Ethical question

[secretagent]

I'm still struggling to find a couples therapist for myself and my wife. The question is, do I tell the therapist about my wife's BPD diagnosis before the first session? If I do, I feel like I'm betraying my wife (she believes that it was a junk diagnosis, and most definitely doesn't want it mentioned). If I don't, I feel like it's not fair to the therapist and may lead to misunderstandings.

We already had one session with a therapist I found. I did not tell the T about BPD ahead of time, and the session did not go well -- we're now looking for a different therapist. I just found someone, but I'm struggling with same question. Any advice?

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[Harri]

Hi

What sort of misunderstandings concern you?

[secretagent]

Hi
What sort of misunderstandings concern you?

For example, like with our therapist before last. We had about 10 couple therapy sessions, which I thought were not especially productive. We then agreed to have to have individual sessions. During our first session, the therapist asked me point-blank if my wife had a diagnosis. When I replied with "BPD", he said that he thought that may have been the case, but it's really not his area of specialty. Naturally, I wished we had that discussion 10 sessions ago...

[No-One]

Best to stop using the label of BPD with your wife and focus on problems with the individual traits:  i.e. emotional dysregulation, highly critical, blames others, projects, silent treatment, jealous, controlling, etc.

It would be best to use a therapist who is familiar with BPD. You could determine that with a phone call or online listing.  Some therapists routinely have an individual session, during the early stages of therapy.  You can always phone the therapist and ask for it, then perhaps he/she can bring it up during your first session (and not say it's your idea).  Personally, it would be something I would want.  I think it can be a valuable tool for the therapist to evaluate each of you individually and gain your perspective of your therapy goals.  Then, when the therapist sees you together, they have an idea of what's going on from both perspectives. Except for an occasional personal session, I don't believe most therapists see clients routinely in both individual and joint counseling.  Although it can be an advantage early on, if done on a regular basis, the therapist can lose their objectivity.

If you wife isn't getting her own individual therapy, and dealing with anxiety and depression issues (possibly with meds), therapy could be unproductive.  Just something to think about, before you invest a lot of money.  Heard lots of stories of how therapy is consumed with the BPD partner blaming the other partner for everything.  If they can't recognize that they are at least part of the problem, there isn't much room to change anything.

Best wishes with the therapy.  I hope it is helpful for your relationship.