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Boyfriend With APD - Frustrated - Nelly - Jul 21st 2008

Question:

I’ve been in a long distance relationship for several months with a wonderful man. We both care about each other deeply. He was diagnosed a few years ago with APD and, it’s safe to say, he has some DPD characteristics as well. Even in a long distance relationship, it gets exhausting for me. I find myself in the role of girlfriend part time and therapist the rest of the time. I feel like I’m constantly having to guide him and nudge him along. But, right now I’m willing to hang in there in hopes of seeing the person he really is instead of the one who has no confidence in himself or his self-worth – seeing the man who can make decisions for himself.

He started seeing a therapist again to deal with his issues and horribly abusive past. On the one hand I’m concerned because the only reason he’s in therapy is because he knows it will never work between us if he doesn’t get "better" (for lack of a better term). On the other hand, at least he’s in therapy. However, his therapist is a social worker. It seems that more and more I’m becoming the focus of their sessions instead of looking at his thought processes and behaviors and how to positively change those (there’s been virtually no discussion about his childhood, parents, etc.). He shares with me some of the content of their sessions; it seems that he’s relaying information based on how he perceived a given interaction between us – although not always how I perceived it – and instead of focusing on what he may have been feeling, how he may have behaved, really just digging deeper and asking more questions, the therapist will say something like, "I don’t see anything wrong with that". (This may not be making sense without examples but I’ll start with this for now – maybe some examples next time.) Anyway, a few sessions ago both he and I felt she didn’t have the background to deal with his issues (it seems like she constantly refers to the DSM IV for guidance during their sessions). She brought up the issue of meds. for his anxiety and he said she was insistent. When he first told me, he was opposed to the idea of meds. but after he and I talked it through he agreed it was worth a try. Well, she never brought it up again! I’m actually concerned at this point that she’s not helping him at all and may be doing more harm than good. Soon, hopefully, he’ll be moving on to seeing a psychiatrist or psychologist.

I just don’t know what to do. What’s my role in this? How do I find the line between being helpful and supportive as his girlfriend and not his "therapist"? How long do I put my life on hold? I feel like I have to push him to do things or they won’t happen (like seeing a therapist) but then it makes him that much more dependent on me. It makes me feel like I’m controlling his life. As I said, I’m not ready to throw in the towel – but I need help! I’m glad I found this site. Any advice is appreciated.
Thank you Dr Schwartz and insightful unnamed – Nelly – Jul 19th 2008

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Answer:

First, I want to suggest to you that long term relationships really do not work, at least, in my opinion and in my experience.

Second, as a therapist I always recommend to my patients that they do not talk about their sessions. Discussion sessions dilutes the therapy and invites bad feelings among family and friends and that is what you are experiencing.

Third, the fact that his therapist is a Social Worker is not the issue. Social Workers are qualified to do this work. If he is interested in medication then it is up to him to bring the issue up to his therapist now that she has mentioned it. Whe will refer him to a psychiatrist for the proper medication treatment.

Fourt, you are his girlfriend and not his therapist. Sharing emotional issues is one thing but do therapy with him is not called for.

Lastly, In my opinion there is something not quite right about a man with Avoidant Personality Disorder being in a long distant relationship. It just seems to me that it is just another way for him to be avoidant and, is therefore, self defeating.

You may need to so some serious thinking about this relationship and what you want for yourself and what you deserve and expect for yourself.

Good Luck

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