Recommendations for suggesting for an evaluation

[Fish1974]

Good evening all,

I'm new here, and it's so wonderful to see so many others experiencing or having experienced the same thing (or similar). I'm sure that this has been discussed with over 600 pages here.. but ain't no one got time to search that many pages. LOL.

How does a person suggest a undiagnosed person with BPD.. to get evaluated? Mainly without triggering them.

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[SaltyDawg]

You don't, unless...

Two things must be present; otherwise, it will end really really badly.

1.  They must be self-aware that something is wrong with themselves, either partially self-aware or fully self-aware.

AND

2.  Are willing to go to therapy to work on themselves.


If both are present, coolly and calmly suggest using "I" pronouns only only when they are trying to figure out what is going on with themself...

"I think that _________________ might be something, I would like to go to  therapist/psychiatrist as it might help in figuring it out"

[CodaDad]

Honestly my suggestion to you is, before trying to help them change at all, is look very carefully inward at yourself to figure out your motivation for doing so. Specifically ya it’s easy to you tell yourself it’s because you love them— but there’s a very good chance you have an insecure attachment style or codependency traits. If so then beware you are setting the both of you up for a potentially very toxic relationship. Otherwise If you Are certain that your motivation is pure, such that you were committed to them whether or not they change, then be sincere, honest, and be ready to trigger them in the process no matter goes hard you try not to. Then leave it up to them because true and lasting change must come from within— and they will just resent you for being their psychology police. Good luck either way!

[Fish1974]

Appreciate the advice.

@CodaDad - I'm not sure how you came to this conclusion off of a question. My motivation here is to try and help her identify 'what's really going on here'. Not just for herself, but her 2 kids too. I think that like so many of our loved ones, they don't really want to investigate the true cause of their pain or they try alternative diagnoses. They think it's something else, as it's a hard pill to swallow (I would imagine) due to the label that society' has placed on folks with mental illnesses. No one wants to have that jacket.

In my previous marriage, my stepdaughter was later diagnosed as suffering from BP1 and skitso (sp). I had begged my now ex-w to get her evaluated etc. She later got mixed up in drugs, and illegal activities. She died in a rehab facility via suicide at the age of 24. I did this for 15 years, so this isn't exactly my first rodeo in dealing with someone that is suffering.

I do appreciate your response.

@saltydawg - She's aware and has been in therapy for a while. I suspect her therapist knows, but my BPD ex is withholding that from me. She's slipped on 3 different occasions about her therapist 'testing' her or her therapist has made comments about mania. I'm only provided the information that my exbpd person decides to share. My ex is a counselor (HS) of all things.. SMH, so I know she knows what that label means from a society standpoint. I think this is why she's truly not exploring it. She is doing things like reiki, horoscope, etc.

[Notwendy]

Unfortunately, in my own situation, denial and projection are a part of the issue. I have an elderly BPD mother who has had multiple psychiatric interventions and years of therapy. One of the reasons it has not been effective is that she spends these sessions convincing the T she does not have a problem and everyone else is the problem.

Her perspective is from victim. Suggesting she needs help is perceived by her as someone insulting her, attacking her character, or they have the problem themselves.

This has nothing to do with intelligence. She's very smart, has read all kinds of psychology books.

I think you mentioned an important thing- you need to feel you tried. However, we can't control their response to our suggestion or force them to do something about it. We are in the situation where BPD mother is making some self destructive decisions.  However, she meets criteria for legally competent, and we have no grounds to intervene, even if it's for her own good. So we are completely powerless. Still, family members need to feel we did what we could. So say what you feel you need to say but the rest is up to your ex.

[Fish1974]

Thanks Nancy! Appreciate it.. all of the comments in all of the threads are really helping me get through.

[kells76]

Hi Fish1974, welcome to the group 

It makes sense that you'd want the best for someone who has occupied a special place in your life. I bet every one of us here shares that value, of wanting loved ones, and people in general, to get help and overcome mental health challenges. The world would be a better place with less loss and trauma.

One of the "double bind" challenges of BPD is that shame is a core component of the disorder. Another challenge is that it's a disorder that manifests relationally, typically more intensely in closer relationships. That makes it really difficult for a pwBPD (whether a diagnosis or traits) to (a) truly hear anything that sounds like "there's a problem with you", especially (b) if it's coming from someone they have, or have had, a close relationship with.

My guess is that ultimately, you'd want to be effective -- you'd want any suggestion you make to be truly heard. That may mean approaching the situation non-intuitively. With most "broadly normal" people, you could say something straightforward like "I'm really concerned about you... I care about you... I think there's something going on, I think you should get checked out by a professional", and the person might be able to say "Well, thank you... I see it kind of differently, but I get what you're saying... I'll think about what you said and talk about it with my doctor".

A pwBPD, on hearing "I think there's something going on, I think you should get checked out" etc, instead of being able to "gray area" it and see both sides ("Well, that's not exactly how I see it, but I get your point"), may instead double down on "I'm not the problem, YOU'RE the problem for even hinting at it... YOU need help, I'm PERFECT". The suggestion might build a stronger resistance in the pwBPD in hearing anything "helpful" from you.

We might need to approach these "Can you see someone and get help" suggestions from a very different direction.

Have you checked out our article (and video) on this topic yet? The article is called Anosognosia and Getting a "Borderline" into Therapy, and contains information and a video from reputable source Dr. Xavier Amador. He has also written a book called I am Not Sick, I Don't Need Help: A Practical Guide for Families and Therapists  -- worth a look in our book review section.

What are your thoughts after reading the article?

[Fish1974]

Hi Fish1974, welcome to the group 

Thank you - I am absolutely in love with this site now. Almost obsessed :-)

My guess is that ultimately, you'd want to be effective -- you'd want any suggestion you make to be truly heard. That may mean approaching the situation non-intuitively. With most "broadly normal" people, you could say something straightforward like "I'm really concerned about you... I care about you... I think there's something going on, I think you should get checked out by a professional", and the person might be able to say "Well, thank you... I see it kind of differently, but I get what you're saying... I'll think about what you said and talk about it with my doctor".

A pwBPD, on hearing "I think there's something going on, I think you should get checked out" etc, instead of being able to "gray area" it and see both sides ("Well, that's not exactly how I see it, but I get your point"), may instead double down on "I'm not the problem, YOU'RE the problem for even hinting at it... YOU need help, I'm PERFECT". The suggestion might build a stronger resistance in the pwBPD in hearing anything "helpful" from you.

This is almost verbatim how I have approached the situation.

We might need to approach these "Can you see someone and get help" suggestions from a very different direction.

Have you checked out our article (and video) on this topic yet? The article is called Anosognosia and Getting a "Borderline" into Therapy, and contains information and a video from reputable source Dr. Xavier Amador. He has also written a book called I am Not Sick, I Don't Need Help: A Practical Guide for Families and Therapists  -- worth a look in our book review section.

What are your thoughts after reading the article?

I have not, but thank you for bringing this to my attention. Now I know how I'm going to spend the next few minutes of my day. LOL

[SaltyDawg]

She's aware and has been in therapy for a while. I suspect her therapist knows, but my BPD ex is withholding that from me.

Mine is aware that 'something' is wrong; however, refuses to do a psych eval, and refuses my unprofessional 'diagnosis' as she puts it.  However, and 1 out of the 3 recent therapists in this mental health journey I believed the first couple's T knew, the other two may or may not suspect BPD, but both of those are very verbal in saying she is not.  The one that said 'there might be something there' when I suggested BPD, but that couple's T ghosted us as soon as she figured it out; but that couple's T gave me some really good parting advise when she stonewalled my wife.  That advice was to go to my wife's individual T and share my concerns, and I did that.  While her individual T refused to acknowlege BPD; however, the end result is that the more severe symptoms of BPD are being addressed and I do notice significant improvement, even though there were a couple of setbacks during the holidays.  Only time will tell if it is a success.

Also, I don't care what the T's call it -- as long as positive progress in being made, I will be happy for her, myself, and my children.

[Fish1974]

Mine is aware that 'something' is wrong; however, refuses to do a psych eval, and refuses my unprofessional 'diagnosis' as she puts it.  However, and 1 out of the 3 recent therapists in this mental health journey I believed the first couple's T knew, the other two may or may not suspect BPD, but both of those are very verbal in saying she is not.  The one that said 'there might be something there' when I suggested BPD, but that couple's T ghosted us as soon as she figured it out; but that couple's T gave me some really good parting advise when she stonewalled my wife.  That advice was to go to my wife's individual T and share my concerns, and I did that.  While her individual T refused to acknowlege BPD; however, the end result is that the more severe symptoms of BPD are being addressed and I do notice significant improvement, even though there were a couple of setbacks during the holidays.  Only time will tell if it is a success.

Also, I don't care what the T's call it -- as long as positive progress in being made, I will be happy for her, myself, and my children.

Thank you for the feedback. I have done just what you mentioned .. asking her to see if I could go to her "T", and she denied me access to her. Now, I could be WAY off base here, but I suspect that she did so.. so I wouldn't find something out. Course this is pure speculation on my part though. Your line about positive progress .. this is exactly what I want for her.

I don't know.. this whole journey is just so frustrating. I completely understand that these relationships are a nightmare for the pwoBPD, and that I should probably let her go for my own mental health (which I am working on restoring now). I still feel bad.. being like everyone else that she's had a relationship with.. and quit on her. Ugh.. One big circle jerk.

Thanks again!

[kells76]

Hey again Fish1974, this line in your update stood out to me:

...I should probably let her go for my own mental health (which I am working on restoring now). I still feel bad.. being like everyone else that she's had a relationship with.. and quit on her. Ugh.. One big circle jerk.

Another facet of BPD that seems so obvious that it gets forgotten, is -- it's a mental illness, and it involves distorted thinking and perceptions.

I'm guessing you didn't personally know each and every one of her former relationship partners? So for at least a few of them, you only know what she's told you?

Given that BPD colors perceptions, thinking, memories, internal narratives...

and that she is the one describing former relationships to you...

I wonder how you might re-frame "I'm just like everyone else... everyone else quit on her".

Could that be her perception of her past relationships?

...

Anyway, if I'm reading your posts correctly, this is an ex? Please feel free to check out and post on our Detaching and Learning...  board as you unwind and/or process your relationship.

Of course, given your specific question above (about communicating with a pwBPD), it is fine to ask that here on Bettering -- which is a great place to learn better communication tools and skills, no matter what!

...

Food for thought,

kells76

[Fish1974]

Thanks Kells,

Yes, this is an "ex".. very very recently. So, I'm really at the stage where my head is still spinning. Sorry for posting in wrong areas. I just got so excited when I started reading all of these stories. Bit overwhelming of course. We've done the cycle 1 time already (breakup & get back together), and then just NYE she made another attempt to invite me over for a booty call, which I declined.. but I fully anticipate another attempt. So, I've really been trying to understand what has "worked" and "not worked" for others. I use these terms loosely. Do I want this in my life? etc.

[kells76]

No worries -- just glad you're settling in. While often members will find a "home board" that best describes their situation, it's OK if you have a question related to a different board topic, to post it on that different board. You're doing just fine 

Additionally, members on Detaching/Healing will be able to give you more specific advice and feedback, just due to their own similar circumstances. So please do feel welcome over there!

I fully anticipate another attempt. So, I've really been trying to understand what has "worked" and "not worked" for others. I use these terms loosely. Do I want this in my life?? etc.

That's a really important question, and it's good that you're asking yourself.

I'll make sure to check over on Detaching for your posts as well;

kells76