How could a therapist NOT recognize BPD after years of therapy?

[bobcat2014]

The more I learn about BPD the more questions I generate... .

My wife was in personal therapy for "depression" for about 10 years. During this time, I came along a handful of times, when things got really bad with triangulation and the other men. How in the world could her therapist not see the classic traits of BPD? The T is very educated and effective in my opinion. Looking back over the years, all of our issues we sought counseling for, clearly demonstrated BPD traits exactly, the spending, the affairs, abandonment, jealousy, and isolation. When I first read about BPD it sent a chill up my body because the description was identical to what I was experiencing. Perhaps the T didn't share her diagnosis with me since I was not her patient, but I think she only considered depression with my wife. Up until 2 years ago my wife was on Prozac, Zoloft, Clonipine  and other SSRI meds.

Ironically, the last two years is where I feel her symptoms have gotten worse, ie, gas lighting, mirroring and splitting to extremes. As mentioned in other posts, I thought maybe she had a mild stroke or head injury.

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[MustangMan]

She definitely needs another therapist, this one might have found its licence in a cracker jack box.  To hold the title does not automatically mean to be good.  After 10 years if I would not see a slight improvement, I would go see someone else for sure.   Also, wouldn't it be a good idea to do a few sessions of therapy with the non, to have its input?

[lizzie458]

Every T has specialties, whether they advertise them or not.  It's a natural development to become more of an expert in certain areas and less of an expert in others during any professional career.  Unfortunately, I have found (as many others here) that T's who can even SPOT BPD are few and far between.  dBPDh works in mental health, and none of his coworkers (all licensed clinicians) are aware of non-standard presentations of BPD ("standard" being typically a woman with fear of abandonment, mood instability, etc. "I hate you, don't leave me" type).  So even though the T may be good at certain therapies (i.e. CBT) or seeing through certain types of people, they may still not be able to see the BPD.  10 years is quite a long time to keep banging your head against a wall... . it took our T about 2 years to realize CBT was not working, and the only reason she figured it out was because she herself had "displayed BPD traits" many years ago, whatever that really means... .

[FullMetal]

It does depend on their training and specializations. 

Our MC, who was actually working on her PHd when we saw her, her speciality was on PTSD and Chronic PTSD.  And she felt strongly that BPD wasn't a good diagnosis.  It may be the end result, but she felt that treating the PTSD and Chronic PTSD that lay beneath the surface was a better approach.  Basically rather than focus on the BPD push it aside and work on the underlying problems.  build up a strong foundation, rather than the broken one, and "fix the building from the foundation up"  Because if you put on a nice facade on the building, yeah it looks good, and could last a lot longer, but those cracks in the foundation (the PTSD) are still there, and can cause the whole thing to fall down.  and once the underlying conditions are treated, and understood, tackling the larger issues is easier and less prone to falling back.  as the work on the foundation has been done.

[bpbreakout]

FuLLM... . My wife's new psychiatrist has raised possible PSTD, complex PTSD, attachment issues, bipolar, borderline & maybe social anxiety. Psychiatrist (quite rightly in my view) believes there are major FOO issues. BPDw is also on medication for bipolar 2 - ie mood stabalisers. By coincidence my own T works in the same practice and has quite a few joint sessions and me and BPDw last year and has also spoken to BPDw's psychiatrist about our situation. My T believes BPDw is "almost certainly" BPD but has strongly advised me not to make anything of this (makes sense to me). I believe BPDw is far more likely to seek help for FOO or general life issues that if she is labelled BPD in which case I think she will run for the hills. She is in denial re BPD diagnosis even though she found my copy of Stop Walking on Eggshells and has been recommnded a 12 months wekely DBT program. Personally as a "non" I found the BPD "diagnosis" really helpfull as it led me to this site. I now know that I may not be perfect but BPDw's distorted thinking and abusive behavior are not down to me. Previously I knew all BPDw's stuff wasn't down to me but I was also very angry and frustrated. Now I "feel" this as well as knowing it intellectually. The BPD diagnosis is important for me but it doesn't mean I have to prove it to anyone. I think a lot of professionals can spot BPD or NPD or other similar things (they are "difficult" people after all) but they don't believe it's in the patient's interests to formally diagnose.