Question about therapeutic approach to treatment

[Beware of Junk Psychology...]

I have a question about therapeutic approach to treatment of BP issues.  

Our once marital therapist remains hers and my individual T.  Since the demise of my marriage, I have had multiple discussions with this women about why she did not pick up on the BPD during our marital sessions.  Those sessions played out like a text book with my pwBPD traits blaming and deflecting/projecting.  

Her primary (and only) point/defense is that my spouse has PTSD.  In T's way of thinking, PTSD causes BPD so the correct therapeutic approach to treating BPD for her is to treat PTSD.  Mind you, IMO, we have made little to no progress and spouse simply split me black to which T responded to me as saying "that is how she does herself".  The T practically poo-poo's all the BP traits and just repeats, these are same as PTSD.

I have argued the following logic with this T; if someone is an alcoholic as the result of PTSD, you must first treat the alcoholism because it gets in the way of dealing with PTSD.  Likewise, BPD traits must be handled prior to PTSD source.

I would like to hear what any of you think (especially Mutt or other Moderators/Advisors)

Full disclosure (if you can't tell); I am angry at T (felt like she made triangle by being T to us individually and maritally).   I think she is somewhat BS'r and defensive passing off everything onto PTSD.  Somehow this T is written into the story line of my recovery from all of this and I simply want to be pissed off at her in a big way... .

[joeramabeme]

I have a question about therapeutic approach to treatment of BP issues.  

Our once marital therapist remains hers and my individual T.  Since the demise of my marriage, I have had multiple discussions with this women about why she did not pick up on the BPD during our marital sessions.  Those sessions played out like a text book with my pwBPD traits blaming and deflecting/projecting.  

Her primary (and only) point/defense is that my spouse has PTSD.  In T's way of thinking, PTSD causes BPD so the correct therapeutic approach to treating BPD for her is to treat PTSD.  Mind you, IMO, we have made little to no progress and spouse simply split me black to which T responded to me as saying "that is how she does herself".  The T practically poo-poo's all the BP traits and just repeats, these are same as PTSD.

I have argued the following logic with this T; if someone is an alcoholic as the result of PTSD, you must first treat the alcoholism because it gets in the way of dealing with PTSD.  Likewise, BPD traits must be handled prior to PTSD source.

I would like to hear what any of you think (especially Mutt or other Moderators/Advisors)

Full disclosure (if you can't tell); I am angry at T (felt like she made triangle by being T to us individually and maritally).   I think she is somewhat BS'r and defensive passing off everything onto PTSD.  Somehow this T is written into the story line of my recovery from all of this and I simply want to be pissed off at her in a big way... .

[Mutt]

I can see how frustrating that would feel joeramabeme. You had a 13 year long r/s. That's a long history and you're trying to put the pieces together. I am sorry to hear that you didn't get the help that you needed with couple's therapy. I can relate.

It's not uncommon for a pwBPD to have several misdiagnosis before being diagnosed with BPD. For example, post traumatic stress disorder PTSD, attention deficit hyper-activity disorder ADHD, narcissism, substance abuse or alcoholism. BPD is often found with other disorders and there's often an underlying clinical depression and anxiety.

Do you feel disappointed that if you had this knowledge perhaps you could have helped your partner and saved your marriage?

[Sunfl0wer]

Hey Joe,

I had a similar issue.  Our MC also saw us each for individual at different points in the process.

I feel that there were obvious flags that our MC could have/should have seen and pointed out... .but didn't.

I feel that the emotional abuse that I suffered by my partner was sometimes compounded by the invalidating enviornment I also experienced in therapy.

I have moments where I'm really pissed that he could not fully hear my experience.  When my r/s with my partner was fully over, I switched therapists as I could not trust him any longer and did not feel that he could offer me much more for my own healing.

I think he tried, is human, but his best did not work well for me.

I can understand why you would be frustrated with the T.  It sounds like she has her story and is sticking to it, "It looks like PTSD to me."

Well, I have PTSD, and I present quite differently in therapy.  I did not have black/white thinking like my partner.  When T asked us both the same question: "What could you have done differently?" or "What part are you responsible for in this?" I was always able to directly answer T questions, rather my BF deflected, blamed, or actually answered as if it was a different question that was asked of him!

Maybe the point that she is trying to make is that knowing your partner has BPD vs PTSD is irrelevant to her as she would have  had a similar approach anyway? 

I think many T are reluctant to use BPD terminology, even when they do know that this is what they are treating.

It is also possible that if she confirms your suspicions then she is in fact engaging in triangulation as you then can use that as ammunition to tell your partner, thus impairing her Tx and trust in the T.

It is also possible she plain does not know.

idk if that helps at all... .

I still have unresolved therapy issues that I imagine I will one day bring up to the current T.

[joeramabeme]

I can see how frustrating that would feel joeramabeme. You had a 13 year long r/s. That's a long history and you're trying to put the pieces together. I am sorry to hear that you didn't get the help that you needed with couple's therapy. I can relate.

It's not uncommon for a pwBPD to have several misdiagnosis before being diagnosed with BPD. For example, post traumatic stress disorder PTSD, attention deficit hyper-activity disorder ADHD, narcissism, substance abuse or alcoholism. BPD is often found with other disorders and there's often an underlying clinical depression and anxiety.

Do you feel disappointed that if you had this knowledge perhaps you could have helped your partner and saved your marriage?

Thanks Mutt, your question goes right to the heart of mine, if T did something different then marriage would have been saved.  

I am re-reading SWOE and starting at the section of what the Non must do for the Non.  Finally, it is starting to sink in a little bit deeper, I can't change her.  I can only change me.  Wishing the T did something different is just another way that I wished she would/could have changed.

Coming to this realization makes me feel awful and powerless.  She couldn't change or did not want to.  The threat of being more intimately closer was too great.  I just really hate all the hating and bad feelings and having 13 years go by and being alone again on the other side with all these bad feelings from what was supposed to be such a happy and lasting relationship and being so totally powerless to change that outcome.

It all feels a bit like having been on a wild airplane ride for 13 years, working like crazy to not get thrown around the cabin and when it is all over getting off at the same destination I started from with a few more grey hairs.  

My ability to see a happy future is somewhat limited which is why I think I still want to figure out if it could have been different with the hidden (and never ending) hope that maybe I can still fix it.

How long did your hurting-healing go on for?  Are you re-married or involved with someone at this point?  

Joe

[joeramabeme]

Hey Joe,

I had a similar issue.  Our MC also saw us each for individual at different points in the process.

I feel that there were obvious flags that our MC could have/should have seen and pointed out... .but didn't.

I feel that the emotional abuse that I suffered by my partner was sometimes compounded by the invalidating enviornment I also experienced in therapy.

I have moments where I'm really pissed that he could not fully hear my experience.  When my r/s with my partner was fully over, I switched therapists as I could not trust him any longer and did not feel that he could offer me much more for my own healing.

I think he tried, is human, but his best did not work well for me.

I can understand why you would be frustrated with the T.  It sounds like she has her story and is sticking to it, "It looks like PTSD to me."

Well, I have PTSD, and I present quite differently in therapy.  I did not have black/white thinking like my partner.  When T asked us both the same question: "What could you have done differently?" or "What part are you responsible for in this?" I was always able to directly answer T questions, rather my BF deflected, blamed, or actually answered as if it was a different question that was asked of him!

Maybe the point that she is trying to make is that knowing your partner has BPD vs PTSD is irrelevant to her as she would have  had a similar approach anyway? 

I think many T are reluctant to use BPD terminology, even when they do know that this is what they are treating.

It is also possible that if she confirms your suspicions then she is in fact engaging in triangulation as you then can use that as ammunition to tell your partner, thus impairing her Tx and trust in the T.

It is also possible she plain does not know.

idk if that helps at all... .

I still have unresolved therapy issues that I imagine I will one day bring up to the current T.

Sunflower, sounds like you and I have very parallel situations from both perspectives of our partners and us as individuals.  What you said about "invalidating environment" is spot on.  The T would actually give my spouse BP-ammunition by suggesting loaded phrases that my pwBPD would run with and then the T would try to address it all as a normal relationship issue.  This T helped me a lot with PTSD personally, I too thought she would have picked up on the differences in responses.  I also agree with you that the T is human and I know she meant what was best.  There were times though that I wished she hadn't made it so easy for my pwBPD traits to exercise the same patterns that were causing us problems to being with. 

I have been back to that T a number of times trying to get closure on what I think is her unwillingness to admit that she did not properly diagnose or address us.  I have sat down for multiple session and read from SWOE to her and discussed its applicability.  I too have found a new T that I feel is more aligned with understanding of traits at play and addressing them.

I hope you are feeling better... .   

[Sunfl0wer]

 

Ammunition, oh gosh don't get me started on ammunition!

How many times the MC tried to tell him to look for signs that I was triggered, so as to soothe me.  Only for BF to use my trigger as a way to be angry at me (for not being a good little NPD supply) and accuse me of being hypersensitive, therefore, triggering him.

So after that, we would argue, he'd bring it up to MC, then accuse me of being triggered.

Then me being triggered... .made his NPD traits feel incompetent... .as MC told him to soothe me... .so when I was triggered... .he would intentionally trigger me more out of anger!

Or when MC said that he should reach out to my son more.  His NPD traits heard "You are not being a good role model for this young man" so his BPD traits picked on me every chance he could for not doing enough for his D... .projecting his shame onto me.  Uhhh... .are you kidding me... .I did more for her than he did for either of the kids combined.

Oh well... .tough weekend here.

I guess I'm doing better than I thought as I felt those stories are actually comical vs painful.  Ridiculous!

[Mutt]

I feel that there were obvious flags that our MC could have/should have seen and pointed out... .but didn't.

I understand the frustration. I think at the top of my list was triangulation and how I felt like I was cast as persecutor and she was cast as victim and the over-arching theme was the same with different T's. I did not understand triangulation at the time or basic psych.  

That's my experience and its not to say your experience(s) were the same. BPD is a persecution complex.

I have moments where I'm really pissed that he could not fully hear my experience.  When my r/s with my partner was fully over, I switched therapists as I could not trust him any longer and did not feel that he could offer me much more for my own healing.

I can understand how depressing, sad and frustrating that would feel. Good for you you switched therapists.  I felt angry with being invalidated in my home, in the therapist's office and with family members and friends. Not many know about BPD and there aren't educational awareness programs.

I found validation with sharing with members here that shared similar hardships. It's like we all talk the same language without having explaining the behaviors directed at us. BPD is chaotic inter-personal relationships and a person may differently with different people.

What do you mean, he doesn't act that way in front of me?

Thanks Mutt, your question goes right to the heart of mine, if T did something different then marriage would have been saved.  

I am re-reading SWOE and starting at the section of what the Non must do for the Non.  Finally, it is starting to sink in a little bit deeper, I can't change her.  I can only change me.  Wishing the T did something different is just another way that I wished she would/could have changed.

I can relate. I was going through the angry stage of grieving the loss of the relationship. I was angry that the tools that were taught were for couples where the set expectation was that both are working 50 / 50 in a relationship. Unfortunately the relationship dynamics are very different where one is an emotional caretaker and its not a reciprocal relationship where we have the right to have one. Our exes suffered from severe mental illness, have social impairments, emotional dyslexia and it takes an hour or a day to return to baseline.

BPD is not our fault. We did what we could do with what we knew at the time.

How long did your hurting-healing go on for?  Are you re-married or involved with someone at this point?

We can find ourselves bitter and angry at the outcome at having have to rebuild and often the non-disordered partner may feel like they may not trust another person to have a relationship.

I think what helps is finding forgiveness for ourselves and our ex partners. It's not the person's intention and it is because of BPD. Inject empathy and compassion to let go of the anger. Read as much as you can about the disorder and understand that there are neuro-biological reasons and that our exes felt more negative feelings than positive ones and felt 9x more than we did.

It was a long journey Joe, and I would have to say it took over two years for myself to get to a good place with radical acceptance. My ex suffered from mental illness and her black and white thinking can be devastating on a family. I know what my role is and I chose to focus on my children to give them emotional support and guidance. They needed dad and I chose this opportunity to work on my life-long emotional wounds.

I have gone on a couple of dates and it was exciting and fun because I have learned so much and want a healthy r/s. I want a particular type of partner and I understand that I am a good person and want a reciprocal relationship. I think for me it'll happen when I least expect it. I'm focused on rebuilding and being dad and I'm happy with who I am and what I have.

[Skip]

I have argued the following logic with this T; if someone is an alcoholic as the result of PTSD, you must first treat the alcoholism because it gets in the way of dealing with PTSD.  Likewise, BPD traits must be handled prior to PTSD source.

joeramabeme, I don't know if this analogy is a good one.  

The bigger question might be the why you are asking.  :)o you feel the therapists made matters worse or missed an opportunity to help your marriage?  Or, is this about who is a fault for the marriage failure?

What disconnect are you trying to connect?

[joeramabeme]

I have argued the following logic with this T; if someone is an alcoholic as the result of PTSD, you must first treat the alcoholism because it gets in the way of dealing with PTSD.  Likewise, BPD traits must be handled prior to PTSD source.

joeramabeme, I don't know if this analogy is a good one. 

The bigger question might be the why you are asking.  Do you feel the therapists made matters worse or missed an opportunity to help your marriage?  Or, is this about who is a fault for the marriage failure?

Why disconnect are you trying to connect?

Skip, that question has been plaguing me for some time and I think I have found the answer. 

I WANTED TO BE VALIDATED! 

I never got it from her or the T.  I did not know that this is what I was seeking when I spent years in MC.  Now that marriage is ending I understood that T could not have changed my pwBPD traits, because she did not want to change.  But I did want T to say; Joe, you have some really valid concerns.  pwBPD can't justifiably blame you for everything, be abusive, minimize and emasculate you etc.

I am also starting to understand why I am looking for EXTERNAL VALIDATION and the fact that I am looking externally means I will be vulnerable again until I can self-validate.  This is the next part of my journey, assuming that I really am getting over the shell shock.

Can you elaborate on why you do not think my alcoholism/PTSD analogy is befitting to BPD/PTSD?

Thanks, Joe