Is contacting his therapist a no-no?

[AnitaL]

Happy New Year everyone.   

My uBPDh has started seeing a therapist that he contacted after asking me for a list of who in our area would accept our insurance.  I (somewhat sneakily) first prescreened the list to include only names of T's who listed BPD and DBT in their skills and training bio.   From the little bit my H has shared with me, which I suspect is highly skewed at best because it comes out when he is in the midst of a rage (i.e., "that lady" said that I should just leave you), it doesn't seem that the T is getting the full picture.  One thing he told me is that she (the T) said that I should come in for a session, since "I don't know how to listen".  Of course I said I'd be glad to come and he said no way.  Perhaps I was too eager? 

Anyway, he has been having a very tough month (and therefore so have I), so I am wondering if it would be acceptable for me to write his T a letter?  I would say something about my finding help at this site, with stories from so many others who experience the same behavior from their loved ones w/BPD, and not knowing or even caring really if he is formally diagnosed with BPD, but just that I am at my wits' end and want him to get the help he needs before our family is torn apart.  I thought maybe a letter could be easily ignored if the T chooses, since I am not expecting a response.  Is this reasonable?  Is it unethical to contact his T who has a confidential relationship with my H?   I just don't want yet another T to be "fired" for not solving his problems, and I don't know what else to do.

Thanks for reading.  Any thoughts would be much appreciated. 

[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.

[HoldingAHurricane]

Just remember that everything you and she hears is filtered through him. Deliberately or not, the information you both get is going to be skewed. As he is her client (although it does vary from country to country) she will likely tell him about the letter and whats in it. Try to let things run their course and anticipate more "she said you have problems/its all your fault". If you pre-screened them for experience in BPD and DBT she will pick up the thread shortly. You might find it helpful to see your own therapist as there is usually work to be done on both sides and it can help to have someone to support you.

[an0ught]

My uBPDh has started seeing a therapist that he contacted after asking me for a list of who in our area would accept our insurance.  I (somewhat sneakily) first prescreened the list to include only names of T's who listed BPD and DBT in their skills and training bio.   From the little bit my H has shared with me, which I suspect is highly skewed at best because it comes out when he is in the midst of a rage (i.e., "that lady" said that I should just leave you), it doesn't seem that the T is getting the full picture.  One thing he told me is that she (the T) said that I should come in for a session, since "I don't know how to listen".  Of course I said I'd be glad to come and he said no way.  Perhaps I was too eager?  

Let's be clear - it will be impossible to know what the T said. Anything you hear from H while he is emotionally excited will be highly colored to support his current emotion. What is happening is that your H is using the T to go after you which is in some form of triangulation.

Anyway, he has been having a very tough month (and therefore so have I), so I am wondering if it would be acceptable for me to write his T a letter?  I would say something about my finding help at this site, with stories from so many others who experience the same behavior from their loved ones w/BPD, and not knowing or even caring really if he is formally diagnosed with BPD, but just that I am at my wits' end and want him to get the help he needs before our family is torn apart.  I thought maybe a letter could be easily ignored if the T chooses, since I am not expecting a response.  Is this reasonable?  Is it unethical to contact his T who has a confidential relationship with my H?   I just don't want yet another T to be "fired" for not solving his problems, and I don't know what else to do.

There are some other threads on this topic if you search. It is always tempting to use the T to go after the partner and for that reason T's shy away from it. Also it is important to remember that BPD is an emotional problem and it needs to be fixed on that level - the facts of life play a lesser role so whatever distorted picture he draws - does it matter? The ability of the T to influence your H matters however and thus the integrity of that relationship is important.

This case is somewhat different in that your H has brought the contact with the T into play (just to rescind). One option may be

to contact T. Informing of the rescinded offer. Telling you are aware H sometimes quickly changes mind and you are confused. You are working on active listening and validation. If she thinks that a session now or at a later point in whatever form would be a good thing you are interested. If she feels in order to make up her mind she needs to discuss this with H and disclose your approach to preserve the integrity of that relationship this would be ok with you provided you get a heads-up notice that the discussion will happen.

In any case you should approach her: Respect her boundaries. Keep it short - don't push information. Information matters little. Behavior counts. As in all relationships.

[iluminati]

Based on the specific details, I would contact the T with no issue.  Let the therapist know that you wish to come in for a group session, based on your SOs word, and leave it at that.  That way, the ball is in the therapist's court.  Either they really want to speak to you, and they can move forward from there, or they'll know that their word is being reported inaccurately.  Either one is helpful to all involved.

[AnitaL]

Thank you for the responses so far.  I am really working hard on thinking this through mindfully, recognizing what my motives are.  I completely understand that what my H is telling me is surely distorted through the lens of his emotions (thanks, An0ught).  I clearly need to keep working on my ability to not get defensive when he pushes my buttons so perfectly. 

Here's more on where I am coming from: 

I truly want my H to get help that really HELPS, mainly because I know he is suffering terribly and is just filled with anger, hate, and despair.  I suspect that DBT is the only way out for him, and I would like to be patient as he and his T discover the true nature of what is going on together.  The problem (*my* problem) is that I do not feel able to be patient.  We have three kids in a 2BR apartment and in a few months we will probably grow out of our current space and need to move (we have a 9 mo. old baby in our bedroom and our two oldest are sharing the other).  The trouble is that moving is itself the focus of almost all of my H's anger.  He believes that moving back across the country will solve all our problems, and refuses to look at any other local housing options.  We've been round and round the moving track and I have even been on board with full intention to move when he panicked and pulled the plug on our plans.  The short answer is that he is unemployed and will not seek employment even for the educational training he has been doing for the past few years, while I have a stable job with full benefits in our current location, and also have family nearby for support  So this is my problem.  I would dearly love to find a house or condo in our current area, and I know (even with the best DEARMAN) he will completely lose it if I do so.  I guess I was hoping to speed along the process of his discovering DBT, not only for his sake but for mine and the kids.

So I think it is true that I need to respect his boundaries and those of the T's.  I may consider contacting her about the rescinded offer of a joint visit, and to let her know what I have been doing on my end without any mention of BPD (thanks for the suggestion, An0ught).  I am working on my end of things as best I can while working full time and caring for 3 kids age 5 and under.  I can barely get a haircut every 6 months, so definitely no time for regular therapy, but I am reading Thich Nhat Hanh and the High Conflict Couple whenever I get a moment, and I do feel I am continuing to make progress within myself if not as a couple.  In fact I probably need to start another thread on the subject of active listening vs. boundaries around verbal abuse based on some of my reading last night.

Thanks again for the insight.  It always helps to hear others' perspectives.  I'll search for older threads on the topic as well.

[Grey Kitty]

Another thought about your H and his T:

The T may be relatively aware of BPD symptoms/behavior in your H, but isn't discussing it with your H. The T has to get your H's trust first before convincing your H to do anything difficult.

I think that you can give your H's T information freely, but just don't expect much back--The T also has a legal obligation NOT to tell you anything about your H, unless he signs some sort of release or something.

[bpbreakout]

I wrote to BPDw's psychiatrist and BPDw 4-5 months ago outlining some major concerns I had over BPDw's abusive behaviour towards our daughter (14) in the lead up to her yr9 exams and requested that they (psych &BPDw) get together to discuss it. BPDw was outraged that I had breached the doctor patient confidentiality. I wrote the letter having told BPDw that I was really concerned about her behaviour and subsequently telling her that if she didn't contact the psych I would. This lead to all kinds of threats which I ignored. Re confidentiality I think what BPDw really meant was that that she wanted to keep things confidential from her psychiatrist and that was the boundary I had broken. I didn't try to engage BPDw in this discussion which would have been useless though I would have done before I got onto this website. We subsequently had a three way discussion on this issue and BPDw tried to enforce a no contact "rule" between me and the psychiatrist. My response was to say well if it happens again (ie me contacting the psychiatrist), and psychiatrist thinks it's innappropriate I'm happy to accept if I have broken any boundaries. The psychiatrist seemed to think it was a good approach and pointedly didn't say anyhting one way or another about my initial letter and BPDw couldn't really say anything after that. My understanding of the confidentiality issue is that whatever is said to psychiatrist by BPDw is confidential unless BPDw chooses to share it with me, so pychiatrist cannot say anything to me direct about BPDw. However if I contact the psychiatrist direct I don't think any rules are being breached. I guess some may regard it as "immoral" but my view is that it is subjective and depends on the situation. I believe I have the "right" to do this though if I were to overexercise this "right" I guess the psychiatrist will start to form views about me and may discount what I say in the future.

In hindsight I'm glad I did this as I think BPDw immediately went into "good behaviour" mode with daughter at home which no doubt helped her with her exams, it made the psychiatrist more aware of BPDw's behaviour than previously though I would say he always had a pretty good idea. Also BPDw has experienced me issuing an ultimatum and following through which may help in the future. I haven't done anything like this since as many people will tell you on this site you have to pick your battles (daughter's exams definately a battle worth fighting for). Good luck, I will be interested to see how you go

[bpbreakout]

Also read your last post about accommodation and kids. Very stressful time with 3 kids under 5 and a full time job. If I was in your position there is no way I would feel able to move away from a secure job and nearby family support with 3 kids to the other side of the country, that's a boundary I just couldn't cross whatever verbal jousting was going on with pwBPD so I wouldn't bother discussing it ever with your pwBPD. Given how busy you must be, maybe you could consider getting family to help you find an accommodation option. At the end of the day BPD or no BPD and DBT or no DBT it sounds like getting somewhere bigger to live is the essential next move for you & your children. If pwBPD doesn't like it and wants to move across the country maybe the therapist needs to be made aware of that and the problems it is causing or maybe you should just get the wheels in motion for a move (I know a lot easier said that done) and quietly leave pwBPD to work out whether he wants to be part of it or not. My experience with BPDw is that discussions about decisions we have to make with our lives can be a waste of time, I always try to have these discussions on important decisions but they often end up with arguments so I often just have to move ahead with things myself and she ends up going along with them even if there was no "approval" given. I would have loved be have been in a relationship we we could have these discussions and make decisions together and compromise where necessary but sadly it's very very difficult with pwBPD.

[AnitaL]

Hmmm... . more food for thought.

One thing I am absolutely certain about is that I would not expect a response from the T.  I do worry about my H feeling that his boundaries are being violated if the T shares the fact that I wrote the letter though.  If that is likely to happen I should probably not intervene. 

[Skip]

Privately contacting the therapist may backfire... . he may be obligated or feel obligated to disclose that contact has been made and hubby may feel violated.  You may also appear to be saying "its all him" or that "changing him to site me is more important than healing him".

I know you have the best intentions - but it may appear manipulative to the doc or hubby...

I would say something about my finding help at this site, with stories from so many others who experience the same behavior from their loved ones w/BPD, and not knowing or even caring really if he is formally diagnosed with BPD, but just that I am at my wits' end and want him to get the help he needs before our family is torn apart.

A better tactic may be to set up an appointment for yourself - share how this is affecting the family - ask what the T thinks you can best do to work on you - ask what the T thinks you can do to best support your hubby or bring peace to the home... .  

For most folks here that have had significant progress - both partners worked on their own stuff, too.

[Cloudy Days]

I'm pretty sure the therapist is required to tell him if you wrote a letter about him to her. This is a professional relationship and she is trying to build trust with your husband, if she did have a letter and didn't tell him about it, that would be against building trust.

Could you possibly sell him on seeing the therapist for your own sanity, maybe going in once or twice a month. You could probably tell him that it would be to treat your issues rather than his, so it would be about you getting treatment too. You could hold off for a month or two until he gets into the grove of things. Personally I like seeing my husband's therapist, she knows what he is like and not only does it give her insight on what he isn't telling her but it gives me insight on how he feels too. I know that not all therapists will do that though. I am very Thankful for the therapist that he is seeing now. It's worth it to find a good one.

[an0ught]

With all the situation where 3 parties are involved it is important to avoid the classic Karpman triangle situation:



where different participants play different roles at times leading effectively only to perpetuate the drama. For more on this check out this workshop here: PERSPECTIVES: Conflict dynamics / Karpman Triangle

To avoid ethical conflicts and drama therapists for practical, ethical and legal reasons have ensure clarity of roles and have to protect confidentiality. It may be worth to take a look at a few pertinent sections of the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association:

3.05 Multiple Relationships

(a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.

A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.

Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical.

(b) If a psychologist finds that, due to unforeseen factors, a potentially harmful multiple relationship has arisen, the psychologist takes reasonable steps to resolve it with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.

(c) When psychologists are required by law, institutional policy, or extraordinary circumstances to serve in more than one role in judicial or administrative proceedings, at the outset they clarify role expectations and the extent of confidentiality and thereafter as changes occur. (See also Standards 3.04, Avoiding Harm, and 3.07, Third-Party Requests for Services.)

[... . ]

3.07 Third-Party Requests for Services

When psychologists agree to provide services to a person or entity at the request of a third party, psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved. This clarification includes the role of the psychologist (e.g., therapist, consultant, diagnostician, or expert witness), an identification of who is the client, the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality. (See also Standards 3.05, Multiple relationships, and 4.02, Discussing the Limits of Confidentiality.)

[... . ]

10.02 Therapy Involving Couples or Families

(a) When psychologists agree to provide services to several persons who have a relationship (such as spouses, significant others, or parents and children), they take reasonable steps to clarify at the outset (1) which of the individuals are clients/patients and (2) the relationship the psychologist will have with each person. This clarification includes the psychologist's role and the probable uses of the services provided or the information obtained. (See also Standard 4.02, Discussing the Limits of Confidentiality.)

(b) If it becomes apparent that psychologists may be called on to perform potentially conflicting roles (such as family therapist and then witness for one party in divorce proceedings), psychologists take reasonable steps to clarify and modify, or withdraw from, roles appropriately. (See also Standard 3.05c, Multiple Relationships.)

These are like all guidelines subject to interpretation and a T does have some digression here. Guided will be the interpretation by 5 central principles (like do no harm etc.) and of course the legal framework which may differ by jurisdiction.



This is not to say no contact should be made only that we need to be clear about our role and intention. It is also be worth remembering that we are somewhat reaching across a fuzzy boundary here. Most of us co-dependents are not so strong on the assertiveness side and may feel uncomfortable to negotiate(as in carefully moving across) such a boundary.

[Mike76]

I contacted my dBPDw T for one reason only recently.   ( I do realize this is the staying board).

I called my wife's T only to say how close I am divorce... . I wanted the T to have a heads up, and to make sure the T talk to my wife about divorce over the next few sessions to soften to blow.

I am going to post a thread by itself, because it may have slightly backfired. 

[AnitaL]

Thanks for the APA info, very interesting.   I am no longer considering writing the letter.  If he starts making vague threats about killing himself (or me) again, then I will revisit the issue, but in the meantime I will leave myself out of their relationship.  Also, I think my seeing his T on my own would enrage him far more than my sending a letter, though I could be wrong.  I doubt he would give me permission to do so, and without his permission I don't see how that's any different from a letter (and possibly worse), from a boundaries perspective.   

I also would just like to clarify that I am, I really am, working on my own side, as the suggestion to do so keeps coming up in the responses.  As I said in my previous posts, I am using every spare moment I have to work on my end of things. I have been reading everything I can about the tools from this site as well as from books and other sources, and am daily trying to put into practice what I have learned (and have been doing so, with mixed success, since I started posting here about two years ago).  If I had time for an actual weekly or even biweekly visit to a therapist with my current work and parenting schedule, believe me I would do it.  Maybe I'm a little defensive here, but I am just so exhausted and there is no relief in sight.  I really feel I am doing the best that I can right now.

[an0ught]

I also would just like to clarify that I am, I really am, working on my own side, as the suggestion to do so keeps coming up in the responses.  As I said in my previous posts, I am using every spare moment I have to work on my end of things. I have been reading everything I can about the tools from this site as well as from books and other sources, and am daily trying to put into practice what I have learned (and have been doing so, with mixed success, since I started posting here about two years ago).  If I had time for an actual weekly or even biweekly visit to a therapist with my current work and parenting schedule, believe me I would do it.  Maybe I'm a little defensive here, but I am just so exhausted and there is no relief in sight.  I really feel I am doing the best that I can right now.

Nobody doubts that you are working hard - you raised an important question for which there is no clear cut answer. Alone working through the decision you just made requires major reflection and is emotionally taxing  .

Cut yourself some slack. Unlike the continuous maintenance energy spent to control a pwBPD the investments in your own growth accrue. Going easier on yourself when you need to is a wise move  as this is a long distance journey.

[AnitaL]

Thank you, I so appreciate all the comments. 

We are definitely in a "something's gotta give" stretch right now in my r/s and I'm doing my best to take charge of my own behaviors and not be pulled/pushed into reacting.  It is exhausting but it is such a relief to be able to write about it here and know that there are people who understand and can give honest feedback.

[Grey Kitty]

Also, I think my seeing his T on my own would enrage him far more than my sending a letter, though I could be wrong.  I doubt he would give me permission to do so, and without his permission I don't see how that's any different from a letter (and possibly worse), from a boundaries perspective. 

From the perspective of having healthy boundaries, they are very different. Talking/writing to his T is getting involved in his stuff.

Going to a T for yourself is only about yourself. (Even if you spend most of your time in T talking about how difficult your H is to live with!)

If you think that personal T would benefit you... . and many here have got a great deal of value from it... . then letting fear of his reaction stop you isn't something I'd recommend.

A simple boundary to enforce with him would be based on this belief: "My T is for my own benefit, and I do not need your permission, nor do I need to discuss anything of it with you."

The same could be said for your support here on bpdfamily.com: Your business, NOT his.

 GK

P.S. You may well be correct that it would enrage him--other members have found this to be true. I've found that my W really fought against anything outside her control that I had contact with. I'm not saying it isn't going to be a battle, just that it may well be one worth fighting!

[AnitaL]

From the perspective of having healthy boundaries, they are very different. Talking/writing to his T is getting involved in his stuff.

Going to a T for yourself is only about yourself. (Even if you spend most of your time in T talking about how difficult your H is to live with!)

Thanks for the support Grey Kitty.  I actually don't think my H would mind my seeing a T at all.  What I think he would mind is if I spoke to HIS T rather than finding my own.  I hope I will be able to do just that at some point.  In the meantime I will definitely keep coming here  .

[AnitaL]

Update--

So shock of shocks, today H came home from his T appointment, crawled into bed and said plaintively "Maybe you should go talk with the lady" (that's what he calls his T, as he can't seem to bring himself to say the word).  "I don't know when was the last time I felt any hope... . I just can't remember.  Maybe you can tell her.  Maybe you should talk to her."   I calmly told him I would be glad to speak with her and asked where I could find her contact info.  I called her -- no return call yet -- but hopefully tomorrow.  Now I'm nervous... . I wonder what she will ask me, or how the conversation will go?I feel like all my feelings could come spilling out all over the place and make me look like the crazy person he probably has told her I am.   How can I make this chance worthwhile to help both him and me?  I'm trying to keep my expectations in check but I'm afraid I am not doing such a good job.

[Murbay]

AnitaL, your last post sounds really promising and I truly hope things work out for you.

What you have to consider is that these are professional people who do this for a living and actually watch body language, and signs as well as words.

My experience was somewhat similar to yours in some respects of my exBPDw found herself a therapist (well hijacked one I had picked out for myself) got in there first to create the lies, tried to use what "he told her" to beat me with, convinced me I was the issue and that he agreed with her AND then he asked for me to contact him to book an appointment. My ex took that as nothing wrong with her and I'm completely to blame. Truth of the matter was, her T saw through her mask and wanted to help me with what I was having to deal with.

He refused to see her after that in account that she was not ready to accept her issues so there was nothing he was going to be able to do for her. He is still my T now, in fact I have a skype appointment with him tonight.

So in respect of you feeling nervous, this could be a very good sign and your T will be able to identify immediately so just go in there and be yourself. The fact that she is asking to see you this early on means she has most likely picked something up already. If I was to speculate, she has some idea of just what you are dealing with and is wanting to offer you help and guidance to you.

The best way you can make it worthwhile for both of you is just to be completely open with her, don't hold back or try to protect your husband. Remember, it's not their job to tell you what to do but they will work through the current issues for you to find solutions that work for both of you. In my case, my T explained exactly what I was up against, told me quite clearly that in my position, he would not stay in an abusive relationship and then asked if I wanted to stay or go. He explained that if I stayed, he would help provide the tools to survive in the household and if I left, he would be on hand to see me through the process.

I think you have a very positive step ahead and I wish you the best of luck 

[AnitaL]

Thanks for your insight, Murbay.  There's been a bit of a setback -- I forgot the T might call my H to confirm his approval of my making the appt, which she did, and he has not returned her call.  I'm going to gently ask him again today if he could call her back, because I'm afraid he's changing his mind already.  sigh... .

[AnitaL]

So he did return the call and apparently the T will not see me alone  :'(, only with him, which he refuses to do, and now he is also saying he is done with therapy altogether as it is "not helping", and anyway he knows what the problem is -- surprise --  It's that I am a terrible wife and he is furious with me and will never forgive me for ruining his life. 

I reminded him that he promised he would go into therapy after having a complete meltdown this past summer which involved threats to hurt himself and me.  I also reminded him that I cannot continue on with the marriage if he has decided that he cannot forgive me nor stop being furious with me.  He went into a rage about how I'll be taking the kids from him, "as I've planned all along", and that he'll "fight me for them for the rest of his life" because they don't deserve a mother like me.  I told him as calmly as I could that what he says seems aimed to hurt me as much as possible and not at all for the benefit of the kids, and that I know I am a good mother, and that his choice to do nothing about trying to deal with this anger is by default a choice to end our marriage.  So I guess I better start talking to a lawyer, because I think my last boundary is being crossed. 

This is so incredibly exhausting.