how does therapy normaly work?...

[qwaszx]

my friend has BPD, she been in therapy for over a year now, hasn’t even gotten a clear diagnoses, and seems like shes gotten worse since she started.(when we met she held down a job for 2 year with some help from me and our boss, she worked out, lived away from home, was trying to sort out her life, we would spend 3 good months and then 3 really hard months, but at least she had a system, now she seems to only be falling down) we've been friends about 4 year, I’ve lived with her for about 3quarters of that time, but couldn’t watch her beat herself up(or stand the mental pain i was in, she was/had taken over my life) anymore, so I left.

We are still very close, we talk every day, she actually helps me out a lot sometimes, and can be the greatest person. and i still just want the best for her and for her to find some peace in her crazy little world.

now my question is wft are the therapist doing? is she not getting what she needs, cuz shes feelin like shes tried her hardest, is failing and isn’t doing ok at all. the only thing I’ve seen is her regress and fall flat on her face, she’s been down pretty well ever since she started goin, so about a year ago... . she cant even get out of bed half the time, and cant work. she still rages, self-harms and is gettin more creative about how shes goin to die(she even once bagged me not to save her and just let her die :'()

shes lives wih her mom now, in her late 20s, with nothin really, had a ~ed up childhood. her moms a bit possive also(pretty sure she might have BPD to, but honestly i have no clue) and if either of them are in a bad mood is a good battle, lot of emotional abuse, manipulation, and odd thinking(her mom will tell her that she can’t trust anyone, that she's the only one who will stay by her, she says a lot of weird stuff  my friend feels trapped and like she can’t leave because she'll be hated by her mom, I think it’d be healthier for both them to be apart. my friend will also throw stuff, hit walls, punch herself, cuts, binges etc. behind closed doors) she has no Idea how to handle her emotions and I fear that one days she will go too far and kill herself... .

when she first started goin they seen her once every month, and the first woman she was seeing ended up getting transferred to a new location. So she started seeing this new therapist who, after a month or two started seeing her ever week.

Last week my friend had about 2 really good days, where she actually got up and spent some time making herself feel pretty(this is huge for her), she felt like she was getting somewhere, she might have a life. On the second good day she went to her appointment with her therapist and was told she would only get seen every other week, so my friend panicked after, and has been on the floor again ever since, shes been either crying her eyes out, numbing or raging for the past week.

I think they are failing her, and Im getting tired of feeling like they aren’t doing enough, that she isnt in the right program, that there being ignorant of her mental state, to me it seems like common sense, give her a program and stick to it, dont jump around, she needs something routine with strict guide lines in her life, some stability cuz shes not stable, something that just stays solid and safe every time, if its a bad week nothing changes, if its a good week nothing changes. something consistent until she gets back on her feet... . DBT not CBT. i honestly feel like shes givin it her all, and would give it her all, she desperately wants and needs the help... .  

Am i being to untrusting of what they’re doing? Am I wrong in thinking that she should be goin at least one or even twice a week(like come on, when you learn to play a sport you get coached every week once or twice a week! But when its her life she needs a coach for she gets told every 2 weeks? How does that make sense?) or am I right in thinking she needs more then this and shes falling through the cracks?

ps i think she needs to get out of her mom’s too, but she isn’t stable at all and has nowhere to go. Kinda out of ideas here…

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[XL]

Welcome. It is easy to fall through the cracks in therapy.

I was actually the first to be diagnosed with BPD tendencies (learned from mother no doubt). I did go through a rough patch of trying to get therapy and failing (insurance wouldn't cover, regular doctors just dumped drugs, the level of crazy was beyond the reach of newbie talk therapy, insurance only covered group therapy, etc).

I finally got in with a GOOD DBT therapist with a PhD and clinical inpatient research/practice with BPD. I started going twice a week, then every other as money got tight. It's worth paying for by any means if insurance won't cover.

Therapy can be draining. You start making changes, and start parting ways with negative influences. It can be a time of upheaval. However, I went through this process well away from my crazy family, and was able to make great changes. I'm worried your friend is stuck in a conflict cycle with their mother. I did need some distance to realize how angry and confusing my childhood was, and experienced some great rage when I started to realize that my negative behavior was learned. So I agree that sharing a household with a disordered parent might be blocking progress.

You really do need to bring in the "big guns" (PhD level, well qualified pros) to deal with this, I'm afraid. Some talk and family therapists mean well but don't quite get how deep this problem runs. The DBT therapists will track binges, drug use, cutting with a smile and a nod. They really operate like an unflinching "disciplinarian" for the patient, yet expect some screwing up to happen along the way. The goal is a slow and steady harm reduction, not immediate elimination. They also aren't afraid to assert a firm "no, normal people don't do that" if needed. The communication skills are crucial as well, and in some ways it's a kind of re-parenting. A lot of these are on the workshop pages (DEARMAN, SET, etc.)

The hard thing too is that life keeps happening. Jobs will be lost, relatives will die, cars will break. These things can cause setbacks to people who aren't very resilient.

One of the best things that helped me was quality, non-emotional activities with stable friends. Movie night. Gym time. Healthy things that get you out of the house on a predictable schedule and reinforce that you're not a lost cause. This might be where you should focus your efforts on your friend.

[qwaszx]

Thank you for the feedback, ya im working on getting her way from her mom, i know they're locked in a cycle, she has a lot of resentment towards her, but being the only parent, or person she has its not easy on her to walk away... . shes covering some of the bills with the money shes getting insurance, so she leaves, her mom loses the house, and they both have nowhere to go... .   plus shes terrified to live on her own, i dont know if she can right now to be honest... .   when it was just her and i living together, anytime i left(even if i made she she was ok) to go see my family/friends i would home and spend the next week rebuilding her... .  

As far as the friends thing goes, thats were i fall in place, thats what i would do, we'd get out, go to the zoos, go to the lake, go for a walk, whatever, just to get her out of her head. shes so bloody ashamed of herself right now that those little things were really hard on her... . but now i live far away, so i cant even do that... .

Also, we dont have the money... .   how long do i ask her to hold on, when i know we're pretty f**ked? shes going to keep trying, but we both know shes not getting what she need, and its pretty hopeless at this point. I dont care, i refuse to give up on her, cuz i know she can do it with the right help. i guess i'll keep building my life, do what i need to do and when i have that sorta money i'll go back for her... . unless there is someother way to get that kinda money, i donno... . :'(

[Grey Kitty]

  qwaszx

I remember all too well how hard it was to watch my wife when she was hurting herself, physically, or just emotionally beating up on herself. Before I understood something of what was going on, it was pushing ME to do things that seemed crazy, and sure didn't help the situation for us.  

We aren't trained professionals around here... .   so we can't really say what sort of treatment somebody needs... .   but what I have heard points in the direction you are thinking--CBT doesn't seem to work as well as DBT, and DBT does involve more time than every two weeks.

Here is a link about DBT for you:

The basic principles behind Dialectical Behavioral Therapy

All that being said... .   you still can't control her treatment... .   the best you can do is advise and hope. One of the best things you can do is take good care of yourself so you are strong and able to support her.

What does it mean to take care of yourself?

How are YOU hanging in right now?

GK

[qwaszx]

oh im hanging in there, just sad at the moment... .   its frustrating when people are always like seek treatment, see a therapist, etc. to her and after years shes ready to get help, and is doin all she can and its almost more of a trap. its like "heres a safety net, we'll help you, you can do this" and i turns out all to be a lie pretty well. how can she not look at herself and think "im failing" when she has some "professional" support and its not working... .   and how can they ask someone to trust them, but be pretty much lying to their face about everything? she already has trust issues! I dont want her to think that the whole systems a joke, and not being honest with her... .

im just sour to it all, and i doesnt help that I've gone for myself to two different places across the country looking to get a therapist, and i have never heard back. just went in filled out the assessments and nothing. the other problem is im no good at goin in and not always end up putting on a brave face, cuz the last thing i wanta do is have some melt down if they ask a touchy question and cry, so i beat around the bush a little when it comes to me. So they think im ok anyways. also im very day to day, if i feel ok going in then i think maybe im actually ok... .  

i dont understand the system... .  whats the point of me goin there if they cant help anyways? all she told me is i have to find a doctor first, cuz i dont have one anymore, and that they couldnt help me if i didnt have a doctor, and then they tell me well there are no doctors anyways... .    so i was thinking i might have to relocate again, and try finding help from another part of the country... . blaha, maybe im just not waiting long enough to find someone here for me... . i still should have heard back my now though, its been over a month... . and i hate hounding people and asking for help.

i was always taught to put everyone before me, that i was a selfish person if i didnt do that, and i learnt the hard way you cant do that. My mom growing up was also controlling and a bit over bearing. My dad was always just say “stop fighting and do what she says”, mean while he was like a slave to her every wish. Im a little confused about my child hood  My dad lives in cronic pain, and is addicted to pain pills, and they just split, so im back to bein my dads bestfriend, and im off topic, and just venting now, opps sorry…I also have ADHD and have never had any treatment for it... . so that something else I need help with.

so im right now working 3 part time jobs, im getting back to things i used to enjoy doing, sorta but i dont really enjoy them anymore. went out this weekend with my friends, first time in awhile so that was fun. Looking at what i need to be doing so i can get the grades to go back to school, and get the help and supports i need in place... . anyways its not all bad by any means, im just frustrated right now... . and a tiny bit stressed  

[Grey Kitty]

It is a shame that getting therapy figured out is so hard. I've done more on my own than with a therapist... .   and when I did find some, seldom had insurance covering anything. I wish I could give you more help there.

i was always taught to put everyone before me, that i was a selfish person if i didnt do that, and i learnt the hard way you cant do that. My mom growing up was also controlling and a bit over bearing. My dad was always just say “stop fighting and do what she says”, mean while he was like a slave to her every wish. Im a little confused about my child hood  

No doubt that that "lesson" hasn't served you very well now that you have grown up and moved out of that system!

What is your relationship with your friend who has BPD? Were you roommates or dating, your story isn't quite clear to me.

[XL]

I was able to do a sliding scale with my therapist, and only went every other week (she wasn't totally pleased about that, but I think I did respond well over time).

There are a lot of educational materials as well. Lineham's books and work books are a good start if money's a problem. The DBT therapist can catch a lot of faulty thinking in the act though, so the workbooks might not be great for someone in real distress. (May be better for you than for friend).

You ultimately aren't financially responsible for your friend. If they are already spending money on CBT though, it could be worthwhile for them to make a lateral shift and seek DBT.

[qwaszx]

funny you should ask that, i actually have questioned just where we stood in our friendship... . We weren’t in a relationship, but we might as well have been. I honestly dont even know, and I know that makes no sense.

she acted the same way with me as shes done with every guy i've seen her date since(ps im a girl). etc, held my up on some plat form, stole my views/beliefs(which it the time i believed were hers, in a sense became me:S), its the weirdest feeling that she projects when shes on cloud 9 and idolizes you, i feels like shes an angle, lmao... .   shes tried to "fix" me(and trust me i never asked to be fixed or gave her a reason intentional to think i needed fixing, i told her i had just went through a huge loss... . my boss who was like my father figure died in a tragic accident, lost my job(the people there were very much my family), lost my house, i lost everything that truly mattered to me. and my mom was kicking me out yet again, i was grieving but i was gettin back on my feet, bottom line, i was going through a hard time and needed an ear who wasnt directly involved, things were starting to look up, i was looking to start a new life, and the job we met at was one i could get the hell out of my town and would have a place to live... . i was 18 at this point, i guess she took it wrong),

she gets almost zen like and it makes you feel like you can tell her anything(to be honest i can, and i still do. i trust her with my feelings, and im very open with her, im putting myself first in almost everyway and having learnt enough now about her, i know deep down her intentions with me right now are good, all she wants for me is the best, though sometimes gets over run with feelings and cant give me that. all she tells me now is to live my life, not to worry about her and that i'll have her support  in chose to do, i feel like our relationship right now is healthier then its ever been, were working on alot as far as my boundaries go, i express myself, what i want and what is and isnt ok in regards to me, if i start feeling way over whelmed i get her to back off. she doesn’t want or mean to be the way she is, if you minis all the crazy, shes one of the best friends i've had and listens to what i need to say even when maybe she shouldn’t).

she once told me when we first met she didnt want me to feel alone(i never really even felt alone until i met her, and went through the motions, i never understood what she meant, i assume now it was her feeling alone, and she didnt want to feel alone) she perfected herself, projected herself on to me, gave me almost $2000 worth of stuff, pulled me in and pushed me out, very very black and white views, very dominate/possessive(would get mad if i had friends over, told me it upset her that i text my friends because she didnt have any, would tell me she didn’t want me in the house and then if i went out would be mad cuz i left... . i missed alot of  's, soo glade were past that part, i missed my freedom) with me over time... .

grey kitty, i think the same goes for me, i've done a lot better on my own then even getting supports. all that seems to do it stress me out... .   but i know i still need something along the way so can keep getting my life sorted out. Thank you for hearin me out

XL what is sliding scale? Im going to try looking in getting "Linehams books and work books", do they sell them in stores? where do i find them?

... .   what do you mean by "the DBT therapist can catch a lot of faulty thinking in the act"? will the books hurt her in anyway if i grabbed them for us both, can some of the stuff be twisted in her mind?

I know im no responsible for her, id like to be in a position to be able to do more for her is all, id like for her to recover, id like for her to be healthy and happy... . like hey if i win the lottery at any point first thing im doing is sending her butt to the best mental health care facility in the world so she can get the help she needs... .   i try and stay hopefully that her life will one day be the one she deserves... .   that everyone deserves... .   maybe just an ounce of peace for her... .    the reality of it is, is that she might never get that, and her life will remain in constant pain and turmoil... .   and that crushes me. i sometimes feel as though shes a cancer patient, whos giving up, simply waitin to die, and all i can do is helplessly watch from the side lines as she fades into the darkness, trying to support and encourage her for a battle im not sure anymore we can win... . :'( i try and stick with the up parts, like one day she might get with she need. i look for every angel to tackle this nightmare she lives in... .   pretty much concidered it all i think... .  

[Grey Kitty]

qwaszx,

I've seen several posters here who are "not in romantic/sexual relationships" with their pwBPD. Some were, then broke up but became "friends", others were more like you. They seem to have mostly the same issues dealing with their partner that people in a "normal" r/s have. They seem to find that the same lessons and tools here on these boards help them in the same way. So I'd recommend you just accept that the status is kinda ambiguous, and do the best you can with it.

As you said, she treated you the way she treated every guy she has been involved with... .  

If you want to maintain some sort of friendship with her... .   which it sounds like you do... .   then you need to accept that (at least for now) she's in a difficult emotional state... .   and that you need the right tools to deal with her and take care of yourself.

I have to say that when you educate yourself and work on your side of things, it really does help a lot.

Have you started reading the Lessons? (in the sidebar)  ------>> >>

You might want to check out this one: Tools: The Do's and Don'ts for a BPD relationship

[Auspicious]

A sliding scale is when a therapist adjusts their fees depending upon the client's income. Some therapists offer this, some don't.

Marsha Linehan's books are available via libraries, Amazon ... .  

I wouldn't think the books would "hurt" her - though it would be much, much better if she could actually go through real DBT therapy. There is group once a week, individual once a week, and she would be able to call her therapist for telephone support when needed.

[qwaszx]

Grey kitty,

I do accept that our relationship is whatever it is. Its confusing sometimes and im trying to figure out just where I need to be to keep myself balanced and be of better use to the both of us. I have read a couple lessons, plus multiple books on the disorder.

Most of the stuff I was talking about when i had first met her, and i had no idea the BPD even exist(i was pretty set in believing in pretty much any mental illness wasn’t real). I was way over my head, ignorant, and was going in blind folded.

It took me a good year to figure out what she has going on. i reserched countless mental illness, trying to figure out just what the heck was goin on.(i've always been a truth seeker), saw "I hate you, dont leave me" in a book store, was like crap, thats her, got it read it all.

I now understand what’s going on at least in the way she think, feels, ways she acts. as far as when she would rage about something, i was never someone who would take it personally (when my dad was coming off his pills he would rage, so i learnt quickly that it was something going on in his mind, almost ignore it and not to let it get under my skin, that it wasn’t even about me, i just happened to be the only person around at the time) but i did ware out over time, and all that changed. its hard juggling when you don’t know what’s going on from day to day, or who would be walking in the door. It doesn’t even matter now, what’s done is done.

so yes, thats what im looking for, more tools for me. i do want to maintain my friendship with her. "accept the fact that shes difficult emotional state" im not sure im understanding what you mean:S.

like right now shes down, shes been down for over a year, with little to no breaks from this. i've been pretty well accepting of this for that long. just sitting back waiting, doin my thing. living my life. saying that its a slow process for her, that its her life, just being her friend and sayin to myself it just take time to heal after all she been through and has going on in her mind right now. i feel like as far as her emotional state goes that hasn’t helped at all... .   i guess id just like to have seen some sorta progress by now. I feel like there needs to be some change because quite frankly what they're doing isn’t working. They either don’t offer what she needs or don’t have the knowledge to give her that kind of treatment. i know i can only take care of me and live my life, are you just meaning i have to take a step back again?

Auspicious

I'd love for her to get in a real DBT program, and im really happy you said what i've read about what a real DBT program offers... .   starting to wonder if no actually offers a real DBT program. Though no one we know can afford that anyways, so we just work with what we have and hope for the best... .   i'll mention the books to her, and see if we cant start with something there for now... .  

[Auspicious]

See what you can find.

I found a real DBT program in our area, and my wife went through it. They did try to work with people of limited means.

It's well worth looking for and asking about.

[qwaszx]

so i've been looking for a therapist in her area who knows BPD or/and does DBT, there are none:-/ the only thing i've found is someone who does CBT, practicing Buddhist and meditator, said she had been teaching mindfulness and how to meditate for many years, studying at Sensorimotor Psychotherapy Institute, and does neurofeedback, she works with people with PTSD... .  oh and she does sliding scale... .  shes just father away... .  

i know its not a real DBT program, but she wasnt scared either about her having BPD.

the one shes seeing now seems afraid to title her with BPD, even though my friend brought the "i hate you dont leave me" in with her, told her therapist that she fits all 10 of the criteria, her words "she scoffed me and said you can read anything and find things you will relate to" so now my friends overly confused, is it therapist denial? shes had every one of her therapist tell her something completely different... . ggrrr... .  so this is the last day she has with this one, and gets a new therapist a couple weeks from now (not by her choice, this has been the third to drop her the last year)

I still feel like they are dentist trying to preform brain surgery... .   

[Auspicious]

In the US, if I'm not mistaken the only people who can actually diagnose BPD (or any other mental illness) are either a clinical psychologist or a psychiatrist.

It's tough. On the one hand, you don't want to get so wrapped up pushing for a specific diagnosis - for one thing, what if you are wrong?  Also, I can tell you personally that a diagnosis is not a panacea.    

OTOH, you want the most appropriate treatment for her, and accurate diagnosis would obviously be more likely to help with that.

[qwaszx]

ya im like 8000 present positive thats what she has. everything fits. her Psychiatrist sedates her to the point of drooling, she only sees him for 10mins a month... .  , and the psychologist only know CBT and that hasnt helped her at all. her one also panics when she would be really down or self-harm... .  when shes really down they call her in for every week, when shes ok they won’t see her for ever to weeks, she panics and falls on her face... . back to the start again. she cant handle the inconsistency. shes not functional at all, your lucky if she can get up to brush her hair or shower.(were in Canada)

the only reason we'd like to have a diagnoses is so that she can get the right treatment(trust me, i in no way want her to have BPD it might be the last thing id like... .  it sucks)