Do T's need to know BPD TO help?

Just wondering,

I told my T about my previous diagnose of Borderline personality disorder and he'd never heard of it.

that's pretty strange that he does not know about that diagnosis

Ha? A therapist who's never heard of BPD?

Well, I am not going to say that psychiatric diagnoses have vital importance in therapy. They are not the same as medical diagnoses for physical ailments. But they have some value in terms of giving a therapist a general idea of what kind of traits a client might have. So this is just a professional lingo that every therapist has to know regardless of whether they like it or believe in it. It's really weird that your T doesn't know what BPD is. I would go online and check if he has a valid license, frankly. If he does, I'd also ask questions about his professional background like which school he graduated from, what type of professional experience he had, what kind of issues he has mostly worked with and things like that. You have the right to ask all those questions because they are all profession related.

BPD is one of the most common disorders in psychiatric settings. I'd be surprised if your T has never worked in a place where lots of people with the diagnosis BPD (whether correct or not) come and go. I'd be concerned if my T didn't know what this diagnosis was...

I agree that it seems very odd that he doesn’t know what BPD is.

That being said, a therapist doesn’t have to know what experience XYZ was like in order to help you discuss it or be there for you as you work through it. BPD is more complex than some other issues people go to therapy to discuss, and I’m sure it would be more effective/beneficial to work with someone who is rather familiar with it... but technically he could be “helpful” regardless if he is a kind, understanding ear that you feel connected to.

I know, it's an odd one isn't it.

He thought it was like split personalities.

Check his license. There is no way a therapist does not know BPD and that it's like split person laity. Something is not right. Be wary!

well, i guess the good thing is if he doesn't know about it, he won't be biased by all the stigma that commonly goes along with the BPD diagnosis that seems to scare off a lot of Ts.

but yeah, i too would be a bit concerned that he does not know about it.

That's true. The stigma is so big that it's not funny. Many therapists refuse to see the person for what they are as a human being once they see "BPD" in their records Besides, most of the time they mislabel client's trauma as BPD. The most appropriate dx label for most those with BPD dx would be C-PTSD. At least, it describes the problem more accurately and sounds more compassionate.

I have BPD- it's not a diagnosis for T's without experience or knowledge of the condition. I would suggest being very careful and looking elsewhere, he could do more harm than good.

I also have BPD and I strongly disagree that CPTSD would be a more fitting diagnosis for most. There are very clear differences between the two. The current diagnostic system has lots of flaws, but there is no point in bundeling together different things. You don’t even need trauma to have BPD.

Also, working with somone who has BPD while that T has no experience sounds like it could go wrong very easily.

I would be curious to know the context of this statement to see if it's at all mitigating. Did you explain what BPD stands for? Otherwise I would leave him in a heartbeat, even if I knew he could actually help me). It's like not knowing that there are treatments for HIV positive people. The guess he made that it's "split personality" is even stupider, unless of course, he could explain what he meant by that.

Supposedly there's differences between BPD and CPTSD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165723/



Though a lot of BPD folks have trauma too.

PDs can be difficult to treat and in my opinion, a T needs to know about them and trained in treating them. I've Avoidant Personality Disorder (AVPD) which is often argued to be a more pervasive form of generalised Social Anxiety Disorder (SAD), and frankly I only had limited improvement in therapies for SAD because the underlying PD issues around disorganised attachment, self worth etc weren't being targeted.

I would prefer a therapist knows what he's treating me for. otherwise it's kind of like going to an eye doctor for back surgery. I might as well just use any random stranger off the street as a therapist. I go to therapist because they have knowledge and expertise in their field, because they should know, they are trained to deal with it as best they can, person to person. You know so the fact he doesn't know is a red flag. I went to college to be a therapist, I can not tell you the number of classes, and the amount of studying of disorders we had to do, BPD is one of the most common ones, and we studied it to no tomorrow. We studied it so much it basically outed me to the entire class without me saying a word.

Anyway, you do have a point a lot of practitioners do have a stigma against it, but there are those that do not. There are those who specialise in it, or at least specialise in the DBT treatment that's usually called for. You could look into that. But BPD isn't something that can just be waved away like it's nothing, it's one of the more severe mental illnesses. You really need to be with someone with at least knowledge of the disease, how else would they help you otherwise if they don't even know what they are treating you for, or what your illness is.

Yes, I think they should know about BPD.

How could it do more harm than good?

From my experience, you need very good boundaries and to know yourself a whole lot when you deal with someone with BPD.

I can only speak for myself, but sometimes I come into a session and I'm a complete and total mess. I can't even really talk about the issue, just sit there and cry, be scared, whatever comes up. My T says that this also provokes emotions in him. Now if the T knows about the disorder, they can judge what to do in this situation. But if not, the T might for example be too comforting, making me get sadder and sadder because that's how I get more comforting. And then at some point the T is exhausted and angry, snaps or tells me to leave. And then I've repeated the cycle I've been in my whole life.

If they don't know what the diagnosis means, how should they know how to treat it? If your doctor told you he didn't know what exactly cancer is, would you want him to treat your cancer?

I agree that a lot of people with c-ptsd are mis labeled as having BPD. However, I don't think they are the same thing at all. I just think Ts are quick to label people with certain traits without looking deeper. Regardless I find it very concerning that this therapist has never heard of BPD and thought it was split personality (which isn't the proper terminology anymore). I'd want to see his credentials.

Good post, I agree with this ((((( hugs )))))