Experience with Therapy that Backfires?

[Intotheforest]

Hi there,
I am wondering if anyone has experience with their PWBPD or uBPD entering into therapy to help them manage the chaos in their lives, not the condition itself, ultimately resulting in a therapist reinforcing their skewed perspectives and outlook?

[Notwendy]

I think this is what happened with my BPD mother. I didn't attend therapy with her so I don't know what was discussed, but it seems she didn't make progress with it.

[Deb]

My dBPD sister has a talent for picking therapists that she can manipulate. None of her children will do therapy with her now. If she can't manipulate the therapist, she quits.

[zachira]

There are many disordered clients who are adept at manipulating therapists. It is common in marital therapy for a narcissist to manipulate the therapist into believing that the other spouse is the problem. A well known trait of many disordered people including those with BPD is to be able to appear normal when in the public eye while being abusive to their close family members and partners in private.

[Intotheforest]

Thanks for these replies. It's such a difficult thing to make sense of as the non-disordered person. Even now I find myself having to ground myself intentionally whenever I have an interaction with her. She has surrounded herself with people who validate and support her, normalizing the chaos she sows and ignoring the patterns. I think one of the hardest things for me in trying to understand her treatment of me through the years has been trusting my experiences and holding her accountable when those around her (and me, in the case of my FOO) look the other way, normalize, and even justify it. It's a wonder any sibling or child comes through it with a solid, clear sense of Self.

[zachira]

In Spanish we say: "Tell me who you hang out with, I will tell you who you are." Certainly one of the most painful and challenging part of being in a highly dysfunctional family are the flying monkeys, the enablers of the behaviors of the most disordered family members. While my parents were alive, I literally spent hundreds of hours listening to my parents bad mouth scapegoated siblings who turned out to be nice people; certainly they were very kind to me. I realized just how disordered my parents were, when my scapegoated aunt took care my siblings and me for a week, while my parents were stuck on the other side of the country. The demeaning tone of my parents' voices when they talked about having to thank my aunt was just heartbreaking. This sort of thing happens over and over again to this day with the golden children doing horrible things still being kept on a pedestal while the scapegoats are put down no matter how generous and kind they are to other family members.

[Deb]

Zachira, this is so true:



People that only know my sister superficially,  describe her as "sweet" and just don't understand how her family can be no contact. That same thing applied to my dNPD brother-in-law. I don't try to explain things to people because unless they've been on the receiving end,  they won't get it. My BIL is gone now, my sister is almost 77. I don't hate my sister.  In fact, I really feel mostly nothing. I feel a little sadness for what could have been if she had gotten treatment. But I don't dwell on it.

[Notwendy]

I think one of the hardest things for me in trying to understand her treatment of me through the years has been trusting my experiences and holding her accountable when those around her (and me, in the case of my FOO) look the other way, normalize, and even justify it. It's a wonder any sibling or child comes through it with a solid, clear sense of Self.

I don't think I did have a solid sense of self- or at least entirely one as a young adult once out of the home. I think I had enough of one to be able to leave, go to college, establish my own life.

The "self"was both mature for my age- having being parentified but my self esteem was shaky and I didn't have the self confidence some of my peers had.  BPD wasn't well known at the time. I knew something wasn't OK with BPD mother, but didn't know what. I knew enough to go to counseling when I started college. It's been a learning experience unraveling it all. 

[Intotheforest]

People that only know my sister superficially,  describe her as "sweet" and just don't understand how her family can be no contact. That same thing applied to my dNPD brother-in-law. I don't try to explain things to people because unless they've been on the receiving end,  they won't get it. My BIL is gone now, my sister is almost 77. I don't hate my sister.  In fact, I really feel mostly nothing. I feel a little sadness for what could have been if she had gotten treatment. But I don't dwell on it.

Exactly. As I worked through the process of trying to understand, I went from self-blame to confusion to grief to sadness...and now I am moving to feeling mostly nothing. Maybe that's acceptance? I do still have flares of resentment and second-guessing myself when she attempts to blame the state of our relationship on me but those are fewer and further between. I still find myself wishing I could explain to others, but have largely accepted that would be futile and would likely backfire. Mostly, though, I'm thankful to have been able to recognize it for what it was, see its impact, and take measures to remove/protect myself and my own family from it. When things get hard, I focus on that.

[Methuen]

I always say my mom refused therapy including when my father or I offered (at different times) to go together with her.  This is true over her lifetime, but there was a one time exception...

I cannot say exactly what happened because I was not there. But she came back from her counselling session ranting and raving and saying terrible things about the counsellor (whom I happened to know but mom didn't know that) including what a terrible person she was and how she shouldn't be a counsellor, and how  mom would never ever see another counsellor again in her life after that...blah blah blah. Typical BPD reaction.  This counsellor is actually an exceptional person, and I've known her for many years.  It's a small town, and I've lived here almost all my life and through my career, I also know a lot of people and families.  According to mom, the counsellor told her she could get all the support she needed from her daughter, and she didn't need a counsellor.  This was such BS, it's laughable! It was mom telling me what she wanted me to hear, but lying and saying the counsellor had said it.  They twist everything. And boy, she laid the pressure on me thick. Guilt guilt, fear, guilt, obligation, guilt, guilt, guilt.

I cannot tell you how many times my mom repeated to me what she "claimed" the counsellor had said, always implying it was my job to be her emotional caretaker and counsellor, and she did this over 2 decades. 

They are relentless in their drive to have their needs met.  So yah, it backfired.

People that only know my sister superficially,  describe her as "sweet" and just don't understand how her family can be no contact.

Sigh.  I can't tell you how many people described my mom this way - but nearly everybody who knew her.  When people said that to me, it was like cutting me up from the inside out, because when everyone else says that, we question ourselves, even though we know our own truth!  People on this board understand the very real "pain" this well meaning, but completely false statement can have on each of us.  I think without the lived experience, people can't "get it".  Here, we "get it".

[Notwendy]

I still find myself wishing I could explain to others, but have largely accepted that would be futile and would likely backfire.

I felt the same way. These people already believed her and it would only make me look bad to say something that could imply that what she said was wrong.

Because of this, I was estranged from her FOO for some time. It was embarrasing to be around them- having them think I was the problem. I know they thought that, because someone hit "reply all" on a group email chain and they actually said it. I was so shocked, and embarrassed.

After some time, they did see things in a different light when, after being around BPD mother, her behavior became more obvious to them, but by then, a lot of emotional distance had come between us and required some relationship repair.

When I was a teenager, she blamed me for the issues in her relationship with my father. I actually believed that when I left for college, my family would somehow be "normal" then. I know now that it wasn't true.

My BPD mother's perception of people was influenced by her projections, not reality or the actual truth about anyone, me or anyone else.

[Pook075]

My BPD daughter seemed like a world-class expert at manipulating therapists.  But maybe that's not what was actually happening.

For therapy to help, a bond must be built and trust has to be earned.  So when my daughter went into therapy and ranted about everyone in her life, the therapist would show compassion.  They had no choice because they had to build trust.  And if we're being honest here, BPDs are suffering emotionally whether their perception is correct or invalid.  The suffering is real regardless and it does deserve compassion.

BPDs always have a faorite person as well, and if the therapist does their job right, they'll be a candidate for that title.  My daughter would notoriously accept any advice she agreed with from a session and ignore anything that she didn't like, coming out of therapy saying something like, "My therapist thinks you're a complete monster that ruined my life." 

The therapist never said that, at least not in that way, and there was a big lead-up saying how my kid could improve her relationship with dad by being kind and patient.  But my kid heard what she heard, making it seem like the therapy is a disaster and counter-productive.

What's the alternative though?  The therapist can be direct and blunt, and my kid would never return.  Or the therapist can build a relationship and aim for small gains over time.  It's one or the other.

So don't take what a BPD says about therapy at face value; it's not the full story and it's the best they can get for where they're at mentally.  Until they're ready to actively change, nothing will happen.  It's still beneficial for them to have that relationship though over time to build trust and steer past the worst of their obstacles.

[Notwendy]

My BPD daughter seemed like a world-class expert at manipulating therapists.  But maybe that's not what was actually happening.

What's the alternative though?  The therapist can be direct and blunt, and my kid would never return.  Or the therapist can build a relationship and aim for small gains over time.  It's one or the other.

So don't take what a BPD says about therapy at face value; it's not the full story and it's the best they can get for where they're at mentally.  Until they're ready to actively change, nothing will happen.  It's still beneficial for them to have that relationship though over time to build trust and steer past the worst of their obstacles.

These are good points. While therapy didn't seem to get my BPD mother to self examination and working on BPD, it's hard to say it didn't help at all. It didn't get the results we wished it did for her- but did it help?

I didn't have any access to my BPD mother's medical care until the last few years of her life, as she didn't give consent to know before that, and even then, I mostly only knew what was communicated to me. While BPD as a diagnosis wasn't on her chart, her medical team had mentioned "personality disorder" and it was clear we were all aware of that. However, since she wasn't specifically being treated for that- there wasn't a reason for the diagnosis.

As Pook mentioned, I think any T who challenged her would have been painted black and she'd never return. Same with her caretakers- if they didn't agree with her, she'd refuse to have them help her. She still needed help though. She did accept the diagnosis of "anxiety", which was troublesome for her- so there could be medication to help with that.

I don't think it was ideal, in the sense that therapy didn't help her BPD but if it helped some of the more troubling symptoms for her- then, there was some help from it.

My BPD mother had a large need to feel validated and so, if the T seemed to believe her perspective, maybe this helped in that way. As with all T's- some may be more effective than others. Some are also self pay so we have to balance costs and effectiveness, however, if it's affordable, maybe some help is better than none at all. Hard to know for sure.

[ForeverDad]

This post is about my initial search for couples counseling.  I specifically researched a local office for a female lettered psychologist in hopes my then-spouse would respond well to my efforts.  However, it turned out this professional wasn't a good fit.

I didn't know it then but my marriage was months away from a horrible separation and divorce.  I sought help for dealing with my ranting and raging spouse but during those three sessions all the counselor asked about was my FOO (family of origin).  I was disappointed to not hear even one suggestion or explanation for the distress I was experiencing in my increasingly high conflict marriage.

I later learned a clue - "sounds like a personality dysfunction" - from a hospital staffer, which led me to Stop Walking on Eggshells and hence here.  I have no idea why the counselor didn't mention the variety of Personality Disorders.  She was looking only into my childhood interactions but the immediate urgency at the time was the imploding marriage.

[zachira]

My mother with BPD had a psychiatrist who was very well respected as a therapist. I think it helped that mom was going to him for medication and that the therapy was doable because she was there for her medication appointment. I doubt mom would ever have agreed to go to therapy. When I was a teenager, my father tried to get mom to see a mental health professional and she refused. I really don't think mom knew she was getting therapy with the psychiatrist. The psychiatrist eventually quit giving her therapy after several months. I think he knew she had a personality disorder. I called the psychiatrist once trying to convince him to schedule family therapy sessions. He said he could not do that. I would have liked to have known what mom was diagnosed with and what the psychiatrist thought about her mental illness. Mom did not want her children to know anything about her mental illness and the psychiatrist could not disclose anything without her permission. I figured some things out indirectly by googling a list of her medications which were all visibly in one place on a counter in her home. She was taking psychiatric medication for psychosis, depression, anxiety, restless leg syndrome, insomnia, etc.,

[Notwendy]

I would have liked to have known what mom was diagnosed with and what the psychiatrist thought about her mental illness. Mom did not want her children to know anything about her mental illness and the psychiatrist could not disclose anything without her permission. I figured some things out indirectly by googling a list of her medications which were all visibly in one place on a counter in her home. She was taking psychiatric medication for psychosis, depression, anxiety, restless leg syndrome, insomnia, etc.,

I wish I was told as well but she kept her medical information private from us. Also, the family unspoken rule was to not disclose that she had any issues and  that she was "normal". It felt like the Emperor Had No Clothes story and we'd be in trouble if we said anything.

One reason I wish I had know is- if she didn't have a disorder- then she behaved like this for some other reason. She would blame others, including us kids, and so somehow I wondered if it was my fault, and also that maybe she didn't like me.

But even as a young teen I could have understood mental illness. By high school I was looking in psychology books to see what might be going on with her as I suspected something was. BPD wasn't a main point in the books yet and no internet.

She told us her medicine was for "asthma". In college, I looked in her medicine cabinet and looked them up and realized they weren't for asthma. I naively tried to speak to one of her therapists but he wasn't willing or able to do that.

With the internet, I found BPD while looking up NPD as someone in our community was classic NPD and he was difficult to deal with. I looked this up for more information. On the page was a link to BPD and it sounded a lot like my mother.

It wasn't until BPD mother's elder years that she signed a consent for her nurse manager to speak to me. I still didn't see her actual records but the nurse carefully mentioned "PD" to me to see if I knew. I told her I thought she had BPD and the nurse agreed. By that time though, she wasn't in therapy and the medicine that helped her was for anxiety and that was the diagnosis they used.

I think a lot of confusion may have been avoided if someone had discussed BPD with me earlier- but it wasn't well known until later.

As for my own personal therapy- I haven't done it continuously. It's been more on an as needed basis. Some therapists have been more helpful than others, but a main benefit for all of them has been someone to talk to, in confidence, as these can be personal situations.

[Deb]

My sister let it slip that while hospitalized,  she'd been diagnosed with BPD. She later denied that she said it, but I have witnesses. Later, her 4th ex-husband and her middle daughter saw her medical records and said that was probably the mildest of what she was diagnosed with.  It's probably  why he got full custody of their then 8 year old daughter.  Now, that youngest daughter has access to the psychiatric records my sister somehow thought would help her get to live with that daughter.  No, it just made sure that my niece knows she's making the best decision to keep her mother at arm's length. 

[Methuen]

My BPD daughter seemed like a world-class expert at manipulating therapists.  But maybe that's not what was actually happening.

For therapy to help, a bond must be built and trust has to be earned.  So when my daughter went into therapy and ranted about everyone in her life, the therapist would show compassion.  They had no choice because they had to build trust.  And if we're being honest here, BPDs are suffering emotionally whether their perception is correct or invalid.  The suffering is real regardless and it does deserve compassion.

BPDs always have a faorite person as well, and if the therapist does their job right, they'll be a candidate for that title.  My daughter would notoriously accept any advice she agreed with from a session and ignore anything that she didn't like, coming out of therapy saying something like, "My therapist thinks you're a complete monster that ruined my life." 

The therapist never said that, at least not in that way, and there was a big lead-up saying how my kid could improve her relationship with dad by being kind and patient.  But my kid heard what she heard, making it seem like the therapy is a disaster and counter-productive.

What's the alternative though?  The therapist can be direct and blunt, and my kid would never return.  Or the therapist can build a relationship and aim for small gains over time.  It's one or the other.

So don't take what a BPD says about therapy at face value; it's not the full story and it's the best they can get for where they're at mentally.  Until they're ready to actively change, nothing will happen.  It's still beneficial for them to have that relationship though over time to build trust and steer past the worst of their obstacles.

I think this is spot on, and probably the strategy some of the best therapists take. 

While the person my mom saw is a person of quality character and good standing, the fact that mom came away from that first and only visit dissing the counselor probably means she moved too quickly, didn't take the necessary time to build a relationship with mom, said something that mom didn't want to hear, and mom with her emotional paper thin skin had a big  explosive reaction, and that was the end of counselling for the rest of her life.  In the counselors defense, she couldn't have known mom was BPD.  But I'll bet she recognized and suspected it afterwards. 

This speaks to Pook's points.  Sessions between a pwBPD and the therapist are a bit of a dance.  The therapist has to be highly skilled to be the "lead" in a dance that could implode or combust at a single wrong step. 

So while we all have stories that may seem to us like the therapist is reinforcing skewed perspectives, maybe for the skilled ones there may be more going on.

Then again, I lived my life by my value of trying to be a good daughter.  I made my mother my matron of honour at our wedding, I included her on holidays with my family, I even included her on holidays with our friends (which led to her claiming them as HER friends  ), I nursed her after her early falls, and all the million little things I would do for her to be kind, or remembered or feel loved...  But as she aged and her "needs" (physical, social, emotional, cognitive) amplified, I was obligated to do more and more to PROVE my love.  I was in my late 50's before I accepted that nothing I could do would ever be enough, and I was "done" with having my kindness returned with negativity, blaming, accusations, toxic emotional abuse, and even hate. More to the point, if I couldn't meet one of mom's "needs" immediately when she needed it (like replacing a phone for her when I wasn't in the country), then she would say things like "you only think of yourself", and "you don't love me!"

So to take Pook's points one step further, if his theory is in fact the approach taken by T's working with BPD, then from the perspective of the BPD, the T may only be as good as the "last time they validated the BPD's perspective", and when the relationship goes south, it goes fast.

With my mom, it didn't matter all I had done the previous 55 years if her need of the moment wasn't met.  All that seemed "dry erased" (borrowing a phrase from NW), and the only thing that mattered was that I wasn't meeting her immediate need right NOW.  It took me YEARS to accept that, because it just seemed so unreasonable, and irrational.

Marsha Linehan, creator of DBT revealed she had BPD as a teenager.  So there it is.  Good things can happen.  But if we've landed on this board and in these conversations, our BPD person probably isn't a Marsha Linehan type.

Still, Pook's point brings a perspective that is worth being aware of.

[Pook075]

So to take Pook's points one step further, if his theory is in fact the approach taken by T's working with BPD, then from the perspective of the BPD, the T may only be as good as the "last time they validated the BPD's perspective", and when the relationship goes south, it goes fast.

When I look back at some of my daughter's closest relationships, it makes me scratch my head at how she could have thought that they were good people.  Her "best friend" in high school was a boy who was super needy, always the victim, and used my daughter for everything.  Yet, she would have died for him in a moment's notice.  He was homosexual as well, so this wasn't a romantic thing.

I think when a BPD has a favorite, they stay a favorite until either a new opportunity comes along or they get too in their own heads.  So I agree with you, the therapist must validate continually or risk being rejected.  And think about what that means for progress for someone that's not ready to grow and change- a simple five minute lesson might take months or years to fully get across in a "loving, supportive way" that the BPD can accept.

For my situation with my BPD daughter, my BPD ex-wife, etc, I realized that I can either love them as-is or I can move on entirely.  I want to be a part of my kids lives so I don't feel like I have any choice, I have to accept the circumstances with the ex and the adult kid.  So my expectations have changed and so has my approach.

For instance, I've learned to listen and not react or try to fix any problems.  I've learned that's a fool's errand and the conversations are much more productive if I validate feelings and lend support with a, "That's so tough, I'm here for you" type of vibe than a "Okay, here's what you need to do..."

If I try to fix, then it's my fault if it doesn't work, and it probably won't work anyway because they're only going to take the part of advice they like and ignore the rest.  But if I just say, "Here, I'm always on your side to help however I can," then I'm not directly involved and I don't get the fallout.  That's what let me flip from black to white in both of their minds.

Are there times they try to drag me into things anyway?  Sure.  But I keep it simple and honest.  "I love you and I'm here for you any time.  What do you need?"  That places it in their court to figure out what they need; I'm just the sounding board.

[Notwendy]

Then again, I lived my life by my value of trying to be a good daughter. 

I was in my late 50's before I accepted that nothing I could do would ever be enough. More to the point, if I couldn't meet one of mom's "needs" immediately when she needed it (like replacing a phone for her when I wasn't in the country), then she would say things like "you only think of yourself", and "you don't love me!"

With my mom, it didn't matter all I had done the previous 55 years if her need of the moment wasn't met.  All that seemed "dry erased" (borrowing a phrase from NW), and the only thing that mattered was that I wasn't meeting her immediate need right NOW.  It took me YEARS to accept that, because it just seemed so unreasonable, and irrational.

The concept of "being good" was emphasized for me early on. I recall BPD mother saying that someone was "being good".

I did try to be a "good daughter" too but if there was one error- one thing that displeased BPD mother, then whatever efforts I had made, whatever things I did that had been "good" seemed to be "dry erased" in her mind.

One idea about why this felt so irrational may be a mismatch of what was "being good". My own concept of "being good" was shaped by pleasing my parents, and as I matured,  by the common shared ethical principles in our culture and faiths. These are more constant. While people aren't perfect and can make errors, the good things they do or did don't disappear with one of them.

For example- Methuen making her mother maid of honor, helping her mother when she fell- these are generally considered good deeds, the kind of actions of someone who is a good daughter. However, if to our BPD mothers, "being good" means meeting their needs in the moment- and in one moment we aren't doing that- these other acts aren't in their consciousness in that moment, and so not registered as "good" to them.

One contingency for her was to be compliant, so having boundaries was upsetting to her.  Where I could also see this was with her caretakers and medical providers in her elder years. They could be very competent but if they had a boundary with her, to her, they were not- in that moment.