Psycho-Babble Psychology Thread 944317

Shown: posts 1 to 25 of 27. This is the beginning of the thread.

 

caught up over issue of diagnosis

Posted by deerock on April 21, 2010, at 10:01:39

hi there,

i keep bumping into this issue with my T but we dont talk about it too often. it came up in a big way yesterday.

i told her that i realize that some of the issues we work on (self destructive behavior, rage, mood swings, impulsivity, splitting) are common in people with borderline personality disorder and i said that i thought she was thinking i had that disorder. She said she did not want to label me. I said my concern was not about labels. Rather my concern was that by thinking that I had these problems, she was identifying behavioral patterns and feelings that were quite unusual. And I said that my concern was that she was telling me that I am experiencing and feeling things she has never ever felt. And she said well what if that is true. And I started to cry and said then that means that I feel like an alien. And the session started to wind down and she said this is it right here, stick with the feeling of feeling like an alien and lets talk more next time.

The whole thing makes me feel really uneasy. Like she sees me as a sick person or a hurt person. Like she acknowledges that I am feeling things she has never felt. That she is well and I am not.

The reason this bothers me is because I used to have another therapist who made me feel quite differently. I would ask him if I had a personality disorder or if something was wrong with me and he would say you know rock, you have tendencies like everyone else has tendencies. Your mind happens to have tendencies towards anxiety or depression. There is nothing wrong with you at all. You have your tendency and everyone else has theirs.

This message seems quite different than when my current T avoids saying that she thinks something is wrong with me yet she will confirm that I feel feelings she has never ever felt before. Its the choice to use the language that it something is wrong with me that she wont subscribe to and thats fine. I pay her to sit there and tell me there is nothing wrong with me. But for some reason, her approach is making me feel that there is something quite disturbing about what goes on inside me otherwise why would anyone bother to identify the behaviors as something that is exactly what borderline personality disordered individuals do.

For anyone who is reading this who is bothered by my reference to BPD as an illness or that there is something wrong with people who have it, I apologize. This has more to do with my personal views on the illness as well as long term prognosis for borderline personality disorder. I believe what I have is not a long term illness yet I am bothered that the T uses terminology that is consistent with BPD which is considered a long term illness as far as I can tell.

 

Re: caught up over issue of diagnosis deerock

Posted by Dinah on April 21, 2010, at 11:20:18

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

I like your old therapist's point of view better. At least your new one doesn't put the actual label on you, and does see you as an individual.

It's a fine line to walk to acknowledge that you have issues or challenges, and still be accepting. Does this therapist seem accepting of you as you are, while maybe still wishing to see you feel better by learning to react differently? Acceptance makes all the difference to me.

I don't know whether the fact that she hasn't experienced the same things you have means anything really negative. My therapist and I are completely different personality types. I'm always surprised when he shares that he does feel the same things I feel. I have way too responsive a nervous system and he's wonderfully phlegmatic. So he can help me learn to regulate my responses in a way that a less phlegmatic therapist might not be able to do. Like when my young puppy from a skittish breed came to live with us and our older dog from a very calm and sensible breed. She'd get anxious about things, and glance over to the older dog, see her calm response, and calm down herself. It helped her grow into a sensible and unskittish representative of her breed. Even though she naturally has a more finely tuned nervous system than her foster mother. It can be good to have a very different therapist, as long as they are calm and accepting about those differences.

In my opinion.

 

Re: caught up over issue of diagnosis Dinah

Posted by deerock on April 21, 2010, at 11:23:31

In reply to Re: caught up over issue of diagnosis deerock, posted by Dinah on April 21, 2010, at 11:20:18

dinah. i love the story about the skittish pup. made my day. what breed is the old dog and the pup?

the therapist is accepting of me. and she is calm. i appreciate your response. its helpful, indeed.

and like you and the pup before its transformation, i am of a wild nervous system and i am working to settle that down. take care. thanks for your support.

rock

 

Re: caught up over issue of diagnosis

Posted by Dinah on April 21, 2010, at 11:46:01

In reply to Re: caught up over issue of diagnosis Dinah, posted by deerock on April 21, 2010, at 11:23:31

Sheltie and Cavalier. The Sheltie grew up to have a very typical personality, in the best sense of the word. Reserved and very much a one woman dog. Lively and intelligent, and completely focused. But without being at all skittish or overtly anxious. She doesn't even bark that much, and I've never had a sheepdog who didn't bark a lot before. The Cavalier is soooo laid back. Nothing at all upsets her. I keep thinking I ought to train her to be a therapy dog.

But watching them when the sheltie was a pup was like seeing all that attachment and emotional regulation theory in practice.

Calm and accepting is good. :)

 

Re: caught up over issue of diagnosis deerock

Posted by obsidian on April 21, 2010, at 23:05:16

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

yeah, I wouldn't want to feel like an alien either. Do you feel comfortable with actually telling her how you feel? Do you feel like she won't understand and/or judge you?

 

Re: caught up over issue of diagnosis

Posted by emilyp on April 22, 2010, at 13:29:57

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

While I understand your concerns and perhaps I would have had the same reaction, I must admit I was surprised about one comment you made:

"I pay her to sit there and tell me there is nothing wrong with me."

Is that what you really pay her for? Or do you pay her to help you look at yourself honestly and help you overcome either weaknesses or other issues?

If you just pay her to sit there and tell you everything is fine, how will you ever progress in life? If you have an illness - regardless of whether it is a long term one or not - how will you ever get better with out making some changes in your life?

I am not saying she is 100% right. But sometimes hearing a little honesty can be helpful. I know that when good friends told me they thought I was depressed, it was helpful to confirm something I knew already. And it made me feel good that they cared enough about me to take the risk to tell me - that is not an easy thing to do, even if you are a therapist.

Finally regardless what she calls it or you call it, if you believe what you have it is not a long term illness, then that is what matters.

 

Re: caught up over issue of diagnosis emilyp

Posted by deerock on April 22, 2010, at 13:38:25

In reply to Re: caught up over issue of diagnosis, posted by emilyp on April 22, 2010, at 13:29:57

hi emily, i can understand why that comment may have made you think twice.

what i mean is that i think the diagnosis of borderline personality, in my case, is a matter of opinion. i have seen many docs who have told me that it is not the case that i suffer from that.

so when i say it is her job to tell me there is nothing wrong with me, what i mean is that i feel she is being paid to tell me i am ok and may have some things to work on but that i am ok. i think telling someone they are borderline is far from encouraging in any way and says something quite different from "youre ok." thats just how i see it.

what i am saying is that if some people who have treated me do not think i am borderline but my therapist does, then perhaps that says something about how she views me which is not helpful.

 

Re: caught up over issue of diagnosis deerock

Posted by fleeting flutterby on April 22, 2010, at 19:27:00

In reply to Re: caught up over issue of diagnosis emilyp, posted by deerock on April 22, 2010, at 13:38:25

>
> what i mean is that i think the diagnosis of borderline personality, in my case, is a matter of opinion. i have seen many docs who have told me that it is not the case that i suffer from that.<<

----flutterby: If you hold what the other docs have said to you as truth-- then why not go back to one of them?.... I'm not trying to be flip-- just was wondering why one would stay with a therapist that they felt was not as right as therapists they had in the past.....


>
> what i am saying is that if some people who have treated me do not think i am borderline but my therapist does, then perhaps that says something about how she views me which is not helpful.<<

----flutterby: or it says something about how YOU view her and that also could not be helpful.

 

Re: caught up over issue of diagnosis fleeting flutterby

Posted by deerock on April 22, 2010, at 20:13:07

In reply to Re: caught up over issue of diagnosis deerock, posted by fleeting flutterby on April 22, 2010, at 19:27:00

<<<----flutterby: If you hold what the other docs have said to you as truth-- then why not go back to one of them?.... I'm not trying to be flip-- just was wondering why one would stay with a therapist that they felt was not as right as therapists they had in the past.....>>>
i've moved, therapists have retired, others i have outgrown.

<<<----flutterby: or it says something about how YOU view her and that also could not be helpful.>>>
i guess its a chicken or the egg thing. i got along with her just fine until i realized she thought i was borderline. i still get along with her quite well actually im just not sure i see a need to label and categorize behaviors and feelings. a behavior is a behavior and a feeling is a feeling. if someone is afraid of abandonment and acts out over that fear, its ok to leave it at that. it doesnt need to be chalked up to a personality disorder.

i understand youre not trying to be flip flutterby. but you sure do come across that way.

 

Re: caught up over issue of diagnosis

Posted by emmanuel98 on April 23, 2010, at 10:39:49

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

From the way you describe the conversation, it seems that YOU said your issues sound like someone with BPD and SHE said she didn't want to label you. So I'm confused about why you are upset with her.

 

Re: caught up over issue of diagnosis deerock

Posted by pegasus on April 23, 2010, at 10:45:22

In reply to Re: caught up over issue of diagnosis fleeting flutterby, posted by deerock on April 22, 2010, at 20:13:07

Hi deerock,

You said: "i got along with her just fine until i realized she thought i was borderline."

It made me go back and read your original post. I didn't see anything in there that indicated to me that she thinks you are borderline. Maybe you left something out that she said? You reported that she told you she doesn't want to label you, and then she indirectly confirmed that you experience and feel things she has never experienced or felt. With the unstated implication being that the things you are experiencing and she has not are (some of?) the things you mentioned: self destructive behavior, rage, mood swings, impulsivity, splitting.

That seems to me to be a fair distance from her surely thinking that you have BPD. And anyway, there are a lot of therapists these days who think BPD is a pretty bogus (or at least, often improperly used or completely unhelpful) diagnosis. Her statement about not wanting to label you sounds to me as though she may be one of those. Or maybe she doesn't see your particular constellation of experiences as equaling a BPD (or any other particular) diagnosis. Maybe she would agree with the statement from your previous therapist, if she thought of articulating it that way. Seems like a good thing to ask her about.

It sounds like maybe the crux of the problem is that it scares you to think that the self destructive behavior, rage, mood swings, impulsivity, and splitting that you experience may be part of a hard-to-treat, long-term, serious problem. And so perhaps you want a T to tell you (and to believe) that they are not? Because then you can have hope for your future.

Hope should never be overrated, IMHO. Based on what you've said about yourself, regardless of whether you could be diagnosed with BPD (personally, I have no idea), I think there is a lot of hope for you. Plus, I know people who were once diagnosed with BPD, and now are no longer diagnosable with that disorder. So, no matter what your T says or doesn't say, or what you read about BPD, there is certainly hope for your future. I hope you can hold on to that.

Peg

 

Re: caught up over issue of diagnosis emmanuel98

Posted by deerock on April 23, 2010, at 10:45:29

In reply to Re: caught up over issue of diagnosis, posted by emmanuel98 on April 23, 2010, at 10:39:49

because she didnt say NO. by not saying anything she effectively agrees with me and by saying she wont label me she is saying she agrees but doesnt want to use a label.

your response makes me feel that you think i am being unreasonable.

 

Re: caught up over issue of diagnosis deerock

Posted by fleeting flutterby on April 23, 2010, at 16:10:38

In reply to Re: caught up over issue of diagnosis fleeting flutterby, posted by deerock on April 22, 2010, at 20:13:07

> i've moved, therapists have retired, others i have outgrown.
>

---flutterby: Oh, I see. thank you for explaining.


> i guess its a chicken or the egg thing. i got along with her just fine until i realized she thought i was borderline. i still get along with her quite well actually im just not sure i see a need to label and categorize behaviors and feelings. a behavior is a behavior and a feeling is a feeling. if someone is afraid of abandonment and acts out over that fear, its ok to leave it at that. it doesnt need to be chalked up to a personality disorder.
>
> i understand youre not trying to be flip flutterby. but you sure do come across that way.<<

----flutterby: Yikes!- sorry. have been told a few times that I "don't sugar coat things"-- I don't mean to come across as harsh.... (and yet some others have said I'm so nice-- it's confusing) I struggle to fit in socially. (maybe the schizotypal - they tend to not be able to fit in or socialize well) I'll try hard to be more careful in how I put things. Also I should probably refrain from replying in some circumstances....
thanks for your honesty

 

Re: caught up over issue of diagnosis fleeting flutterby

Posted by deerock on April 23, 2010, at 17:42:38

In reply to Re: caught up over issue of diagnosis deerock, posted by fleeting flutterby on April 23, 2010, at 16:10:38

you're entirely forgiven. i completely understand. do take care and have a great afternoon.

 

Re: caught up over issue of diagnosis

Posted by morganator on April 23, 2010, at 17:57:51

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

>Like she acknowledges that I am feeling things she has never felt. That she is well and I am not.

It's likely that she has not experienced the feelings you have. It is even more likely that she is well and you are not. Why do you have a problem with this? Don't we see people like therapists because we are not well and they are of sound mind and capable of helping us? As long as she acting as if she is superior to you, I just don't see a problem with what she is doing.

I don't know about sticking with feeling like an alien. I do think it is important to try to figure out why it is that you are feeling like an alien so you can begin to do something about it. I think this is what she wants you to do.

 

Re: caught up over issue of diagnosis

Posted by morganator on April 23, 2010, at 18:12:21

In reply to Re: caught up over issue of diagnosis emilyp, posted by deerock on April 22, 2010, at 13:38:25

> hi emily, i can understand why that comment may have made you think twice.
>
> what i mean is that i think the diagnosis of borderline personality, in my case, is a matter of opinion. i have seen many docs who have told me that it is not the case that i suffer from that.
>
> so when i say it is her job to tell me there is nothing wrong with me, what i mean is that i feel she is being paid to tell me i am ok and may have some things to work on but that i am ok. i think telling someone they are borderline is far from encouraging in any way and says something quite different from "youre ok." thats just how i see it.
>
> what i am saying is that if some people who have treated me do not think i am borderline but my therapist does, then perhaps that says something about how she views me which is not helpful.

I just don't see a problem with her viewing you as possibly suffering from Borderline Personality Disorder. I also think that if you might have it, it would be in your best interest to know that you do. It's like cancer or HIV, not knowing that we are ill makes it impossible to find a way to treat the illness. I'm sorry if I sound like I'm being hard on you.

I wish my therapist had realized a long time ago that I was bipolar and told me that she suspected it. This may have helped me avoid some of the issues I have dealt with over the past few years. I would have done research on it and done whatever I could to avoid having a major episode.

I have a friend that was diagnosed with Borderline Personality Disorder and he feels he is better off for it. He realized that his parents were largely to blame for the development of his disorder. Instead of getting angry and bitter about this, he used this knowledge as a way to take himself off the hook and have compassion for himself. It was no longer his fault. He was not just born f*ck*d up.

 

Re: caught up over issue of diagnosis

Posted by morganator on April 23, 2010, at 18:25:19

In reply to Re: caught up over issue of diagnosis fleeting flutterby, posted by deerock on April 23, 2010, at 17:42:38

Even if you do have BPD, I believe you can reach a point of being completely healed. Anything is possible. I think your therapist is just being honest, she doesn't know for sure whether or not you have BPD and just can't say no. My therapist also told me I she did not want me to feel labeled. She actually wasn't sure about my diagnosis with bipolar, but I think now she believes it(I don't see her anymore after I left a message telling her to F off and "Go to Hell". I was in the middle of a very agitated mixed episode). I would confront your therapist about this. I wish I had been more open with my therapist about a lot of things. Not being open with your therapist about every single thought, action, behavior, feeling, emotion, will only hurt you in the long run.

 

Re: caught up over issue of diagnosis morganator

Posted by deerock on April 23, 2010, at 18:41:20

In reply to Re: caught up over issue of diagnosis, posted by morganator on April 23, 2010, at 18:25:19

thanks morgan. i agree. i should be open with her. the issue is, that i do not believe she is well and i am not.

thats why i like what the other therapists told me. they thought i was well. this therapist thinks i am not well. that bothers me.

i have issues but i do not think that means i am not well. bpd means i am not well.

 

Re: caught up over issue of diagnosis deerock

Posted by morganator on April 23, 2010, at 18:54:46

In reply to Re: caught up over issue of diagnosis morganator, posted by deerock on April 23, 2010, at 18:41:20

As far as I'm concerned, if we are in therapy, we are not well. Maybe we have to admit this so we can get better. Maybe you have BPD, maybe you don't. My therapist once said that I was becoming stronger. I thought, "Does this mean she thought I was not strong in the first place?". I realize now that I was in denial for a long time-I was not strong.

 

Re: caught up over issue of diagnosis fleeting flutterby

Posted by Dinah on April 23, 2010, at 19:16:40

In reply to Re: caught up over issue of diagnosis deerock, posted by fleeting flutterby on April 23, 2010, at 16:10:38

I've read many of your posts, and haven't noticed you to be harsh, fleeting butterfly.

But then, my therapist is convinced I'm schizotypal too, and certainly I've struggled with not fitting in.

 

Re: caught up over issue of diagnosis morganator

Posted by Dinah on April 23, 2010, at 19:20:48

In reply to Re: caught up over issue of diagnosis deerock, posted by morganator on April 23, 2010, at 18:54:46

I think the whole idea of "personality disorder" seems so horrid when it's first brought up. I used to argue with my therapist "You are saying that my personality is disordered!! Not that I suffer from this or that disorder, but that there is something wrong with my personality!!"

I understand a bit more now what he meant, but even now, it's a sensitive topic. It's just a bit different in tone, and I wish they'd do away with "personality disorders" as a diagnostic category. I understand how upsetting it can be.

 

Re: caught up over issue of diagnosis

Posted by emmanuel98 on April 23, 2010, at 19:40:52

In reply to Re: caught up over issue of diagnosis emmanuel98, posted by deerock on April 23, 2010, at 10:45:29

It does seem to me that you are being a wee bit unreasonable. You brought up the borderline issue, assessing your own issues. She declined to label you borderline. I don't see what you're angry about.

Anyway, if you have issues that YOU assess as being borderline-like, why shy away from the borderline label so strongly. The BPD label leads to a whole slew of research on what therapies work (DBT especially) and why. Labels help therapists work out treatment programs based on empirically validated studies. BPD has been well studied and there's a lot of research out there about what works. Maybe, if you have borderline-like issues (self-harm, splitting, abandonment fears, explosive moods) you would benefit from borderline therapies.

I was never diagnosed as borderline, but I had explosive moods and a trauma history and was admitted into a DBT program. I didn't get upset about being effectively "labeled" as borderline. I just appreciated being able to get in this program and learn DBT methods. It helped me a lot.


> because she didnt say NO. by not saying anything she effectively agrees with me and by saying she wont label me she is saying she agrees but doesnt want to use a label.
>
> your response makes me feel that you think i am being unreasonable.

 

Re: caught up over issue of diagnosis Dinah

Posted by morganator on April 23, 2010, at 20:56:37

In reply to Re: caught up over issue of diagnosis morganator, posted by Dinah on April 23, 2010, at 19:20:48

Well said Dinah. Though I have to admit, when I was told I may have some sort of personality disorder I did not take it too personally. It immediately made sense to me and I understood where it came from. Try having a major horrific mixed manic episode, being hospitalized, being diagnosed with bipolar, and then being diagnosed with a personality disorder within a 2 month span. I'm not trying to minimize other people's feelings. I understand everything is relative.

 

Re: caught up over issue of diagnosis

Posted by morganator on April 23, 2010, at 20:58:13

In reply to Re: caught up over issue of diagnosis, posted by emmanuel98 on April 23, 2010, at 19:40:52

> It does seem to me that you are being a wee bit unreasonable. You brought up the borderline issue, assessing your own issues. She declined to label you borderline. I don't see what you're angry about.
>
> Anyway, if you have issues that YOU assess as being borderline-like, why shy away from the borderline label so strongly. The BPD label leads to a whole slew of research on what therapies work (DBT especially) and why. Labels help therapists work out treatment programs based on empirically validated studies. BPD has been well studied and there's a lot of research out there about what works. Maybe, if you have borderline-like issues (self-harm, splitting, abandonment fears, explosive moods) you would benefit from borderline therapies.
>
> I was never diagnosed as borderline, but I had explosive moods and a trauma history and was admitted into a DBT program. I didn't get upset about being effectively "labeled" as borderline. I just appreciated being able to get in this program and learn DBT methods. It helped me a lot.
>
>
You just better articulated a point I was trying to make earlier.

 

Re: caught up over issue of diagnosis deerock

Posted by floatingbridge on April 25, 2010, at 0:58:58

In reply to caught up over issue of diagnosis, posted by deerock on April 21, 2010, at 10:01:39

> And I said that my concern was that she was telling me that I am experiencing and feeling things she has never ever felt. And she said well what if that is true. And I started to cry and said then that means that I feel like an alien. And the session started to wind down and she said this is it right here, stick with the feeling of feeling like an alien and lets talk more next time.

Hi Deerock, maybe this has been said already, so forgive me for diving in before reading the thread--to me, this sounds like productive therapy. I've never used the word 'alien'. I'm trying to think of what word I use--'outsider', 'toxic' to others, 'made wrong' (as in created fundamentally and irredeemably flawed, like I was missing some important organ that everyone else in the entire world has).

She isn't saying she doesn't know. If she's worth her salt, and let's hope she is, she knows what those terms really mean and isn't afraid of them--isn't spooked by them. She can maybe handle them in herself and you. Now, admitting that one feels like an alien seems to be an act of courage and of trust. I know that trust ain't easy, nor is it continuos. My ability to trust is quite intermittent.

> The whole thing makes me feel really uneasy. Like she sees me as a sick person or a hurt person. Like she acknowledges that I am feeling things she has never felt. That she is well and I am not.

It's alright to be hurt, esp if with somebody safe. You can heal.

>There is nothing wrong with you at all. You have your tendency and everyone else has theirs.

Yes, true, but how helpful is it if that is all I would hear from my therapist? I need mine to push me a bit into some uncomfortable places--gently, of course.

For a long time I--I am using an I statement here--worried that I 'had' BPD. Finally my doc convinced me that that label was less important with my obsession with it and that was what needed some attention. He's the first therapist that helped me gain any traction in therapy--and trust. After almost two years I can say I trust him pretty much ;) This has really helped provide a model or re-parenting of a healthier relationship.


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