Q. My 16 year old daughter has been seeing a therapist, Ph.D, for 4 months. Since day one, she has HATED this woman. She tells me she feels demeaned, that when she tries to tell the therapist she is suicidal, for example, the therapist replies with "That's bulls*** - stop playing mind games with me!!" Her only other comments in therapy are "Why do you say that?" or "What makes you feel that way?" - never any declarative comments on what my daughter is saying, other than the mind game one and telling her "I feel soooo sorry for your poor parents!"

My daughter, being typical borderline personality disorder, knows how to "push her therapists' buttons" as, again, she despises her. In one time doing this, the therapist replied with "F*** YOU!". The therapist says it was said in humor, but my daughter did not take it that way. She insists she is unable to bond with this woman. The therapist definitely has no sense of humor, and won't acknowledge any humor my daughter presents. To be honest, I did not like the woman, either, when I first met her, but never voiced this to my daughter as the therapist is supposed to be a 20 year expert in treating adolescents with BPD. 

I am going to go talk to the therapist and go over some of these issues next Tuesday. I know my daughter is given to MAJOR manipulation to get her way, and usually I am able to tell when she is doing this. This time, however, I believe her totally. 

What questions can I ask this therapist, other than does she subscribe to the "old" understanding that BPD is a character disorder, or the "newer" information that BPD is a form of dyslimbia, and with the right form of meds (my daughter is currently on 50 mg Luvox and 200 mg Tegretol, both taken at night), a BPD patient needs to be taught a new way of handling responses, preferably by a supportive therapist who is also ready to point out any manipulation she sees?

Bottom line, my kid says she feel so much worse after seeing this woman, and NOT because of the therapist getting to any issues, just that sometimes the session ends with the therapist telling her to "Get out!" and generally she feels the therapist is trying to tear her down to make her dependant on the therapist. Thank you for your time.

 A. It sounds as if you have been very deliberate and comprehensive in investigating your daughter's concerns about the therapeutic relationship. It also sounds very appropriate to sit down and discuss these concerns with the therapist. However, I'm not so sure that any one question (or answer from the therapist) is going to help you or your daughter at this time. I'm uncertain as to whether you have participated in the development of her treatment plan or the direction that her treatment has gone. It sounds as if you have not been happy with the therapist's approach regardless of the inappropriate comments you described. My suggestion would be to explore whether you and your daughter can come to an agreement with your therapist on a therapeutic approach. Regardless of any professional's credentials or background, one of the most important factors in a successful therapy outcome is the relationship with the therapist. Without this, it is unlikely that your daughter will succeed in her treatment.

          

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