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I was trained not to ask questions but to make statements. You get to ask questions during the intake assessment, but there you should probably be working off a form. After that, questions usually narrow things too much. Let the client lead, and if you’re confused about something or wondering, say so — that leaves it broad. Specific questions tend to narrow things unnecessarily, most of the time.

If I were you, I would see if you and your wife can see the therapist separately a few times. Then, you could bring up the topic without fear that your wife will get upset. You could also speak with the therapist over the phone before the session. It's likely that you will have an intake assessment, so you could mention the suspected BPD there too.The therapist should be able to bring up the subject in a non-threatening way. I'm glad you two are getting help.

Great question!If it’s done correctly, some version of the following steps should occur.Initial consultation to determine counselor-client fit.Intake assessment: A semi-structured assessment that includes things like past history, nature of presenting problem, medical status, family of origin issues, risk assessment, cultural assessment, and mental status examination.Collateral information collection (from family, friends, etc., if the client agrees to it), or screening instruments or - especially in the case of personality disorders - formal psychological assessments, scored and interpreted.Confidential consultation with another qualified professional with expertise in personality disordersReview and elimination of differential diagnoses (ruling out what else it could possibly be)Write up of diagnostic impressions and rationale for diagnostic formulationWillingness to reassess as counseling continues and new information comes to light or it becomes clear the clinician missed or misunderstood something important and their initial diagnostic impression no longer accurately explains what is going on.Some important considerations when diagnosing personality disorders is that most of them are highly stigmatized in U.S. American culture, so formally diagnosing one is a very powerful statement. This requires some humility on the part of the diagnosing clinician, both in willingness to seek consultation and go through the differential diagnostic process EVERY SINGLE TIME, and in a willingness to admit a mistake if they get it wrong. Or, perhaps even assume there is a possibility of error and plan on revisions as counseling ensues.Another important consideration is that our (U.S. American) understanding of personality disorders is a little behind. Meaning, our research wasn’t adequate for many revisions between the DSM-IV-TR and the DSM-5, and some expected changes, like the addition of C-PTSD and the resulting reduction in prevalence of BPD didn’t occur. So, it’s especially important to remain open minded when diagnosing a perceived personality disorder and consider that answer from all angles, and be humble enough to revise the conclusion if necessary.