Working With a Licensed Online Therapist

What’s your experience working with the adult children of parents with borderline personality disorder (BPD) and narcissistic personality disorder (NPD)?

I’ve been a therapist for almost 11 years now, and a good portion of my career involved working with clients with personality disorders. Most of my colleagues shied away from working with clients with BPD, NPD, and other personality disorders, but I felt very drawn to it. I became a therapist because I was incredibly passionate about helping people who were willing to invest the time and energy needed to improve their emotional health and relationships. And, I thought, if there are groups of people who are seeking therapy and most therapists do not want to work with their mental health struggles, maybe I can help bridge that gap.

While working with clients with NPD, I quickly learned that most (if not all) of my clients with NPD had external motivations for therapy. They were coming to therapy, but they were not interested in self-reflection or working towards change. These clients would typically end therapy by just not showing up to therapy one day.

I can’t say how much progress I truly made with these clients who had NPD. However, I do think I was able to provide a lot of hope and help to their family members. While working with the people closest to them in family therapy, I was able to help by providing some validation that the abusive behaviors seen in NPD were not normal or acceptable. I also helped them learn more effective strategies for communicating with the person who had NPD.

While working with clients with BPD, I found much more hope and progress. I obtained additional training in dialectical behavior therapy (DBT) which is the gold standard, research-backed treatment for BPD. I saw tremendous progress with many of the clients I worked with who had BPD, and I truly loved working with them. Therapy for BPD takes years of consistent work. In reality, it is something that needs to be managed with the support of therapy throughout a lifetime.

Treatment for BPD is not easy, and I truly commend anyone with BPD who commits to doing the work. Unfortunately, like all people, not everyone with BPD is willing to commit to working on themselves consistently in therapy and between therapy sessions. They might go in and out of therapy, quit therapy when the therapist challenges them, or be working with a therapist who does not have the training needed to actually help. And, when someone with BPD is not managing their symptoms appropriately, to the people closest to them suffer immensely- unmanaged BPD involves extreme mood shifts, emotional volatility and rage.

When I opened my private practice in 2018, I continued to work with clients with BPD for a few years. Throughout the past several years however, I decided to make a change. I was frequently getting referrals from therapist friends and colleagues for clients who had a partner or parent with BPD or NPD due to my experience with these populations.

After stumbling into this specialty, I realized love working with these clients even more than what I was previously doing. So, I decided to shift my focus to working with the adult children of parents with BPD and NPD. I’m able to apply the knowledge and experience I have, and I’m able to help clients who would otherwise struggle to find a therapist who truly understands the challenges of their family dynamics.

Why are you so passionate about working with clients who have parents with BPD or NPD?

I have a special interest in working with the adult children of parents with BPD and NPD because I myself am an adult child of a parent with BPD. In my own personal therapy experience, I found it very challenging to find a therapist who actually understood the dynamics involved when your parent has a personality disorder. Despite their best intentions, these therapists often gave horrible advice such as discouraging me from setting boundaries or ceasing contact. Some even made excuses for abusive behavior.

I have found that many therapists who do not have training and experience in working with clients with personality disorders do not understand how to support the partners or family members of people with BPD and NPD. This can be very harmful because the way to set boundaries with someone with BPD or NPD looks extremely different than setting boundaries with someone without these disorders. There are things that must be taking into consideration, such as emotional and physical safety concerns, what the consequences of setting boundaries may be, and how to cope with those consequences. Additionally, discouraging someone from setting a boundary or ending a relationship with someone who has repeatedly abused them is bordering on gaslighting in my opinion.

I luckily was able to work with two really amazing therapists who understood and validated my experiences with my parent with BPD (one of which I continue to work with now). I hope to provide the same hope and relief to the clients I work with as these therapists have provided to me.

Your other specialty is treating OCD. How did this become one of your specialties?

Maybe you already guessed it (or maybe you already read my page about Obsessive Compulsive Disorder). This, like my other speciality, is something that is near and dear to my heart because I, too, have OCD. And, funny enough, I didn’t even know that until a few years after I became a therapist.

Most people with OCD experience symptoms for almost two decades before they receive a diagnosis. For me it took a bit longer than that. I always knew I was an anxious person, and so did everyone around me. But, it never occurred to me that I had OCD. Even in grad school to become a therapist, I didn’t identify with the brief video we watched showing clients with OCD. And, this is not uncommon.

There are many high functioning people with OCD who have managed to live successful lives through a combination of avoiding things that trigger their obsessions and engaging in compulsive rituals that help to calm themselves down when they are triggered. Many of these rituals are often mental compulsions, things like reassuring yourself, reviewing events, or even mentally cancelling out a bad thought somehow. Things that are not evident to anyone other than the person with OCD.

And, the obsessions with OCD are awful. Obsessions are horrible, intrusive thoughts that violate our value systems. They often seem too awful and shameful to say to another human, so we don’t. Thus, prolonging the silent suffering.

Unfortunately, people with OCD often seek therapy for their anxiety, but the therapy ends up actually making their OCD symptoms worse. That’s because the only effective treatments for OCD are exposure and response prevention/ERP (a very specific and structured form of therapy) and/or anti-depressant medications. And, the anti-depressant medications have to be prescribed in higher doses for OCD than other mental health issues which is why if someone is not accurately diagnosed, the medicine will usually be prescribed at too low of a dosage to help.

I think it’s important to talk about my OCD, so the clients I work with know they’re not alone. I know how long it took me to get treatment, and I know how much harder my life was before I received effective treatment for my OCD. I’m really passionate about helping clients with OCD get there sooner than I did.

Why should I work with you?

The honest answer I tell everyone who asks me this question- maybe you shouldn’t. Look, I love being a therapist. I am truly so grateful that I get to do this for my career. But, I’m definitely not the perfect therapist for every person on the planet. And, if you don’t think I’d be a good therapist for you, then maybe I wouldn’t.

I’m direct, I use profanity, I’m sarcastic at times, and I try to find humor in tough situations. That’s not everyone’s cup of tea.

I’m also someone who is always rooting for my clients. I’m never going to judge you. I’m not perfect, you’re not perfect, but I admire all of my clients for trying really hard to improve their emotional health and relationships.

In a nutshell, I don’t want to convince anyone to work with me. I want to encourage everyone I talk with to choose a therapist who they like and want to work with. If that’s me, great, and if it’s not, that’s ok too.