a state of rage, his eyes moving very fast, tense muscles, mouth foamy, yelling - terrible memory. When he calmed down he said he went "a little too far". At the same time I had to leave the house and call the emergency line. He said he didnt realize he raised his voice. Is this dissociation?

Whats the basis for fast marriage and trapping their loved one as soon as possible, it seems to be quite common that they want to make sure youre locked in before the abuse starts. There seems to be a total lack of empathy.

[O'Maria]

Is the perception of you being theirs also the reason why they don't need to impress? This means they will never work on a relationship and understand the concept of mutually fulfilling.

I heard him say many times: You either hate me or love me. You said you will love me forever.

So he counted on me being there forever even though he treated me like dirt.

[2010]

What you want to find is a therapist that specializes in PTSD. You are in need of a listener that understands the stress you've had to endure. You will spend a fair deal of your time re-living the bad experiences by re-telling them to a therapist. This hopefully sheds off the confusion and doubt that it was your fault and releases the pain. Once you've re-lived most of the bad, the therapist should guide you away from toxic shame, on to anger and then acceptance that this person will not change unless they do their own work. Your work is your work. Your brain has to heal from the emotional trauma. This can only come after you let go of controlling the outcome of the BPD's life.

Stay away from Dialectical Behavior Therapy. It is a business model.  It is social/emotional training for persons suffering from BPD. If you are a non-BPD with a BPD loved one or family member- you can get pulled into a false hope with DBT businesses. Speaking from experience, I wasted 6 years. Dont gear your therapy toward the BPD partner. BPD partners have a laser like precision of falsifying presentations and making you look BPD- which really treats the DBT therapist to a second patient.

Find a therapist that deals with your own emotional trauma and not DBT couples therapy. Google "borderline males" and you'll find a few women therapists online that do phone consultations. Hope this helps.

[O'Maria]

2010,

I probably suffer from PTSD after all the abuse. And now I have to relive all those painful memories.

I am a non-BPD, don't have any personality disorders or other mental illnesses. No abuse growing up in a normal hardworking family. As a teenager I fainted a couple of times (low BP) but since I lost conscience my mother had me tested for all possible diseases including epilepsia (came back negative). At the same hospital I had brain scans and electroencephalograms. Everything came back normal and I have never had problems, never used any medications or drugs. My self-esteem took a hit during this turbulent relationship and like you said their laser sharp attacks and projections cause emotional damage. Maybe more than I am aware of. 

This is the first time I feel the need to talk to a therapist individually to get my energy back.     

[PotentiallyKevin]

Anyone who is suspected of having BPD should really be very thoroughly examined and assessed and monitored closely if she has children; its just unconscionable to allow little kids to be raised by a mother who is incapable of relating to her child as anything more than a possession or an object without feelings.

Its a recipe for tragic emotional damage to the child.

-LOAnnie

Amen LOAnnie. Unfortunately my exBPDgf's mother was allowed to adopt a girl from China. So not only is she screwing up her biological children, but gets to add trauma and tragedy to already wounded/abandoned Chinese girl.

[PotentiallyKevin]

Find a therapist that deals with your own emotional trauma and not DBT couples therapy. Google "borderline males" and you'll find a few women therapists online that do phone consultations. Hope this helps.

Sorry mate,  I will have to disagree with you here. I found a therapist who specialized in DBT, and actually uses DBT with me. DBT can be wonderful for anyone, skills like mindfulness and self-awareness can help anyone detangle their stressful emotions. Also, a therapist who specializes in DBT will know intimately what it is like to be in a BPD relationship. They have worked with BPDs and know them in and out. My therapist was very blunt with me and told me to get out of the relationship, that I was playing with fire... .this was coming from someone who almost exclusively works with borderlines. Just because they work with them, doesn't mean they are "on their side."

In my opinion, a therapist who is skilled in DBT is a great plus!

[O'Maria]

I was told to get out of the relationship too when I saw a counselor. The therapist said very clearly that this man is mentally ill although he didnt mention Borderline.

He asked me if I can identify the pain and if I have changed while living in a chaotic home. Very good questions. After this I started reflecting more over what happened and also analyze the stressful moments. I found this website, I read a book called Emotionally Abusive Relationships and Bingo! I am a typical victim of verbal and physical abuse. In this book they list BPD traits and my bf has 9 out of 10. The selfmutilation came out one night when he took a kitchen knife and held it over his wrist.

I read another book called the abusive man - can he change. Went through a list of situations and came to the same conclusion as the counselor "unlikely to change". Too much crap for too long, hates psychologists and is in denial.

 

[PotentiallyKevin]

 Wahahaha! My BPDgf read that book: The Abusive Man - Can he Change, and came to the same conclusion about me! 

When I asked her how I was being abusive, she stated that "shoving BPD down her throat" and wanting her to get therapy was abusive, and so was not respecting her. When I asked her how I was so disrespectful, she stated things like my car is never clean enough and that if I really appreciated her, my car would always be clean. Or because I stopped dressing up for her as much as I used to meant that I was doing this on purpose to disrespect and undermine her.

I am sure standing up for my feelings was abusive to her, or not inviting her out with my friends was the ultimate abuse anyone could ever do to another person.

Lastly, because I couldn't quite get over her infidelities, by not forgiving her completely - was abusing her.

Forgive me world, I am such an abusive d-bag!

[SeaCliff]

Mobo -

Since you seem to know a lot about BPD as well as have answered some of my posts in the past, do you know anything in regard to hypnotherapy possibly helping someone with BPD and one or more personality disorders? As I already describe my Severe Borderline wife as acting as if she were under hypnosis due to her dissociative behaviors, it may be very ironic if a hypnosis treatment actually improved her mindset?

I have had a few people who I know (including a hypnotherapist friend) tell me that they are beginning to see more success with hypnotherapy and BPD as they address each of the 9 (or more major) symptoms such as "abandonment fears", "dissociative paranoia", "emptiness inside", "lack of impulse control", and others one by one in the hypnotherapy treatments within supposedly a relatively short period of time. What do you, or anyone else, think in regard to this same potential treatment?

Here is an article link (Google: "Hypnotherapy and Borderline Personality Disorder" for several other articles too) -

www.selfgrowth.com/articles/borderline_personality_disorder_and_hypnotherapy.html

[2010]

a therapist who specializes in DBT will know intimately what it is like to be in a BPD relationship. They have worked with BPDs and know them in and out. My therapist was very blunt with me and told me to get out of the relationship, that I was playing with fire... .this was coming from someone who almost exclusively works with borderlines. Just because they work with them, doesn't mean they are "on their side."

Unfortunately for me, this was not the case. The DBT center that I endured was insufferable in their quest to "school" both of us, telling me time and time again that if I could not make it work with my BPD partner, that I would be unable to graduate the "classes." It was by far the most emotional and needless torture that I have ever experienced- 6 years of false hope and emotional rape. And in the end, when I walked out, the BPD partner nearly brought their business down by projection, blame, and rage.

I learned a valuable lesson and I'm hoping that the DBT center learned their lesson too: that is, it is a mistake to think that therapists enter the profession because of their remarkably well adjusted personalities and know everything about DBT.  In order to know about BPD, you really have to LIVE through it. It's a mistake to assume that your therapist has that previous experience.

DBT is a business model- run by people in the business of offering you reaction formations. They have no vested interest in seeing the BPD person or the partner walk away. The bottom line is: Do it like you did- SOLO and on your own therapy schedule, but do not go into therapy with the BPD partner. It's madness.

[PotentiallyKevin]

rick22, that is definitely an interesting angle on treating BPD. I do know that hypnosis works better on people who have poor cognitive control than others... .when i studied hypnosis in one of my psych classes, the studies showed about 10% are highly receptive to hypnosis and 10% are almost completely immune to hypnosis, the other 80% are somewhere in the middle. I am such a skeptic about hypnosis - I have also NEVER blacked out while drinking and I used to be a heavy drinker. I have passed out before from drinking, but I remember ever moment up to head spinning out of control and passing out. But, I do have friends who swear they "black out" when drinking, or cant remember what they did but were perfectly active. My exBPDgf was someone who blacked out a lot from too much drinking... .she also "dissociated" many times in our three year relationship - those moments were always #@$%#$% bizarre.

Anyways, i have a theory about cognitive control, blacking out, and hypnosis. I bet borderlines are highly receptive to it - but what exactly would hypnosis accomplish? Borderlines most likely have a biologically unsound brain that cannot be "reversed." This means, they will always be highly reactive. They need to learn skills to combat this such as reality testing, mood regulation, and many other CBT related skills.

I have bipolar disorder. My moods will never be "normal." However, I have been medication free now for 5 years. I no longer feel I need it. There are weeks when I am chemically depressed or chemically elated, but I have learned invaluable skills through CBT to challenge my underlying beliefs and thoughts and how to regulate my moods through taking the appropriate actions. I am a huge believer that you can learn to think healthily even though the brain might be "off key." I am not convinced that hypnosis - or any other therapy that deals in the subconscious - can teach these skills. It may be a powerful tool in dealing with trauma, and may be a great addition to CBT/DBT but I highly doubt that it would be effective by itself.

Very thought provoking though. I am a big believer that the best solution for a borderline is a combination of CBT/DBT and a psychoanalytic approach that deals directly with core trauma such as transference-focus therapy. I am not convinced that DBT alone will "cure" BPD, but it will substantially help with the borderlines ability to function, which is probably the most important factor in treating BPD - hence why there is so much focus on DBT and it has been receiving the most spotlight.

[PotentiallyKevin]

2010,

Sorry to hear about your bad experience, it took me MANY therapists when I was being treated with bipolar disorder to find "the one." Also, I went through a few therapists that claimed they knew DBT before finding the amazing therapist that I now see, who specializes in DBT.

I think your problem is that you went to a ":)BT Center." Most of these "get healed quick" centers don't work out the way they claim and are concerned entirely by profit. You are right, they are a business, not a practice. Find an individual THERAPIST who specializes in DBT. Interview them before you commit to a session. Ask them exactly what they know and how they feel about BPD. I put in my add:

"I am looking for a therapist who is experienced with the relationship dynamics of borderline personality disorder and codependency (<-- other than I hate that word now!). I prefer someone who is experienced with DBT and has years of experience working closely with both borderlines and partners of borderlines."

Also, I am a big believer in having a SEPARATE therapist than the BPD. One who is solely yours to work out your issues with you. There is no need to for the BPD to have contact with your therapist.

[SeaCliff]

Thanks, Mobo. I appreciate the exceptional feedback as well. I do believe that therapy (short and long term) may be very helpful to people with various personality disorders. The proposed hypnotherapy treatments probably may be much more effective if done parallel to a another long term therapy treatment. I have never personally been hypnotized, but I have several close friends and family who have been and they really believe in the potential for improving Borderline behavior.

From my perspective, it seems like a moderate to severe Borderline is someone who may be hypnotized easier than the average person off of the streets due to their weakened cognitive thought processes. I know and understand that there is no magic short-term "cure all", but I am interested in the possiblities of hypnotherapy treatment if done with a solid long term therapy treatment as well.

As we are controlled more by our subconscious (our primary controlling layer of awareness which stores our knowledge, habits, beliefs, and attitudes) and unconscious (human body functions like breathing, heart beating, reflexes, etc.) mind more than our conscious mind (Our analytical mind - the least amount used of our 3 main layers of total awareness to life), then possibly these hypnotherapy treatments may be beneficial to some people. If you really want to CHANGE someone, then you really need to get to their subconscious mind anyway possible. Here is a short article on the 3 main layers of the mind's awareness -

www.my-introspective.com/Myself/7.5.3-Levels-Of-Human-Mind.htm

Since I prefer to take various "wild" ideas and throw them against the proverbial "wall" to see if they stick, then I try to be somewhat open minded to any and all solutions no matter how dumb the ideas may first appear to others. Since I am willing to laugh at myself first, then I am not as concerned about others laughing at my "wild" ideas. As my Borderline is into Yoga and Pilates, then possibly I may one day convince her to try this more spiritual type treatment. Who knows? I am desperate to try anything at this point.

Again, my Borderline already acts like she is under hypnosis due to her dissociative behavior so why can't this same "hypnosis-like" behavior be reversed? Here is another article link below on hypnotherapy treatment and BPD. Please read at least the middle portion of this article under "hynotherapy" as this same person writes about the benefits for various mental health disorders like BPD and even schizophrenia.  

What is most intriguing to me about hypnotherapy is that they may be able to address some of the patient's early childhood trauma issues which may be the root cause of the same patient's current personality disorder behavior! If I can't "cure" my Borderline, then perhaps I should consider being hypnotized myself so I stop caring so much about her (somewhat of a joke). Article link here -

www.naturalbloom.com/articles/hypnotherapy-185/