Is it worth pushing for a diagnosis?

[dimples2]

My husband of 22 years knows there is something not quite right with him but basically he's in denial. He stopped drinking about 6 months ago and none of the BPD behaviours went away (he just had less anxiety in social situations and I am more relaxed that he won't turn into Angry Drunk who rages at me once we leave the situation). I have been pushing for an assessment (quite gently, but I've put my foot down finally) because many times in the past he has made promises after rages and other inappropriate behaviours. Of course, once things are "back to normal" these promises always fade to nothing once I've forgiven him and am just happy to have peace in our home again.  He says I don't respect the fact he's stopped drinking (well, there can never be enough praise of course) and as I've told him, not much has changed (just what I described above). He is more agitated or dead quiet in social situations because he can't have those 2 or 3 drinks to calm him. As I've described in another thread, he has become super health conscious and exercises at least 4 hours a day. Social situations are uncomfortable now because he won't eat most of the food people serve and he just wants to leave so he can go burn calories.

Anyways, is it worth pushing for a diagnosis? I know he could draw it out (hey, it's summer!), quit treatment multiple times for multiple reasons or latch on to something else as the excuse for behaviours that do come up (currently, it's allergies, bladder issues, heightened hatred of his mother who didn't leave the dad as she promised through a horribly abusive childhood), etc. etc. I am emotionally detached enough now that I don't get sucked in for as long as I used to but I often second-guess myself and my concentration/productivity is very poor because I can't stop replaying things in my mind to confirm that my feelings and ideas are valid). I just thought a diagnosis might help me really confirm what I'm seeing so I don't second-guess myself. I am leaning towards leaving and thought it might also be valuable in separating as I know he will start a distortion campaign and I will really need something objective to hang on to them (and possibly show our teenagers at some point).

My therapist disagrees and can't understand at all why it's important to me. She feels I should just understand that I don't like his personality and leave for that reason (she agrees he's verbally abusive based on my examples as well as impulsive and emotionally dysregulated, attention-seeking and controlling). It's not enough for me. That leaves room to say I haven't tried hard enough; I am being superficial; I'm bored of him or fed up with things that I should have known were "part of the package". I am way too committed to leave based on those reasons but I would respect the opinion of people who have received a diagnosis of their significant other and what it did for them or the opinion of those who were able to move on or at least make some real decisions without one.

Thanks!

[schwing]

Hi Dimples2 and 

Pushing for a diagnosis when you uBPD loved one is in denial of their disorder is like pushing an alcoholic to go to AA when they are still in denial that they are an alcoholic.

If your husband's motivation for recovering from BPD is primarily to stay in a relationship with you, then he will associate his efforts to recover more with your needs than with his own.  Perhaps he will only do just enough to keep you from leaving him.  He needs to recover because he wants to change.

Otherwise it's the same situation as if an alcoholic goes to rehab to placate his family's/friend's demands, rather than for the sake of him/herself.

Best wishes, Schwing

[morningagain]

Hey dimples,

The problem with diagnosing BPD is that it requires rather full disclosure, which is something that we are all reluctant to do, and I believe anyone with BPD will be far more reluctant.  Nevertheless, it does happen.  Alternatively, family members can provide information, but again, the BPD person will tend to feel betrayed, probably quite a bit more betrayed than people without BPD, and it generally requires the patient's formal OK.

My wife started and quickly stopped therapy several times while we were together.  Still today she flips out on me if I deign to mention it to her.  It is a losing cause for me to have anything to do with it.  I try to only bring it up when she suggests reconciliation.

She did finally get diagnosed - but it is a sad and jagged road it took to get her there... .

In my stbxw's case, she was involuntarily committed by the E.R. doc.  And still she avoided complete diagnosis, but that was as likely for insurance purposes.  They diagnosed her with bi-polar which is covered by insurance, with "BPD features".  Then she was prescribed intensive dbt (5 hours per day, 5 days per week) which she declined.

Six months later, we separated.

After the separation, she had her daughter removed from her care by the state.  In her efforts to regain custody, she submitted to a number of evaluations, and presumably, the state may have contacted her sister, but in any event certainly spoke with her daughter.  Here was where she was formally diagnosed with BPD.  Long terrible story, but that is the 'how' without the story details.

And still, she refuses any therapy except twice per month with a therapist to help her work on her parenting skills.  Fortunately, this therapist is very good, and has her doing some real therapy work that could actually help her a lot.

At least in my stbxw's case, it took her world collapsing, and then the diagnosis practically forced on her.

I am not sure if I want to scream, cry, or run away, but it seems evident that she will continue to resist therapy, but who knows?  A miracle may happen yet.

In the meanwhile, I am doing my best to stay separated and keep from getting fully enmeshed again.  And it ain't easy... .

[dimples2]

Thank you for your honest answers. He quit drinking and went to AA for six months because he knew it was over otherwise (last binge was a "big" birthday party he held for me - so embarrassing). He's now stopped attending AA saying it doesn't suit him - he was just conditioned to drink socially and now knows he doesn't have to (so, I am well aware that if he does this with something so concrete and obvious, he'll avoid a diagnosis at all costs most likely, unless I leave him). There will never be full disclosure on his part - I have to keep reminding myself of that. And, when he does say he'll get help, it's always "for us" and "for the children" no matter how many times I tell him to do it for himself. He can't take any responsibility.

Our kids are away for all of July and he just wants to spend time alone with me, trying to be romantic, complimenting me constantly, pouting if I arrange to do something without him etc. He just commented on the "rough patch" we went through and how it's in the past now - huh? Seems pretty current and fresh to me. He asked for a divorce twice in June following some benign comments I made an an inquiry into how he was coming along finding a psychiatrist (his idea at the time). I thought I could gently usher him along because he really was having some moments of clarity, but, of course the moment has passed and he's right back where he was. We had a nice evening with new friends he wanted to impress and I felt myself relax just briefly and try to forget, but I really can't. I think too much damage has been done.

I am so distraught over the thought of separating and him not being on some kind of track that will lead to him getting help. He just finished telling me how much I've helped him in his life. I used to love those comments and it would make me do more to help him but now I realize it was unhealthy to some degree.  I was always helping/rescuing him; he never did anything for me without him gaining something.

What if he's right and it is me? What if I have regrets? What if he quickly moves on? What if one or more of my kids suffer if we separate (although I know they are probably more distressed by his emotional lability than I let myself believe)?

Thanks again for your stories and comments - I guess I look for ways to delay the inevitable - I know that assessment and treatment could take years, if ever.