uBPDh finally seeing a psychiatrist

[Ceruleanblue]

My uBPDh is finally seeing a psychiatrist. He is only doing this, I believe, because he thinks I'll leave him if he doesn't. His therapist did recommend he go to one, but I think mostly because his family doctor put him on some medication she, his therapist, didn't agree with. I feel he and his therapist have a very odd relationship, and I've wondered so long why she hasn't sent him to someone else. He's been seeing her three years, and we also went to her for marital therapy, which I stopped going to because I was the only one following her advice. She was getting nowhere with him, and it was just too frustrating to watch. She knew he physically assaulted me at times too(thankfully that stopped), but again, she sort of made light of it, and kept treating him. In fact, she wanted him to see the psychiatrist who would soon be joining her practice. I don't dislike her as a person, and I know she's tried, but it was her who convinced my husband to go off meds that his doctor put him on. Don't therapist take the same oath doctors do: First do no harm? Well, her encouraging my husband to go off meds was heartbreaking, because I know his doctor was on the right track!



My question is this: Am I allowed to go in with him when he sees his Psychiatrist? Because I know he'll lie, and downplay all his behaviors. His family doctor was on the right track, had my husband on medication, told him this was a "mental health issue" and that if he'd escalated during his three years of talk therapy, he should at least try a medication. In short, his doctor listened to ME, and how my life/our lives have become, due to my husband's rages and dysregulating. I don't want to attend every meeting he has, just ONE so I can tell his psychiatrist the truth. I know he won't be honest, I know he'll blame all his behaviors on ME, he is very, very good at that, and he doesn't even see reality the way most of us do. He can create his own reality.

I'm not even sure I can stay in this marriage, he has gotten so bad, but I do want him to get help. Please advise.

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[slimmiller]

I think all too often we give the therapist too much credit when we have to stand back and realize that PDs are very much chameleons. They will BS and snow the therapist to the point sometime where the therapist almost seem to coddle the condition itself instead of calling the PD out on their behaviour. I think the reason is two fold, first not all therapist are good and or even aware of BPD, (My counselor at first looked like a deer in the headlight when I mentioned BPD. She had no clue and no understanding of it, but she is a good therapist with run of the mill problems, just not BPD), second, all too often 'if' the therapist puts their foot down and calls the PD out on their behaviour, they will bolt and quite therapy altogether.

My ex and I tried therapy but when the counselor called her out on several things and suggested boundaries, in other words didnt tell her what she wanted to hear, she was done with it. It was much easier for my ex to then paint me as the problem instead of taking ownership of it.

Are you going to therapy for yourself?  That was really my biggest help when my ex begin her extinction rages and cheating. The very nature of a PD is to 'not' fix anything, instead they blame the non. Thats where therapy was a life saver for me

Also this board was invaluable to me. Reading and learning helped me the most

[Boss302]

My uBPDh is finally seeing a psychiatrist. He is only doing this, I believe, because he thinks I'll leave him if he doesn't. His therapist did recommend he go to one, but I think mostly because his family doctor put him on some medication she, his therapist, didn't agree with. I feel he and his therapist have a very odd relationship, and I've wondered so long why she hasn't sent him to someone else. He's been seeing her three years, and we also went to her for marital therapy, which I stopped going to because I was the only one following her advice. She was getting nowhere with him, and it was just too frustrating to watch. She knew he physically assaulted me at times too(thankfully that stopped), but again, she sort of made light of it, and kept treating him. In fact, she wanted him to see the psychiatrist who would soon be joining her practice. I don't dislike her as a person, and I know she's tried, but it was her who convinced my husband to go off meds that his doctor put him on. Don't therapist take the same oath doctors do: First do no harm? Well, her encouraging my husband to go off meds was heartbreaking, because I know his doctor was on the right track!



My question is this: Am I allowed to go in with him when he sees his Psychiatrist? Because I know he'll lie, and downplay all his behaviors. His family doctor was on the right track, had my husband on medication, told him this was a "mental health issue" and that if he'd escalated during his three years of talk therapy, he should at least try a medication. In short, his doctor listened to ME, and how my life/our lives have become, due to my husband's rages and dysregulating. I don't want to attend every meeting he has, just ONE so I can tell his psychiatrist the truth. I know he won't be honest, I know he'll blame all his behaviors on ME, he is very, very good at that, and he doesn't even see reality the way most of us do. He can create his own reality.

I'm not even sure I can stay in this marriage, he has gotten so bad, but I do want him to get help. Please advise.

I'm no mental health professional, but based on my experience with meds (antidepressants), they can make it harder for you to see the situation as it is, and thus understand the need for change. Or maybe this doctor wants to see your husband as he is, "unmedicated," to get a good handle on what's going on with him. That may be a good thing. BPD is often misdiagnosed (my BPDx was originally bipolar, dontcha know... .), and meds can mask what's really going on with the patient. Again, I'm not a professional, so that's a layman's opinion, but if you wanted to know, I'm sure you could ask the psychiatrist what the game plan is (it wouldn't surprise me if what I'm talking about is the case). In any case, assuming your husband is BPD, then meds aren't going to fix that. I'd say to be patient and see where this leads. It may make it harder for you to cope with him, but maybe it also points the professionals down the right path for long term treatment.

And I wouldn't worry about what he tells his therapist - how does that affect you one way or another?

Best thing you can do to help him... .is to help YOU. YOU need to go to therapy too.

[sweetheart]

Hello Ceruleanblue,

If your husband is ok with you going, there is no reason why you cannot attend the apt together. I have been to many P appointments with my dBPDh. I, however only ever went with my husband in a supportive capacity, I said very little apart from an occasional prompt or reminder. For me when my husband is more unwell he is much less able to cope with me being with him, so I don't go with him.

My concern for you is that from what you have written in your posts your husbands mental state sounds quite unstable, which also fits with his referral to a P. For you to attend with him initially might create more problems for you in the short-term and it is clear that you are already under an immense amount of stress. You do not need him to have more ammunition to make you even more of a target.

What I have done over the years when my husbands mental state has been particularly unstable is that I have written to his P an account of how he is presenting at home, including whether he is compliant with current medication and any other relevant issues. You can ask for this to be treated as 'third party information' and for it to be confidential, in that it is not disclosed to your husband. For me this has worked well.

What I also now realise is that even letting the P know about how my dBPDh is from my perspective cannot change how my my husband is outside that appointment. This disorder is cruel and all consuming, and depending on where your own 'line in the sand' is, it might be that although your husband is seeing a P it is still not enough. Unless your husband becomes a danger to himself or poses a significant risk to others, a P's powers are really quite limited. Your husband has to want to engage in the treatment being offered, and there really is no quick definitive fix for a pwBPD.

[MaybeSo]

It's up to your husband who goes to dr. appointments or who he shares medical information with.

You can always call or write a doctor or therapist and give them your input which they can  passively receive; but ethically they have to share it with their client if you do that.

[maxsterling]

It's definitely frustrating when you pin all your hopes on a therapist fixing your pwBPD, and then nothing changes.  I've been down that road.  I thought her going into the hospital would help her.  I thought the group therapies would help her.  Or the IC.  Or the meds... . I'd look at the paperwork she brought home, and I'd know they were giving her tools on how to manage stress and emotions.  Her AA literature also dealt with the same issues and gave her tools on how to help herself.  And then nothing would change.  Was she even listening?  Sometimes she says she wasn't.  She would just tune out.  And she was diagnosed BPD many years ago, been through DBT, and all kinds of therapies.

And I was very, very frustrated.  That frustration didn't ease until I quit thinking about what methods she is using to help herself and whether or not she was doing her homework, and instead focus on the behaviors that affect me.  The reality is - if she doesn't want to participate in therapy, if she doesn't want to go to AA meetings, if she doesn't want to take her meds, or wants to lie to the therapist - I have no control over that.  But if she wants to rage at me, I *do* have control over that - I can leave.  That is what I have control over. Trying to manage her therapy only exhausts me and frustrates me, and no matter what she did or didn't do regarding therapy, if I had to be involved and force her to go, it would exhaust me.  She has BPD.  I expect her to blame others.  I expect her to not want to do the work.  And if I know she isn't doing what is asked, I will just be frustrated and blind to whatever progress she might make.  I think it is fine to say I have a boundary against her screaming at me because that is a boundary to protect me.  But I don't think it would work to say "go to therapy or I leave", because then I am now in effect responsible for her mental health, and giving such an ultimatum would be counterproductive to her healing.

I'd suggest the same to you.  Going to therapy with him just so you can make sure he is telling the truth won't do any good, and is likely just to frustrate the hell out of you.  Even if he is brutally honest and properly diagnosed, that still doesn't mean his behavior will change.  My guess is that your hopes are like mine were - that he go in there, be completely honest, and the T calls him out on his crap.  It won't happen that way - that's just not the way therapy works because if it did happen that way, he would never go back to therapy and would never, ever help himself.  I think you will be happier if you let him do his therapy the way he wants to, set boundaries against bad behavior, and do some deep thinking about whether this situation is something you can live with or not.

[Ceruleanblue]

I've had a ton of therapy myself. I was seeing a therapist a couple months ago, but she went on leave. I found another therapist, had two sessions and she got offered another job and left. She was the only one there that took my insurance. I'll probably start looking for another therapist.

I'm constantly reading, researching, and trying to find out more about what I can do, but this wears on me too. I think at the end of the day, my uBPDh has to help himself, and I have to help myself. Which right now, means me getting better.

I do want him to get a proper diagnosis though, for his sake, not just my own. If you won't own up to the issues, it's not like getting an accurate diagnosis.

[MissyM]

Max, I agree that trying to control a BPD spouse and their recovery can make us crazy.  I do not agree that having a boundary with a BPD addict that they be in treatment as a condition to staying in the relationship, is inappropriate.  The specialists we have worked with say that I need to have the boundary that my BPDh is working on his recovery and his plan.  My dBPDh came up with his sobriety plan with his therapist and they asked my input.  I did not define for him what he must be doing, only that he will need to follow this contract for me to be willing to stay in this relationship.  Of course, my lack of boundaries in this relationship have helped it get out of control.  There is a difference between keeping boundaries and trying to control.  I have vacillated, in the past, and either have had no boundaries or try to control everything.

I see nothing wrong in going to see the psychiatrist with your spouse and letting them know what is going on, I would do the same if my dBPDh was seeing a cardiologist because he tends to minimize his symptoms and I do not see this any differently.  Medication change has really helped my dBPDh, mainly by allowing him to be more available for all of his therapy and 12 step work.

[Ceruleanblue]

Boss302:

I don't care what he tells his therapist, but I really do want him to be truthful about his behaviors with this new PSYCHIATRIST. I think his therapist does coddle him, or at least not push him, just like another above poster stated. And I do blame this same therapist for encouraging him to go against a well established medical doctors advice, and medication. His only "bad" symptom was that he was fidgety. My uBPDh made threats of divorce if I didn't go get on meds, and I'd already gone to my doctor, and been told I didn't need any. So I eventually got put on meds I didn't need, just to shut him up, and prove to him that the issue isn't ME. I'm not saying I'm perfect, but I try. I try really hard, and no matter what tools, techniques, empathizing, disengaging, engaging... .none of them work with my husband. He is just going to rage, dysregulate, blame, and be almost impossible to live with.

Just when I think I'm coping, he comes up with some new way to hurt me. He seems to enjoy hurting me. That is the one thing that really makes me wonder if this is worse than BPD... .and maybe strays more into being a Sociopath.

MissyM:

And yes, I too would go along if he was seeing a cardiologist, or something else serious. Heck, if I had something serious, I would want someone going with me, just because I sometimes forget or miss a point they make. Like you, I'm not going to try to control anything, I just want him to be truthful, and I know he has huge issues with flat out lying, or downplaying. And I think my boundary for staying is also going to be that at least he is making an effort with working some plan. I've been killing myself trying to change when I'm not the one acting out, then I changed to try not to set him off, then I tried acceptance, but he has just gotten much worse. I want to stay, but all effort can't be coming from me. I know he may change very little in the end, but if he at least tries, and is working a plan, I can assess where to go from there.

[maxsterling]

Missy - perhaps I wasn't clear   it is perfectly appropriate to have a boundary with an addict that says you will not be in a relationship with an addict unless you see a progress controlling his or her addiction.  And same goes with BPD in general, it's perfectly appropriate to have a boundary where you won't stay in an abusive relationship.  Not only is it appropriate, but needed if you have any hope in being happy.  But in my experience, telling the pwBPD that you must do xyz or I will do abc always makes things worse.  pwBPD have lived their whole lives with people trying to control their behavior, telling them to calm down when they can't, telling them to "just relax" when they are furious, or telling them "you have nothing to be angry about" when they are already angry.  Saying a boundary that requires them to change their behavior or you will take some action they view as you trying to control them, and things get worse.    It took a while for me to realize this, but when I have said "if you don't stop screaming, I will leave,"  that is in fact me trying to control her behavior because I don't want her to scream and abuse.  And her reaction?  To scream louder and start throwing things, claiming that I am trying to control her.  She will scream that I am treating her like a child, and that she is an adult (even though she is acting like a child ).

I know it's hard to do, but I think in those instances it's better to leave out the "you" statement out of it - "It's obvious that this is a big issue, and I feel like things have gotten too emotionally heated for me to be productive in solving this problem.  I need to take a break and I will be back in an hour to discuss things more."  The reality is that I would be leaving because she won't stop screaming, and she knows that, but at least I would not be directly blaming her.   But the difference is that I am telling her that I am leaving because I can't handle the situation, not because her behavior is causing me stress (which it is).  Same goes with therapy and meds. She's lived her whole life with family, dating partners, and friends telling her she needs to go to therapy or take her meds or else.  And - nothing has changed - she still hates going to therapy and taking meds.  When people tell her that, she just finds new friends, boyfriends, or quits talking to those family members.  I think in this case it works better to be positive and supportive and encouraging - "I've noticed you seem down lately.  I know those medicines sometimes have side effects that aren't fun, and it's certainly frustrating when you take pill after pill and feel no different.  It's important to be honest with your doctor about how you feel so that they can find a medicine that could work better for you - it's not an exact science, and it takes time." Yeah, sounds hokey because what you really feel inside is, "you are an abusive jerk, and I am soo out of her unless you change."  But if that is the way you really feel, wouldn't you will be much better off just ending it rather than try and pose an ultimatum?

Just think about the reverse - ultimatums are the crap that they throw as us, and we hate it.  Am I right?  It took me awhile to realize that I was doing the same thing to her.  She would tell me if I don't do this or that, this relationship would not last and she would move out in a month.  And I was furious and felt controlled.  And of course her "this or that" would be things that are inconsequential (to most people) or things beyond my control. So in my case, she would want to talk about getting married, and I would tell her I want to talk about solving immediate issues first - such as her being happy. And she interpreted that as me saying "I won't marry you until you are happy."  In a sense, that is what I was saying, and definitely what I was thinking.  And of course, she would be LIVID - because she felt her happiness was something beyond her control, and that I was just trying to force her to change.  That's not so say that having a boundary that I will not marry an unhappy person is not appropriate or needed - because it absolutely is!  What isn't fair is for me to string her along and wait for her to change, when if having a happy partner was a requirement, I should end it and go out and find a happy person.  Of course, we are not married, have no children or shared property, so there is no extra incentive to try and preserve things.  But I think the point is the same - that nobody likes feeling controlled, and if we try to set a boundary that tells them they must do something our way or we will leave, we might as well just pack our bags because at that point there is probably zero chance of them adhering to our boundary. 

[MissyM]

That makes much more sense, Max.  I do not say, if you don't go to a meeting or therapy then we will divorce.  I have said that he needs to stay with his own sobriety plan, which he came up with and has ownership of.  The thing with a psychiatrist is different than a therapist, although my husband's therapist does want my input.

Curulean -  I don't know about other BPDs but my husband wouldn't intentionally lie to a psychiatrist but he forgets symptoms, and that is true with any kind of doctor he sees.  My dBPDh is nonfunctional and quite scary when he isn't on any meds, so my concern would really be that a doctor treat him properly.  I feel afraid for him when he isn't medicated.

[Ceruleanblue]

Yeah, well my husband is rather deceptive, and secretive, and refuses to really admit he has any issue other than "anger", and he really doesn't seem to want to work on that. It's weird to me that he has gone to therapy for three years actually. I think he started going because his ex had left him for another man. He didn't deal with that well at all, and he was really playing the victim when I met him. I sadly bought into it, and parts of it were true. She did do some crazy things to him, and he has the knife scars to show it, but I'm now realizing, they both did crazy things.

I'm trying to be the stable one, but it's taken such a toll on me. My nerves are shot, I'm a nervous wreck, and I am always having to remind myself that I am a good person, because he tears me down so much.

[Boss302]

Yeah, well my husband is rather deceptive, and secretive, and refuses to really admit he has any issue other than "anger", and he really doesn't seem to want to work on that. It's weird to me that he has gone to therapy for three years actually. I think he started going because his ex had left him for another man. He didn't deal with that well at all, and he was really playing the victim when I met him. I sadly bought into it, and parts of it were true. She did do some crazy things to him, and he has the knife scars to show it, but I'm now realizing, they both did crazy things.

I'm trying to be the stable one, but it's taken such a toll on me. My nerves are shot, I'm a nervous wreck, and I am always having to remind myself that I am a good person, because he tears me down so much.

My heart breaks when I hear things like this because that's where I was not so long ago. And if you're not careful, you can lose your very essence in a relationship like this - all the sudden this becomes "your normal." That happened to me. 

It got so bad with me that my mother called me at work and told me she didn't know who I was anymore. I'd compromised so much of me to 'cope' with my BPDx that I wasn't really me anymore. I was putting up with things that were absolutely, fundamentally wrong in my life. And like you, my BPDx insisted I take anti-depressants too. Why? To help me cope. When every fiber of my being told me that the situation with my wife was horrifyingly toxic, those drugs "dulled' the natural emotional reaction I should have had to my life and my family's life going as fundamentally off-course as it was going - horror and anger. But instead, those meds dulled my natural reaction, so I could "deal" with the situation. And when I came off the antidepressants, my old instincts came back... .and after it became clear my BPDx wasn't going to change, I left her. To this day, she blames our divorce on my "being off my meds." So sick... and so sad... .and I'm so sad to hear this is what your husband expects of you.

I know this is the "staying" board, and I hope your problems work out, but at some point, you have to decide what's no longer acceptable to you. You need to decide how much hurt, how much pain, how much fear you can accept from this man. You are NOT his mother - you're his wife, and the husband / wife relationship is NOT based on unconditional love. It's a deal, and both parties have to hold up their end. If he isn't, then at some point you have to start making choices. And if you choose to stay, you're going to need very clear boundaries, and a ton of support.

[Ceruleanblue]

Maxsterling:

I agree with what you say. I hate the ulltimatums he's given me, so of course I'm not going to give him an ultimatum. I'm just stating on here, where it's safe to do so, what my boundary is going to be with him, and what to me is the bare minimum of what he'll have to do in order for me to take him back, and stay in this. That means the ball is in his court, because I've done all I can do, and I can only work on me. And by being away from the dysfunction for a while, I'm realizing that I've put up with far, far more than I ever should have.