Q

My wife is obsessive compulsive and possibly has borderline personality disorder. We were going to marriage counseling at my church but our Christian counselor told me he isn’t a physician and cannot diagnose mental illness. I cannot live with my wife’s behavior. I’m frustrated and want to give up. How do you handle a spouse’s mental illness?

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A

During my long practice as a psychologist, I’ve seen the pendulum swing wildly from over diagnosing mental illness to under diagnosing. We seem to be in a season of over diagnosing again.

Mental illness is generally considered a dysregulation in a person’s normal cognitive, emotional, or behavioral functioning. But this leaves lots of room for interpretation. According to this definition, I’ve been mentally ill a number of times—but I don’t believe I’ve really been mentally ill. Can you relate?

That said, there is value in getting a diagnosis, but only insofar as it leads to effective treatment–whether psychotherapy, medication, or both. A proper diagnosis leads to proper intervention and treatment.

Be aware of this danger, however. Since we live in an age of easy access to information by way of the Internet, many people read up on different diagnoses and then label their mate or friends with various disorders. It’s common to become frustrated with someone’s behavior, seek out information, and then label another person. Exercise extreme caution when seeking information, as you often see only that for which you’re looking.

An additional, related danger/ bias is the understandable desire to explain what you’re experiencing. I presume your mate is acting erratically, and you discovered Borderline Personality Disordered individuals have erratic mood swings and behavior. However, there are many other plausible explanations for whatever behavior you see. I encourage you to exercise caution in using the label of mental illness.

Assuming your wife really does have a bona fide disorder that disrupts her normal, everyday cognitive, emotional, or behavioral functioning, I’d like to offer these suggestions:

First, understand the value and limitations of diagnosing a behavior. If you’re concerned about your wife’s cognitive, emotional, or behavioral functioning, talk about the issues with her in a most respectful way. Approach the topic with extreme sensitivity and only for the purpose of proper medical/ psychological treatment. Guard against labeling your mate or using a diagnosis to inflict harm or blame.

Second, seek a professional opinion. Do not be so insensitive as to lecture her about her behavior, citing the latest information gained from your research. Leave diagnosing to the professionals.

Third, seek professional intervention. Any significant emotional problem will require professional intervention, and these interventions can be very effective. Emotional problems rarely simply disappear. If anything, untreated, they may worsen with time. Appropriate medical/ psychological intervention (these often enhance each other!) will usually make a positive impact.

Finally, work together on changing emotions and behavior. Whether you are dealing with a true mental illness or symptoms of emotional abuse, trauma, a troubled marriage, or work situation, you will be ahead if you collaborate to find the solution. Most emotional problems can be remedied with clarity, gentleness, love, compassion, and expert psychological/ medical care.

 

 

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