How do I get her help.

[LouisLake]

Hello,
I have a high suspicion my wife has BPD. She has tried regular therapy before for her ptsd and eventually thought she didnt need it/the therapy was no longer doing anything. Problem is she still has her moments and they can be vicious. Also, the therapy was for her ptsd, not geared towards treating her bpd. My question is how do I get her diagnosed and get proper help if everything I read says to not tell the person with bpd that they likely have it?
Thanks

[PLEASE - NO RUN MESSAGES]

PLEASE - NO RUN MESSAGES This is a high level discussion board for solving ongoing, day-to-day relationship conflicts. Members may appear frustrated but they are here for constructive solutions to problems. This is not a place for relationship "stay" or "leave" discussions. Please read the specific guidelines for this group.

[lmnoprob]

Hi there,

It took a long time for my wife to get a diagnosis and to accept it. I suspected that she was BPD for about a year before it was formally diagnosed. I discovered it while reading about the condition which also affected my sibling, and realized that many of the behaviors matched this relationship too.

Unfortunately, before the diagnosis and treatment, it took my wife hitting some rock bottom places, and me learning how to hold really firm boundaries about what behavior I would tolerate. If you haven't already, I would read up on boundaries, how to hold them, and how to center them in your own experience--you have the right to be treated with love, respect and kindness, and even in a conflict, we can reasonably expect our partners to fight fair. Fair fighting rules are a tool given to us by our couples therapist pre-diagnosis, and they really brought to light how out of control our conflicts were getting. There are lots of versions of fair fighting rules online, and you can pick and choose which are important to you.

Pre-diagnosis, I knew something was wrong, but I couldn't put my finger on what. I had to do a lot of reading about what healthy conflict looked like before I was able to recognize what was reasonable and what wasn't. Books I relied on include "The Essential Family Guide to Borderline Personality Disorder", Harriet Lerner's "The Dance of Anger" and the "Dance of Intimacy" (these aren't about borderline but they offer some great insights about family systems and what healthy conflict can and should look like) and anything I could get my hands on about boundaries and emotional abuse. I read these on an e-reader so I could do so in privacy without the cover declaring my suspicions! I'm not going to lie, this was really really hard (it still is...see my recent post about her current flareup...) but it paid off big time, in that I significantly improved my own mental health and wellbeing, and raised the bar for my expectations of her behavior. When she realized she didn't have the capacity to behave in a way that would allow for this and other relationships to continue when I/we held firm boundaries, she eventually got, and accepted help. The first step for her was to get treated for a neurological condition that she had downplayed for years. They put her on medication for this that also really helped BPD symptoms. This was the point at which she was able to hear that there were issues that were rooted in her behavior, not some sort of persecution in which I and all her medical team were out to get her...At this point, it actually helped to have the diagnosis named, and once she started reading about BPD, she agreed that it fit her perfectly. Now she fully accepts the diagnosis (although we are struggling to find a new care team after moving, but that's another story).

Personally, I don't like the model of professionals not telling people a diagnosis, although I understand the reasons for it being fear that they will avoid treatment. In my wife's case, knowing the diagnosis helped a lot. In fact, she is upset with a former therapist for NOT diagnosing her (or for not telling her if he did). But we are both big readers, with lots of education. My wife tends to do well with a framework that help her understand something, which is not how everyone processes.

That said, I broached the possibility of BPD with her before the formal diagnosis, and while she didn't deny it, it didn't really stick. It did take several professionals weighing in. So I guess my overall advice is for you to get clear about your own needs/limits, and to not give up on finding a therapist that is a better fit--sometimes it takes a few tries. We went through at least 2 before the third identified it, and referred her to a psychiatrist that formally made the diagnosis. We both had individual therapists, and went into couples counseling, but had to try a few different therapists. It took a lot of persistence, but we eventually got there.

[Cat Familiar]

Because BPD is a shame-based disorder, people who have it are reluctant to admit to it, as they already have a history of believing something is inherently wrong with them and have spent a lifetime of trying to cover that up or project it upon others.

This article might be helpful:  https://bpdfamily.com/content/how-to-get-borderline-into-therapy