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Health & Fitness

Terrible Therapists: Bad Marriage Counseling Hurts People with Borderline Personality Disorder

I am an expert on Borderline Personality Disorder (BPD) and write extensively on the subject. I became familiar with it in the 1980’s, wrote a 175 page doctoral dissertation on it, presently blog about it on Patch, and have numerous clients affected by it (either themselves or through a friend or loved one). I gave up the practice of psychotherapy because I think it serves no good purpose to label, diagnose and talk to people year after year about their problems. Although I do not diagnose my clients with this, or any, disorder I do not dispute the fact that the term is widely used within the mental health field.

It typically denotes a chronic and persistent pattern of maladaptive behavior that includes harmful “acting out” (suicide attempts, high-risk sex, etc.), and harmful “acting in” (alcohol and drug abuse, eating disorders, etc.).  I do not approve of the pharmaceutical industries’ agenda to have doctors label, diagnose and prescribe dangerous and addictive pills to hook unsuspecting consumers. Also, I do not agree with how people are labeled and treated in therapy – especially women and minorities. It is all a scam, in my humble opinion.

I became a certified life coach to avoid the pitfalls I see in the current, mental-health zeitgeist (read: DSM5). If you are unsure as to what BPD means exactly, I encourage you to read other posts I have written that describe it in depth. Also, there is no shortage of good literature about BPD in the DSM-IV-TR, DSM5, and various trusted websites.  

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A recent client and I had the following exchange: 

Client:  A therapist my wife and I were seeing diagnosed my wife with BPD and I want to know if I should leave my wife and get custody of the children?

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Dr. Jabin:  Why would you do that? 

Client: The therapist said BPD is a severe mental illness that is not curable. I am starting to see signs of BPD in my toddler and nine-year old daughter.

Dr Jabin: I disagree that BPD is a “non-curable disorder.” My personal experience with clients is tells me otherwise. I have coached people so successfully that they can no longer be considered BPD by therapists who diagnose. Aside from my success with my clients, there is new longitudinal research that suggests the most troubling symptoms remit by the fourth decade. I do not believe you are actually seeing BPD in your toddler, nor do I think you should contextualize your nine-year old’s behavior as occurring along a BPD continuum. 

What I found the most troubling was that this man was part of a “couple” who had gone to marriage therapy for help. Instead, the therapist aligned him or herself to my client and together they conspired to triangulate against the wife.

So perverse is this, yet so common too, that I am moved to write about it. The therapist even had the audacity to suggest to my client that he leave this country and return to his country of origin where he could successfully wrestle away his wife’s parenting abilities due to a power and money imbalance.  

I was trained in graduate school that American psychologists should not rush to label foreigners with western diagnoses – especially a stigmatizing,  “non-curable” diagnosis. Did this therapist understand that he or she was in a trusted position to point out resources? It does not appear to be the case. 

No wonder so many couples do not get the help they need and deserve when they go to marriage therapy. Despite the fact that couples go to counseling they do not get the tools, learn the skills, or find the resources that they need to repair the marriage. I believe this is because too many marriage counselors are horrible at their job. God help the unsuspecting clients who end up in the throes of a therapist with a secret agenda -- such as "acting out" his or her own traumas under the guise of "therapy." 

My client’s wife may have some valid reasons for her inappropriate behavior towards her husband that could be respectfully and competently looked at in a more empathic way. A good therapist could gently persuade her to try new and different things to get better results. This woman did nothing to deserve a therapist misusing her position of power to wrestle her husband and children away from her. She did deserve compassion, empathy, hope, and a chance to heal herself and her marriage. Why else would this woman leave the comfort of her home to attend marital therapy,  put her children in the paid care of another and agree to attend counseling with her husband? Not for this trickery, I assure you.  

Therapists with unresolved personal problems that negatively color their therapeutic outlook pose a danger to society. Our society puts doctors and therapists on pedestals to be the gatekeepers of morality and virtue. 

Doctors get to decide what behavior is “normal” and what behavior gets labeled “disordered.” Judges depend on therapists’ input to help them rule in favor of leniency or harsh sentences. Therapists persuade judges and juries every day about which parents are more fit and which offenders are deserving of second chances. Being a doctor carries a lot of weight in society.  Therapists who can’t manage their own healthy relationships should not be able to advise clients on what they should or should not do. Every therapist should be in therapy in order to be accountable and to know what it feels like to be the client.

I advised my client to get his wife to a medical doctor for a complete physical that includes blood and urine work. I reminded him that as women age our hormone levels change and that all his wife may need are vitamins and whatever appropriate pharmacology  would help her feel better . This may or may not mean antidepressant medication.  

One of my favorite sayings, and my mantra, is this: If you hear hooves approaching, expect to see horses and not zebras.  This reminds me that the cause is usually something fairly more obvious (depleted hormone levels and specific life event stressors) rather than the exotic (an incurable, mental-disorder dreamed up by the gatekeepers of moral society). 

Another favorite saying of mine speaks about the Art of Detachment. It goes like this: "Detach with love, not with an axe." I seriously doubt the couple's first therapist is correct to advise my client that he should relocate his family to their far away country of origin, lawyer up and rip away the young children  from their mother forever. Did I mention that this couple had an arranged marriage and their religion tells them they are married for life and eternity?

Psychological Ethics 101 tells American therapists to respect other cultures, learn about client cultures that are markedly different from our own, seek out knowledgeable colleagues for help, and do not pathologize these people because they are not displaying typical American values and norms.  Hopefully, my readers know better than to agree with the advice of a terrible therapist.

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