Thank you for your questions. Given how well you described yourself it is apparent that you have done some diligent work toward self-exploration. I can certainly appreciate the anxiety and fear that emerges for a patient when she thinks about disclosing what feels like embarrassing information. Its a normal reaction given our tendency to seek full acceptance. However, I would encourage you to work through this block and to find a way to talk to your counselor about your concerns. When people start to reveal intimate details they have intentionally excluded in therapy it paves the way for more exploration and potential resolution of their problems. The other benefits is that you will probably learn that despite your fear of being judged or rejected, your counselor will still value you as a person and the therapeutic relationship becomes even more intimate and safe.
One way to approach this difficult situation is to talk about your fears before you reveal or disclose any information you are not ready to talk about. This will result in a productive dialog that may make it safer for you to reveal more in the future and relieve some of your symptoms. Talk to her about your fear of judgment and any other associated fear. I think she will appreciate the opportunity to discuss these concerns with you.
With regard to the medication, you may want to reconsider taking medication if the obsessive and paranoid features are interfering with your daily functioning. As you may already know, the key to effective medication is consistent and regular use as prescribed by your doctor and finding the correct medicine and dosage. I also encourage you to talk to your counselor about medication.
I hope my reply was helpful. You can do this, especially given you trust and feel safe with her. Good luck.
Thanks for your reply. I'm not sure why they cannot talk to each other, this is vital for continuity of care. If you signed a consent giving them authorization to exchange information would that make a difference? Its something to consider.
If your doctor has concernes about prescribing you medication that means you are left with making a choice. If you think it would really make a difference and want to try medication again you can talk to him about how important it is to you and why. If he still refuses and you want to take medication you may need to ask for a second opinion. GPs are conservative about prescribing psychotropic medications. You should probably see a psychiatrist or ask him for a referral.
Similarly, if it feels like therapy is not helping you are faced with the same problem. Do you stay and talk to her about how you feel or seek someone else. If you really feel that you have a personality disorder its probably worthwhile to seek an expect in personality disorders. From what you described, its possible that you have some features but its also possible that its something else. Its impossible to know without a comprehensive evaluation.
There are a variety of strategies you could use (CBT being one) but given what you described about yourself and preference, some form of long-term insight oriented and/ or relational therapy may be a good fit. Dialetical behavior therapy has demonstrated good outcomes with personality disorders and is another choice.
Of course the first step is getting the diagnosis. You should have an evaluation first before you start considering treatment because you want to be sure the treatment is appropriate.