FOR SURE, regardless of their degrees or licensing, people who are trained to work with borderlines are the people to see--and maybe lots who aren't trained but are intuitive about the condition and the dependency issues, or who have a lot of stamina and excellent boundaries, can do the efficient work with us.

AND, I agree that the quality of the relationship is essential to the treatment.

However, I still think you need a formal diagnosis, and I find it really hard to believe you don't have one, because your insurance company does require one. So...at the very least, don't you want to know what that dx is?

Also, in some states, an insurance company will not pay for DBT led by MSWs--mine refused to pay for DBT training led by anyone less than an LCSW, and you can't BE in DBT without a personal therapist as well, and that therapist also had to be an LCSW. I really liked one of the LCSWs available to me while I was in DBT, but I elected to stay with my PsyD because of his ongoing research on borderline personality disorder because I am his patient--by the way, many, many psychologists will only take one borderline patient at a time because they require intense work (unless the psychologist is an expert in personality disorders). My t's experience and expertise with my dx is, afterall, part of what I am paying for.

Bottom line, this is a matter for you and your t, AND, I also think it is worth asking your t to get a consult on this. Pain is probably inevitable in therapy, but if the conversation consistently gets bogged down in conversation about your relationship with your therapist, then I think it's time to revisit the treatment approach. (That's the reason for the consult.)

This is a fascinating thread! I am really glad for it: it is leading me into some close thinking about my own therapy