It surprises that couples T's aren't aware of pwPD's wearing a mask

[pursuingJoy]

It surprises me that couples T's aren't more clued up on the dynamic of pwPD's putting on a mask for their weekly counselling session. I'd imagine that most non's are not in a great shape when they rock up to couples counselling, in my case I was all over the place.

Enabler, I really needed this. I think it is what's contributing to some of my frustrations with MC. Thank you.

Today my H was cussing at the TV, pacing the room and giving the TV both birds during a football game. My nephew is visiting and had never seen him this way, so his eyebrows were up. After a loud and repetitive streak, my N18 and D14 giggled quietly and nervously. He snapped at them for laughing. Later I got an earful about how he is finished with my daughters blatant disrespect, if his own daughter had laughed he would have ripped her a new a-hole.

[Cat Familiar]

PJ, the frequent negativity is so difficult to be around. 

My husband was grumpy for days because our Thanksgiving event at our friends’ house had received a foot of snow days earlier and he was concerned about the drive. It was a reasonable concern, and when the party was changed to a house at a lower elevation after more snowfall, he even threatened not to go, because he thought those people didn’t like him.

We went. Very little snow. Had a great time. And when I asked him who he enjoyed talking to the most—it was those people who “didn’t like” him. 

[zachira]

It surprises you that couples T's aren't aware of pwPD's wearing a mask. There are very few therapists who have the qualifications to treat people with personality disorders. To be aware of another's mask, one has to be willing to stop wearing a mask. For most of the history of mankind, we lived in small bands, in which everyone knew everyone so wearing a mask didn't really work. Now we are living in a narcissistic culture which encourages people to put on an act of being some kind of superior person while denying having any weaknesses or vulnerabilities. We depend too much on the spoken words. If we really look at body language and actions, we can see that the words don't match. It is just sometimes people have a need to believe what they hear, instead of taking the time to find out who this person is in most situations, and not for the time the person is in the therapy room or in other brief encounters.

[I Am Redeemed]

I think zachira is right, the average marriage and family therapist may have some knowledge of pd's but may not be educated in the area of diagnosing them, especially when they are presented with both partners at once to assess. A lot of therapists and counselors have master's degrees and specialize in certain areas (marriage and family, addictions, trauma, etc.) but may not have received in-depth training about pd's. It certainly is frustrating though when you seek some type of validation for your experience and want the T to see that you are struggling with more than just your run of the mill conflict resolution or communication skills that "regular" couples have.

[pursuingJoy]

zachira and I Am Redeemed, great observation. Are there ways to know whether a therapist has experience treating PD's?

[Cat Familiar]

An hour therapy session is very little time for a therapist to get a good understanding of relationship dynamics. And it makes things even more complicated if the partner with a personality disorder puts on the charm while the non erupts with a litany of years of repressed complaints. Then who looks unbalanced?

The most valuable thing I got from over a year of couples therapy was learning that the psychologist thought my husband has a personality disorder. She told me that two years later, when I saw her individually for therapy, shortly before joining this forum.

Even though my husband is very mild on the scale of BPD, my experience with marriage counseling was very unproductive, though it led to a slight improvement in our communication.

Far more valuable was doing individual therapy and participating here. Having understanding of how my previous way of communicating with him wasn’t working, being able to shift how I spoke with him, and realizing that though I did influence his mood, that the surprising mood shifts and angry attitudes were not my fault—that really solved a lot of problems for me.

[I Am Redeemed]

I agree with what Cat said entirely.

If a T doesn't advertise that they have experience with pd's, then the only way to know that I can see is to ask them directly. That's what I did with my T (not marriage counselor; I didn't know about pd's when my ex and I tried couples' counseling). I described behaviors that my h had displayed in my marriage and told her I had done some reading about pd's and recognized that he had traits, at least, whether he qualified for a full diagnosis or not. She was learned enough to recognize that the behaviors did sound like cluster b.

Our marriage counseling never went anywhere. The most that came out of it was that the T diagnosed him tentatively with Depression with Psychotic Features, tried unsuccessfully to get him to take meds and check in for a short inpatient stay, and told me that the best advice he could give me was to call the police if my ex got violent (which is what eventually happened). My stbx was (is) very, very low-functioning and had extreme behaviors with legal consequences that a T could work with when trying to assess him. However, he was still able to present as a person who was "working on getting better" and could "talk the talk" really well. He could say just enough in counseling to make it look like he was stable, when in reality he was delusional, paranoid, abusive, and still using drugs, and this is exactly what he did when he returned briefly to individual T about a year after we tried marriage counseling.

[zachira]

You would like to know what to look for in trying to find a therapist who is qualified to treat personality disorders. First of all, studies have found over and over again that the therapeutic alliance, a trusting relationship developed between the client and therapist, is the best predictor of successful therapy outcomes and not any particular kind of training or experience the therapist has. This I think would pertain in particular to dealing with personality disorders. Does the therapist have the ability to read body language, pay careful attention to incongruencies in actions, words, and stories told? In my experience, we get taken into by people with personality disorders when we decide to believe narratives that don't ring true, when the body language is more about charm than genuine self confidence and compassion for others, and we choose to be taken in by the charm instead of realizing that the incongruencies mean this person cannot likely be trusted to treat us with kindness and respect over time.
Therapists are often told to avoid treating those with BPD because of how the client goes from loving the therapist to hating the therapist, and the risk of having false claims made to the licensing board about the therapist by the client with BPD.
Some therapists like to believe that with the right therapy, nearly any client can be helped. Studies show that most couples do marital therapy when it is way too late, that 1/3 are hiding an affair from the spouse and another 1/3 are having an affair that the spouse knows about.
So basically I am saying pay attention to what the therapist picks up on and how the therapist effectively responds.
If a therapist says they have experience with personality disorders and are seeking to treat people with personality disorders that is a good sign. There are therapists who have written articles and books on treating personality disorders which you can find through a google search.
I have spent years in personal therapy, and I have had therapists that weren't as helpful as I would have liked. I finally found the right fit for a therapist when I knew what I wanted in a therapist and what I wanted to work on. I interviewed several therapists before I found the one that was a really good fit and went to her for several years until she moved out of town.

[pursuingJoy]

Not all therapists are alike, for sure. Have you ever encountered a therapist who you suspected hadn't worked through their own stuff? That was a weird experience.

All really helpful insight. It truly is sobering to realize how many couples enter into MC too late, or with the wrong motives. MC, any kind of T, really, is not a fix in and of itself...success comes from an individual and personal commitment to improving and growing.

Sometimes I question my H's desire to grow. Something as small as asking him to reduce his cussing is interpreted as "non-acceptance of who he's always been" because "I just want to change him." Sometimes he comes back after he's thought about it and has a different perspective.

My therapist seems insightful and wise, def approachable and well meaning. I don't think she has a ton of experience with PD's because she mostly does clinical work, but counseling is her passion. She is exceptional (in 20 years I've seen 6 different therapists,  3 I only saw once and left).

I'm going to chat with our MC tomorrow, and will keep going, but this thread has given me some important thoughts. I feel like I'm going in eyes wide open.

[zachira]

PursuingJoy,
Yes, there are many therapists who have never worked on their own stuff who want to fix others. I know several therapists who have never had therapy themselves. There seem to be quite a few therapists that have NPD. There are many therapists who are top notch. Most of the members on this site have had to figure out what they were looking for in a therapist and sometimes had to go through a few therapists before finding one that could help them.

[pursuingJoy]

I spoke with the therapist for about 30 minutes this morning, sharing what happened last Friday, including the successes of the Thanksgiving visit, his explosive anger that night, and that I felt somewhat invisible in the last two MC sessions because of the mask he presents.

Long story short, she said that her understanding of our relationship (from our time in MC) was different than the one I was describing. We will proceed as usual with our conversation today by discussing our last visit with his mom and the day's events. I need individual sessions with her so I will schedule that, and he usually follows suit with his own session. She may recommend that he see a separate therapist individually, as her focus will always be on our relationship. It sounds to her that he needs to work through some additional things. I offered that I am depressed and very open to doing the same.

I'm thankful I spoke up to the MC. I'm scared he'll refuse to grow. Just all the feels at the moment.

Thank you all for helping me process this.

[formflier]

Pursuing Joy

I remember back in the days when almost all of my energy was focused on getting whoever the preacher or therapist was at the moment to "see the light" and then hope they would have the magic potion to get my wife to "see the light" and get help.

FF's old dream.

Mrs FF: "Oh my mercy me...I accept that I have Paranoid Personality Disorder and that it's not normal to believe my husband is married to another woman (secret ceremony in our barn), has a love child with another woman he has been sneaking back early from deployments to do the nasty with and who then drops him off at the airport (drained of all his mojo) yet appearing to have just gotten back from overseas (appearing meaning plane tickets, cell phone records, hotel receipts, financial records...etc etc), who has a harem of women he regular sees while telling his wife he is running to the store, McDonalds, (pretty much anywhere a quicky can be fitted into his schedule.)

Umm...I really wish I was kidding about all those details, they're just the tip of the iceberg.

I also realize that some may be overcome thinking about the MOJO I must possess to be able to pull all this off...if you need to take a break to collect yourselves...I completely understand...

Looking back on my journey I have to say I agree with Cat Familiar.

The most valuable thing I got from over a year of couples therapy was learning that the psychologist thought my husband has a personality disorder. 

I finally got to spend time with a PhD level psychologist who also saw my wife and I together some and spent some time individually with my wife.  Then my wife declared her non Christian (and a list of other things and said she would never go back and from time to time tries to get me to  quit going).

The neat thing is my P totally understands my wife.  So much so that I'll say XYZ happened.  Then my P will say "I bet FFw said ABC..."  And she is almost always dead on right.

Furthermore, she has been able to help me understand my role in our relationship and my wife's personality disorder.  That allows me to change my role, which forces my wife to "dance differently".

My life is so much calmer.  Do I have the marriage I "want"?  No, not really but I enjoy my marriage.  When it's not enjoyable I go do something else that is enjoyable and from time to time I "stick my toe back in the water" of my marriage to see if things have calmed.

So...a long winded FF story to try and plant the seed that "success" in therapy can come in many different forms.  I encourage you to be open to whatever comes.

Best,

FF

[pursuingJoy]

Mrs FF: "Oh my mercy me...I accept that I have Paranoid Personality Disorder and that it's not normal to believe my husband is married to another woman (secret ceremony in our barn), has a love child with another woman he has been sneaking back early from deployments to do the nasty with and who then drops him off at the airport (drained of all his mojo) yet appearing to have just gotten back from overseas (appearing meaning plane tickets, cell phone records, hotel receipts, financial records...etc etc), who has a harem of women he regular sees while telling his wife he is running to the store, McDonalds, (pretty much anywhere a quicky can be fitted into his schedule.)

Umm...I really wish I was kidding about all those details, they're just the tip of the iceberg.

Oh my goodness FF. Wow! 

The neat thing is my P totally understands my wife.  So much so that I'll say XYZ happened.  Then my P will say "I bet FFw said ABC..."  And she is almost always dead on right.

Isn't it a relief not to have to explain? I was sharing with the MC what happened with him cussing at the TV then snapping at kids, and she asked, "Was he drinking?" But she already knew.

It was valuable to hear that the MC thinks that my MIL has BPD, and I think she's correct. Some days, I'm thankful there is a diagnosis, and I'm not crazy. Other days, it's a really heavy burden to bear alone.

It was interesting to hear you describe coming to terms with your marriage. I met this lady who'd been married 27 years, and I asked her what the secret was. She said, "Honey, marriage is hard because people change." To date, I've not heard a truer statement about marriage.  You have to learn to roll with the punches.

So...a long winded FF story to try and plant the seed that "success" in therapy can come in many different forms.  I encourage you to be open to whatever comes.

Thanks FF.

The MC has been very open about her role and that has been helpful. She suggested that it might be time to schedule some individual sessions with her. I have a feeling we would both benefit from counseling from another therapist, individually, as I think we each have stuff to work through before we bring it back into the marriage. 

[formflier]

  You have to learn to roll with the punches.

Yes, and also you have to find a few things that are really important to you and hold those close as unchanging values.  Not everything...but what really matters to you.

Essentially...FF as a 20 some year old thought everything had to be done perfectly...and I could do it all perfectly...(you get the picture)

Now as a 50 year I realize that not everything matters, but some things matter greatly. 

So I either roll with the punches (most of the time) or I'm willing to "go to the mat" over something that matters.  Going to the mat doesn't have to be mean, but it is helpful to be clear.

So...something like I'm going to have my right to privacy...period.  My wife can do what she needs to do to care for her feelings about that, but giving up my password just isn't going to happen (nor will I ask for hers).

You've got this!

Best,

FF

[sweetheart]

My experience both working with pwBPD and being married to a h dx with BPD is that as most of us know, the intimacy of a close relationship is where the characteristics and behaviours associated with this illness rise to the surface.

My work in forensic psychiatry brought me into close contact with many types of personality disorders in the patients I worked with. I knew the patients had or might have BPD, NPD, ASPD and so on and I believed that the work I was part of was helpful and supportive, understanding and so on. Otherwise I wouldn’t have been doing the job.
I had the luxury of patients that would be in my care for years such was the nature of where I worked, and I still made plenty of mistakes and wrong calls. Ultimately all a therapist has to work with even when there is a dx is what takes place in the room and what their patients are saying to them.
Couples therapy is not clinically indicated for a person with a personality disorder, or where there is a more than a suggestion there might be one.

Set against what I thought I knew as a professional and what I now know as a SO of 14 yrs to someone with BPD, is that I knew absolutely nothing about this illness. And now being on the other side of the hospital door, I realise that there very few clinicians really really skilled in working with this disorder. Certainly in general psychiatry it is rare here in the U.K. to have a multi-disciplinary team work in a holistic way taking into account what other members of the family have to say even where BPD is indicated.
There are of course specialist treatment units for personality disorders using DBT and other recognised clinical therapies.

People here may or may not know, that historically it has been v difficult for a pwBPD to find a good T, therapists IME are often scared of what they know will arise in the course of T with a pwBPD, allegations and false accusations,, ongoing projections and pathological lying etc this is the nature of the beast and as a T there is sometimes, again IMHE, sometimes a reluctance to poke it and see what happens. So it might be that the T is fully aware of the masking that goes on in the therapeutic space but does not want to actively work with it.

For me where there is a belief that a SO’s behaviours are arising out of a personality disorder individual therapy for yourself and your partner or family member is the best option. And I would always check that the T or even P has more than just an intellectual understanding of BPD, they need experience of what it feels like to be on the therapeutic receiving end of a pwBPD.
Always ask before you commit to any kind of therapy a T’s professional credentials and the amount of experience they have working with BPD;  and if the fit doesn’t feel right then find another therapist.

[formflier]

My P is very skilled in this area, yet she often expresses sessions with me are exhausting for her.

And I'm not the one with BPD...but BPD is in the mix.

Best,

FF

[pursuingJoy]

So it might be that the T is fully aware of the masking that goes on in the therapeutic space but does not want to actively work with it.

This is really interesting sweetheart. It makes sense. T's are human, after all.

I really like our MC but I have this nagging sense, mostly coming from her very positive outlook, that she is reluctant to look at some touchy pieces that we're dealing with. She has a way of smoothing things over. I can't figure out if it's me just wanting to move faster, and she knows we can't because of my husband, or if she doesn't want to go there.

For me where there is a belief that a SO’s behaviours are arising out of a personality disorder individual therapy for yourself and your partner or family member is the best option. And I would always check that the T or even P has more than just an intellectual understanding of BPD, they need experience of what it feels like to be on the therapeutic receiving end of a pwBPD.
Always ask before you commit to any kind of therapy a T’s professional credentials and the amount of experience they have working with BPD;  and if the fit doesn’t feel right then find another therapist.

Thanks.

[sweetheart]

pursuingJoy that sense you have from your T is probably spot on.

In my experience of therapy, if you’re feeling it and are aware of something in the therapeutic space, it more often than not means that it is there.

My preferred style of therapy is psychodynamic psychotherapy, which has its roots in psychoanalysis (just not as lengthy . so I would expect to look at what is said and what is not said. The unspoken sense of what is also in the room is as important for me as is what is being said.

Another way of thinking about what the therapist might be communicating by not exploring those ‘touchy pieces’ is that they don’t feel that it would be helpful for you and your SO to explore them, either yet, or even at all. By not going to those places the T may be fully aware that your partner is not able to emotionally navigate these issues, so they leave them alone.

It might then be that you decide to take those issues to individual T to explore them there, but in a safer environment.