His therapist thinks he doesn't have BPD?

[daylily]

My uBPDh, who shows all signs and symptoms of BPD, started seeing a psychologist about three weeks ago, and has gone for three sessions.  I finally told H before he started going to therapy that I thought he had BPD.  It was risky, but I thought he was ready to hear it, and he was.  He did research on it and agreed that he probably has it.  His only hesitation was the fear of abandonment, which he doesn't think he has. (He wants to come off as strong and needing no one, so it was predictable he wouldn't admit that he fears abandonment.  His behavior shows that he does.) 

After three sessions, he came home and told me that his therapist thinks there's something wrong with him, but he doesn't think it's BPD.  I asked why, and H said that the therapist told him that it's probably not BPD if someone admits that they may have it or admits that there's something wrong with them.  Apparently, H is too self-effacing for a BPD diagnosis.  I call bull.  H has hit rock bottom, and it seems like someone with BPD in that position would be able to acknowledge that they have it?  Predictably, he's using it as an excuse for why I need to change - he has BPD and there's no cure, so I need to put up with his behavior.

Anyone have any opinions?  I know it's only three sessions, and H is probably skewing what the therapist said.  But H is saying he's practically arguing with the therapist to try to convince him that H has BPD but the therapist isn't buying it!

  Daylily

[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.

[HopefulDad]

My uBPDh, who shows all signs and symptoms of BPD, started seeing a psychologist about three weeks ago, and has gone for three sessions.  I finally told H before he started going to therapy that I thought he had BPD.  It was risky, but I thought he was ready to hear it, and he was.  He did research on it and agreed that he probably has it.  His only hesitation was the fear of abandonment, which he doesn't think he has. (He wants to come off as strong and needing no one, so it was predictable he wouldn't admit that he fears abandonment.  His behavior shows that he does.) 

After three sessions, he came home and told me that his therapist thinks there's something wrong with him, but he doesn't think it's BPD.  I asked why, and H said that the therapist told him that it's probably not BPD if someone admits that they may have it or admits that there's something wrong with them.  Apparently, H is too self-effacing for a BPD diagnosis.  I call bull.  H has hit rock bottom, and it seems like someone with BPD in that position would be able to acknowledge that they have it?  Predictably, he's using it as an excuse for why I need to change - he has BPD and there's no cure, so I need to put up with his behavior.

Anyone have any opinions?  I know it's only three sessions, and H is probably skewing what the therapist said.  But H is saying he's practically arguing with the therapist to try to convince him that H has BPD but the therapist isn't buying it!

  Daylily

I think you just realized one of the risks of telling your pwBPD that they have it... . poisoned the well with the therapist from the get-go.  I think his therapist needs to be open to the option longer, but in any case that's where things stand now.

As for the bolded, if my BPDw accepts a diagnosis and responds in this manner, she'll be in for a rude awakening.  I'll be very clear that while there indeed may not be a cure, that will never be an excuse to quit any medication or therapy.  I don't *need* to put up with any BPD behavior.

[lostandunsure]

Well... . I'm not sure that I agree that admitting they have a problem is a reason to not diagnose someone with it.

When we first found out about BPD and to me, everything fit, and I told my wife about it (I read the day after that it might not be a good idea to do something like that and why) but she seemed open to the idea. She was hesitant to run with it until she had an official diagnosis, but once she had that, it was kind of a relief for her. She finally had something to say that this is what was causing her problems all her life. It was an answer to the question "What's wrong with me".

As for the bolded point, I agree with HopefulDad... . There may not be a cure, but that does not mean that I have to accept that change isn't possible. It's just really hard. There's no cure for diabetes, but there is treatment, there are things that can be done. And there is a lot of success with DBT and other BPD specific therapies out there. Will you need to change things, sure, in any relationship with a person with an illness, all parties make changes to accommodate things, the key being ALL parties. If he's not willing to change and learn how to deal with his BPD, why should you?

[an0ught]

Hi daylily,

Anyone have any opinions?  I know it's only three sessions, and H is probably skewing what the therapist said.  But H is saying he's practically arguing with the therapist to try to convince him that H has BPD but the therapist isn't buying it!

Interesting. Looks like they are forming a relationship and are having their first conflicts.

Looks like at the moment the door to BPD diagnose and DBT as a solution is closed with that T. If he is committed to that path he may need another T but the risk is that he gives up before that happens.

If he continues with the T is there a chance that he will learn anything of value? BPD is driven by a multitude of factors and working on any significant of them can lead to some progress. The T knows at least there is a high conflict relationship whether it is BPD or not the aspects to work on are communication and respect. Have they figured out what to work on?

[Nonamouse]

I had the same experience. Her therapist kept saying she met all the criteria but that she had seen BPD and they all denied having it. My wife goes to therapy and is genuinely sorry, admits all the things she does, and how sorry she is about it and wants to change. But it doesn't follow her out the door. Because of those things, the therapist would never diagnose her. She said it was attachment disorder.

I think a lot of general practice therapists only have limited understanding and experience with BPD. Or they don't want to diagnose because they think it would be devastating to the client. Unless they're in the office dysregulating at them, most just don't get the Jekyll and Hyde. It was really frustrating. Unfortunately not many people that specialize in DBT or BPD exclusively accept insurance and that's also a contributing factor.

It also played into my wife's flip flopping on it. Sometimes she accepted it and said it all made sense now, other times I was a liar who just wanted to hurt her and I was the one with BPD.

Really for me the diagnosis doesn't matter anymore. We don't ever talk about it. I have validated it myself just being on these boards and reading so many identical stories. I would not focus too much on tying to force him or the T into making that diagnosis but focus on taking care of yourself, learning how to handle the situations and that will in turn help him. I'm not saying don't be supportive but just beware of trying to fix the BPD. It can't be fixed, only mitigated.

[daylily]

Thanks for your responses!  I am not as concerned about him getting diagnosed to prove me "right," more just that he gets the "correct" form of help, like maybe DBT.  We'll see how things progress.  I'm just happy he's still in therapy and sticking to it (for now).

[Ziggiddy]

I know this is a late post but thought it worth mentioning - I have a friend with BPD. She is so happy and charming and sociably mobile in public that even though I worked in close quarters with her for sometimes hours at a time it escaped me. So very adept at moving conversation around she would often come off as the innocent victim of other people who were trying to 'ruin everything' for her. She met a friend of mine who is professionally adept (from work in the psychiatric field with psychiatrists who treat BPD) AND who was in therapy herself to deal with her own mwuBPD and the girl managed to fool her as well.

It was only due to a suicide threat, a suicide gesture and a suicide attempt and the accompanying histrionics and later , clear splitting behaviour which alerted that something was wrong (although I didn't know what then) After the suicide attempt I recommended she get help from a T which she did within hours. She was in therapy with one T for several weeks up to 2 x p/week then began seeing a second T for 'emergency care' but 6 weeks later neither T had a BPD diagnosis for her. Finally it  become irrevocably clear that this is her disorder. Just thought I'd share that some people are very very good at camouflage - especially if they are smart, charming and know how to play the waif to perfection.

[daylily]

Ziggiddy,

I think you nailed it.  My H is skilled at playing the victim.  The therapist thinks he has depression and anxiety over his life circumstances, which H believes are mostly my fault.  We're starting marriage counseling next week and H already is making it into a game, saying he's going to get the marriage counselor to tell me that he's "right" and I'm "wrong."  I just hope he's not successful.  I'm not the master manipulator that he is.

[Grey Kitty]

Thoughts #1: Your H's individual T is his, just like your individual T would be yours. Try not to get too involved if you can avoid it. (And if you have your own individual T, don't let your H get involved)

Thought #2: Mental health professionals have varied views and understandings of BPD. Some don't know much about it. Others think that it only covers the extreme cases (very low-functioning), and won't identify it in a higher functioning person. I had a two say that my wife didn't have BPD when she was exhibiting most of the symptoms.

Thought #3: The label "BPD" doesn't always help in treating it. I suspect some T will avoid discussing that diagnosis, even though they are actively treating it.

Thought #4: What really matters is the results, not the label... .

Stick around here if the tools and lessons here help you deal better with your H... . don't worry about whether he "really" has BPD or not.

And if his T is helping him, that is what matters... . not whether the T says he has BPD or not.

Question... . is the marriage counseling with his T or with somebody different?

[AnitaL]

Hi Daylily,

I've been gone for awhile after switching boards due to my husband getting arrested for intimidating behavior toward me and assault & battery (for taking my phone away forcibly and hiding it when I threatened to call them).  However, I am now in counseling separately and jointly with my H, who is also still not diagnosed w/BPD.  He instead was told he had "mild depression" and put on Prozac by his individual T in conjunction with a psychiatrist he has seen a few times.  His individual counseling also has been focusing on his feeling that he got the short end of the stick in life and his resentment over what he views as sacrifices to support my career, and help with "finding himself", and I sincerely doubt that he has fully revealed the extent of his emotionally abusive treatment of me. 

So here's what has been the crucial element in my wilingness to proceed without the reassurance of a BPD or other diagnosis that gets at his long-term, troubling behavior patterns:  We have both agreed that we need separate therapists as well as couples counseling, and we actually got a couples counselor who was highly recommended by both our individual T's, and we also signed release forms so that they may all communicate with each other.  (My T specifically said she thought the couples T was experienced and skilled enough to "handle" my H, who has snowed or stonewalled T's before.)  This is, I think, the only way to be sure that the "full story" gets to his individual therapist, and as others have said, the diagnosis label is far less important than how the therapist handles him. 

Unfortunately we had to hit rock bottom to get to this point -- therapy by my H on his own was not enough for him to really face the big issues of his own role in his unhappiness and resentment.  But now that he is on an antidepressant and faced the real situation of being separated from his family (I had a restraining order against him), it has finally sunk in that we need serious help.  This isn't a success story (yet?), but I would say that the BPD diagnosis won't really matter if the T is good enough to recognize the patterns and the potential for cross-communication among our T's will helpfully prevent him from playing the one-sided victim role successfully. 

My heart goes out to you, as I know the circumstances of your situation are quite similar to mine.