Why Trusting Therapists Is Difficult with BPD

August 15, 2022 Mel Bender

People who have borderline personality disorder (BPD) have a reputation for being difficult to treat in therapy and not trusting therapists. As someone who has BPD, I can attest to this: I can be very defensive, and I have a habit of trying to do the therapist's job by diagnosing myself and telling them what I think I need. I also don't stick with any therapist for long and have been known to bail with almost no warning.

It's not that I'm trying to be difficult; it's that I find therapy difficult, and my behavior reflects this. Many of the symptoms of BPD come in direct conflict with being able to connect with a therapist. I struggle with impulsivity, sensitivity, and unstable perceptions of myself and others, and these challenges make it incredibly difficult to stick with therapy over the long term or trust a therapist. In my life, there are very few long-term relationships.

Trusting My Therapist and Being Vulnerable During Therapy

My biggest challenge in relationships is my inability to trust anyone fully. This is especially true with people in authority, and I perceive therapists as authority figures. I immediately put my defenses up. If I can't lower those defenses, I can't be open about my feelings and concerns. The result is going through the motions of therapy with a minimal genuine investment in the process.

It's not that I don't recognize that I'm mentally unwell. I know I am, and I desperately wish I didn't suffer so much emotionally. Trust, however, isn't something that can be forced. To sit down with a stranger in an office and be honest about deeply personal things is no small feat. It doesn't take much for me to get overwhelmed and shut down.

It's scary to be emotionally vulnerable. I'm always worried about being judged and rejected. The irony, of course, is that this is the very thing I do myself: I'm quick to judge and reject other people, especially therapists. It's a defense mechanism.

Doubting How Much Therapists Can Help Me Makes Me Distrust Them

Another reason that I struggle to stick with therapy is related to the fact that I've been told many times that BPD is for life. The impression I have is that my mental illness is less about what's happened to me and more about who I am as a person. If I'm cursed to live with this illness forever, I wonder what meaningful difference a therapist can make. Arguably, I may never know if I don't give a therapist a chance for longer than a few sessions. I also won't know the meaningful difference sticking with other people in my life could make unless I commit more to them.

I see many vicious cycles at play in all of my relationships: avoiding conflict, stifling feelings of discomfort, trying to be what I think the other person wants me to be, taking things too personally, and ultimately walking away when being in the relationship feels unbearable.

I'm good at acting like I'm more confident and comfortable than I am in therapy sessions. However, you can't act when you're trying to be open and vulnerable. Finding the courage to take off my armor and put those defenses aside is both necessary and terrifying.

The Search for the Right Therapist Is Worth It

It's helpful to remind myself that just because I've struggled to find a therapist I could trust and was able to be truly vulnerable with in the past doesn't mean it'll never happen. Even if my BPD diagnosis means I can be difficult to treat, if I have the genuine desire to get better for the sake of myself and the people who care about me, perhaps I can find the courage to endure discomfort in therapy and learn to extend trust in good faith.

The suffering I endure hiding from myself and others can't be worse than the discomfort of being vulnerable with someone who is qualified to help people like me. I need to believe that deeper healing is possible. In the end, learning to trust myself -- my strength, my resilience, my courage -- is the key to trusting anyone else, be they a parent, friend, or therapist.

APA Reference
Bender, M. (2022, August 15). Why Trusting Therapists Is Difficult with BPD, HealthyPlace. Retrieved on 2024, June 17 from

Author: Mel Bender

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