Revealing Your History to a New Therapist

Stigma remains alive and well when it comes to borderline personality disorder, even within the healthcare community:

“A study assessing mental health staff attitudes towards consumers with BPD found that over 80% of staff viewed this population as difficult to work with, and indeed, more difficult to treat than consumers with other mental illnesses.”

In a recent post, I described feeling as though I was experiencing high-functioning depression and feeling overwhelmed. I contacted a new provider and we set up a phone consultation. I described my current situation, and she was empathetic. She asked me if I’d had therapy before, and I believe in being transparent, so I told her about my history of anorexia and BPD, but I assured her they were both under control and those were not the reasons I was seeking treatment now. I emphasized that the reason I was seeking treatment was to avoid my depression becoming worse and to not feel so overwhelmed.

She told me she had no experience with eating disorders or DBT — and I repeated that my eating disorder and BPD were in remission. We got into a discussion about my inability to set clear boundaries with some people in my life. She said she thought what I needed was a refresher of my DBT skills. She wasn’t going to work with me.

After she hung up, it took a couple of minutes to sink in: She wasn’t going to work with me. And then the possibilities of why began to wash over me. She seemed supportive until I mentioned my BPD history — which I don’t regret. I want potential providers to have an idea of my history before they start working with me, so I don’t get “accused” of hiding anything. Do clinicians believe that a client can truly recover from BPD?

One study states that “research during the past 2 decades has clearly demonstrated that BPD has a positive trajectory over time. Many of the specialized psychotherapies help patients with BPD, but long-term functional recovery is difficult.”

So the answer to the question of whether a client can truly recover from BPD may be: to a point, but perhaps not fully. I clearly recall telling her that I was currently working three jobs, one of them as a full-time social worker. With me, it’s not about an ability to function; it’s more like: No wonder I’m feeling overwhelmed.

I will never know for sure why the therapist declined to work with me, and I need to accept that. I may have my suspicions based on a 15-minute conversation and her attitude shift, but perhaps that was exaggerated in my mind because of the rejection. I consider myself fortunate that this has never really happened to me before. Honestly, I don’t know if I will continue searching.