Does therapy every help a PD?

[Prototypian]

I've tried to get my PD spouse to get help and she literally sees the counseling as a "her against the world" kind of battle.   The idea that anything done could be anything other than right vs wrong is seen as a view that the counselor doesn't understand.   Family counseling has resulted in inflexible up front statements before a session especially where she (spouse) suspects we are going to discuss hoarding or throwing things away or donating to Goodwill.   Same type of thing with parenting or expectations for kids.  If that is a topic she will start with "we can talk about kids expectations but I will not participate in any discussion involving rewards or loss of privileges because I believe people should do their chores and expectations without any need for that kind of motivation so if you are going to even discuss this I won't participate".

Those are just examples but she preloads the counseling with things that are absolutes especially when she suspects that we are trying to have a discussion.

Has anyone worked with their PD and counseling where things have helped?

[square]

I don't think therapy can be helpful if a person isn't open to it.

Your wife is closed down very, very tightly. Any efforts to reach her or change her seems to build more brick walls, metal doors, gator filled moats, catacomb-depth chasms, moonshots.

[Cat of the Canals]

I think it's certainly possible... but like square said, I think it generally has to be the PD seeking it out for themselves. Kind of like rehab for an addict. If they aren't willing to admit they have a problem (which seems to be the case with your spouse), why would they change?

[notrightinthehead]

From your description it seems that your wife is not aware that she has a problem. In order to benefit from counselling the person needs to have an awareness that there is a problem and a willingness to work on it. You describe your wife as someone who believes she is perfectly ok and what she does is the right thing. Why would someone like that think they need counselling?
On the other side, if you had your wife evaluated by a mental health professional, if they could see that your wife is hoarding rubbish, possibly creating a health hazard for the family by doing so, and witness one of the explosive rages you have described before,  what would the diagnosis be?

[Kat54]

Everything should be up for discussion, no parameters or rules of what's discussed and what's not. That means unfortunately she's not open to therapy in my opinion.
Like someone else said, it's like an addiction, they have to want to get the help.
My own life experience with addiction. Conjoling, pushing begging and then they go through the motions to make nice and please everyone by going to therapy or counseling. But in the end they are the only ones who can end the craziness and they have to truly want to address their issues.

[Free2Bme]

My take is that your wife seems more interested in securing the status quo for herself (household/kids run in the same old patterns).  She has to protect this because she believes she depends on her rules/habits in order to function.

She wants things just the way they are.  Agreeing to Tx is part of that, meaning her motive is to check a box, not to be transparent/vulnerable , open to change.

[Blodyn]

I've never experienced therapy with any of my PD FOO and to be honest I wouldn't attempt it because I don't believe it would work.

I say this as someone who has worked in the therapeutic services in the past.  I'm a retired psychiatric nurse who worked alongside family therapists, psychiatrists, psychologists and psychotherapists.  The general consensus amongst the professionals was that people with BPD (Borderline Personality Disorder) faired much better in treatment than say someone with Narcissistic Personality Disorder (NPD).  In my experience I have never met someone with NPD who has even agreed to enter therapy.  This is because NPDs believe that they are always right and the rest of the world is always wrong.

NPDs are also very controlling and would attempt to control the narrative and the outcomes.

I follow various teachers of narcissism on YouTube and one of them, Dr Ramani has a useful video called Couples Therapy with a Narcissist: 9 Things You Should Never Do.  It might be worthwhile checking this out.

From what you've described your spouse is exhibiting signs of trying to control both the narrative and the outcomes.  I don't know how comfortable you would be in doing this but family therapy sessions are the ideal space to raise how you feel about the pre-session directives.  Would you be able to be honest with your wife and therapist about how this makes you feel.  I appreciate that it is easy for me to say what I've just said.  You know your spouse better than anyone,  and it might antagonise her and cause her to fly into a rage.

Like I say, I have no direct experience of attending therapy with anyone that I know who is PD, but as many of the others have commented, it is really down to your spouse to want to engage with any help on offer.

We had a joke in the psychiatric services, it goes like this -

Q - How many psychologists does it take to change a light bulb 💡?
A - One, but the light bulb must want to be changed in the first place.

[1footouttadefog]

I have been reading here for years and for the most part, few PD folks are able or allow themselves to participate in therapy in a meaningful way.

It seems that as often as not, therapy gives them more tools and an increased vocabulary to use against the non partner. Additionally it seems common for the pds to decieve the therapist and gain them as an Allie against their partner

Theraoybis more often reported as successful when the non get there own therapist and works on n things from their end