How important is the actual BPD diagnosis?

[Before you can make things better, you have to stop making them worse...]

My BPD hub is currently in therapy but continues to go in and out of denial about his diagnosis of BPD. He was diagnosed with BPD by 2 prior therapists and I feel he unquestionably has BPD and he agreed with the dx initially. After he left his diagnosing therapists (for various reasons), we worked very hard to find him a new T who specializes in DBT with BPD patients. Hub has been seeing him for months but now is telling me he doesn't think he has BPD. Although he says he's working on "his issues." However, his "issues" are not related to any of his problems with BPD symptoms. This worries me bc I'm afraid he won't be working on any of his BPD behaviors.
I feel like it's the same as if 2 docs diagnosed me with lung cancer & I started chemo for it, but then I decided I don't have cancer, but instead I have a broken arm, so I'm going to treat that instead. Needless to say that when I gave him that analogy, he didn't like it (to put it mildly).

I'm not a fan of labels in most cases, but I think in the case of BPD, the dx is critical to getting proper treatment, since it can be so very difficult to treat. So I'm not sure what to do here. I feel like if I push him to re-accept his dx, he will resist even more, but if I just let it go, he'll be wasting his time in therapy and not working on his issues that are so badly affecting our r/s.

Any thoughts on the importance of a dx and/or what I should do here?

[bananas2]

My BPD hub is currently in therapy but continues to go in and out of denial about his diagnosis of BPD. He was diagnosed with BPD by 2 prior therapists and I feel he unquestionably has BPD and he agreed with the dx initially. After he left his diagnosing therapists (for various reasons), we worked very hard to find him a new T who specializes in DBT with BPD patients. Hub has been seeing him for months but now is telling me he doesn't think he has BPD. Although he says he's working on "his issues." However, his "issues" are not related to any of his problems with BPD symptoms. This worries me bc I'm afraid he won't be working on any of his BPD behaviors.
I feel like it's the same as if 2 docs diagnosed me with lung cancer & I started chemo for it, but then I decided I don't have cancer, but instead I have a broken arm, so I'm going to treat that instead. Needless to say that when I gave him that analogy, he didn't like it (to put it mildly).

I'm not a fan of labels in most cases, but I think in the case of BPD, the dx is critical to getting proper treatment, since it can be so very difficult to treat. So I'm not sure what to do here. I feel like if I push him to re-accept his dx, he will resist even more, but if I just let it go, he'll be wasting his time in therapy and not working on his issues that are so badly affecting our r/s.

Any thoughts on the importance of a dx and/or what I should do here?

[isilme]

You can lead a horse to water but you can't make it drink - that's the biggest lesson to learn with regards to BPD.

I think the diagnosis is good for YOU to have, as it validates that yes, someone else can see and confirm the behaviors you see.  And that's all it's really good for. 

pwBPD don't want to accept the shame of admitting the drama in their lives is most often their own making.  They need to be able to project it and blame shift away from the responsibility for it.  some in very few circumstances seem to accept the diagnosis when one is made, most do not.  And then, even fewer of those who accept it, take the steps as prescribed to "fix" themselves.  It takes a very self honest and self-aware person to benefit from behavioral therapy as it is.  BPD is about NOT being either of those.  It hurts too much. 

Mostly, knowing that yes, it's most likely BPD, allows you to now know what steps YOU can take regardless of what your pwBPD chooses to do.  Because YOU can choose to take that drink of water or not - you cannot force it down their throats.  The only person you can control is you.  That is the biggest lesson all of this ahs taught me.  I control me.  I control (as best as I can) how I react when H gets off track.  I control how much I let it hurt me, I control how much I may argue back.  I control how and if I validate his feelings, or in the right moments, if I can challenge them gently in a non-confrontational way.  I encourage what I feel is positive and responsible behavior.  I try to put boundaries around negative behavior.  I try to tell myself to let go of feeling responsible for all of H's feelings.  I tell myself he's allowed to get mad, be depressed, rant and rave, as long as it's not in a way that is abusive to me.  And that I am allowed to leave the space if that happens.

BPD is an emotional disorder.  The analogy to a cancer diagnosis is similar to one I like to use - diabetes.  I like diabetes a little better, as I think it's a bit closer in scope.  Diabetes blood sugar highs and lows can result in irrational behavior.  Constant life style modification is required.  It does not get "cured" or go into remission, but is there forever.  BPD is there forever.  It's part of the learned behavior and chemical make up of the person with it.  It can be mitigated, a lot though the actions of the "non" in the relationship.  Some people claim it improves with age, some claim it gets worse.  Some say that diet and nutrition seem to play a big factor - I know H's rages are most often when he is hungry or ahs had terrible things to eat recently. 

So I think the diagnosis is fine for you to help YOU fight gaslighting and to know you are not alone in what you see happening.  But as for convincing your H to work on his issues, it's not going to get you very far.  The very nature of BPD to avoid blame, and admitting you have a personality disorder and you have some responsibility for learning better, new ways to react to things is a really BIG step for a pwBPD.  Some can do it, but it's a seed to plant, and water every so often and leave alone.  It may grow, but just like any psych issue, the person needing to make changes has to WANT it.  My mom is a chronic abuser of prescription meds.  She was stuck in erhab a few times against her will.  Did nothing.  She had to want to work on things to get past it and she never did.  Baby steps will help things improve for you.

[Grey Kitty]

Let go of whether he denies the diagnosis or not; choose your battles, and that one isn't going to help you.

If you have diabetes, uncontrolled blood sugar levels cause all kinds of health problems. More important than agreeing on the diagnosis is regulating blood sugar.

If you have BPD, uncontrolled/unmanaged emotions lead to really bad behavior (which you are often the target of!)

Confronting him with the BPD diagnosis will trigger shame, sending his emotions for a ride, which leads to guess what--more bad behavior. Don't start that mess.

I've found that addressing bad behavior directly (boundary enforcement) is one of the best things you can do.

The other thing you can do some of is assist in managing his feelings. Ultimately that is for him to do, not for you, but you can help by avoiding invalidation (which triggers him!), and validating him (which helps him manage feelings in a constructive way).

Let his therapist decide whether to tell him that he has BPD and how.

[waverider]

BPD is so hard to treat, it feels like there is not light at the end of the tunnel as it is so broad in its consequences, its no wonder patients want to turn away for respite from what seems endless and pointless to them.