How do you get therapist to correctly diagnose BPD?

[Jseeksanswers]

My H has not been formally diagnosed with BPD. He has been told he has bipolar,  depression and anxiety and the therapists and doctors we have seen all want him to get medication.  After 20 years of marriage we briefly separated and after some pretty traumatic life events for my H we are working on saving our marriage.  I know that a diagnosis should not come from me. We each have our own T and also a marriage counselor.  His 1st appt back with his T (after stopping to see her when we split up) is at the end of the month. Should I call the T to voice my concerns about what I think his diagnosis is or leave it to the professional so as not to cloud their opinion? I know I'm not a professional but he meets every one of the criteria for BPD from the DSM.

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[pearlsw]

Hi Jseeksanswers,

I'd like to address this from a few angles and hear yours and others thoughts as well.

Have you seen this page from the site?

Telling Someone You Think They Have BPD

There is an important quote from this page I want to share for your consideration:

From VeryWell.com:

by Erin Johnston, L.C.S.W (March 7, 2007), reviewed by Steven Gans, MD

https://www.verywell.com/understanding-romantic-BPD-relationships-425217

"It is important to look at the reason behind wanting a spouse, or anyone, to be diagnosed with a personality disorder. Often, relationships with BPs are difficult and fraught with hurt, anger, and misunderstandings. It can be hard to empathize with the BP, and it can be difficult not to see a diagnosis such as borderline personality disorder (BPD) as a validation, proof that the BP has been wrong and hurtful in the relationship.

Having a therapist seemingly agree with the BP and not give a diagnosis of BPD can cause additional hurt and frustration. However, it need not be the invalidation that it seems. When invited into someone’s therapy session, discuss the specific issues that are present in the relationship and don't get too caught up in the diagnosis.

If a person gets a diagnosis of BPD, it is not going to immediately change her behavior or feelings. A diagnosis only gives a name to the symptoms and difficulty a person is and has been experiencing. Her relationships with others will pretty much remain the same, for the time being.

Use the therapy sessions as an opportunity to clarify some of the issues in the relationship. The therapist will listen and make a diagnosis based on his assessment of the clinical presentation.

Meanwhile, look at some books written for friends and family members of those with BPD.

That said, if you are able to speak with the therapist (you have his permission?) you could ask about it if you so choose. I think it is just good to have your expectations in check given the statement above.

Also keep in mind this is a diagnosis, from what I've read, that is not always shared with the patient as it can be very upsetting for them, so there is that too.

You say he meets all the criteria. That is certainly a lot to deal with. Are you interested in committing to using the tools here and completely altering your communication style? You can't control him or the outcomes, but a lot of self work could cut down on the pain associated with these kinds of relationships generally speaking.

with compassion, pearl.

[Jseeksanswers]

I read the article and I don't really have any issues with him never knowing the diagnosis.  I would prefer the T know the diagnosis to best help with a choice of therapy.  I'm very interested in learning the tools to change my actions

[pearlsw]

I read the article and I don't really have any issues with him never knowing the diagnosis.  I would prefer the T know the diagnosis to best help with a choice of therapy.  I'm very interested in learning the tools to change my actions

Hi Jseeksanswers,

That sounds great! What kinds of problems are you currently experiencing? Can you describe some of the situations are you facing please? That can help us point you towards the right tools and get discussions going about concrete situations.

take care, pearl.

[Jseeksanswers]

Right now the biggest problems are anger and depression.  It's very difficult to communicate during these times.  I would really like the T to help focus on some behavioral techniques that would help him.  I understand this won't happen if he doesn't accept that something is wrong.  He does think something is wrong but blames it on us moving.  This then created every problem that has happened since (it's been almost 2 years). Any articles on communication would be really helpful for me.