Welcome to health care magic! I have gone through your question and from that it looks like she needs medicines, along with counselling. For counselling sessions to be successful the patient and caretakers, all have to do their homework and follow advices given in therapy. I don t think that your wife is able to carry them adequately. In mood swings patient also cannot control her/ his behaviour.... moreover, with so much disturbance in mood, it is more likey that with medicines, it can be controlled, and later she can accept therapy sessions easily. Please see a psychiatrist, a detailed interview and may be some psychological tests will clear her diagnosis. If she takes counselling sessions, I think with some efforts she might agree to take medicines also. medicines do help a lot and are not addicting .... the details provided are not enough to pinpoint the diagnosis but looks like may be a case of bipolar disorder! or personality problem or some paranoid state??? Both of you are reputed doctors, I can understand your problem but I think she really needs to see a psychiatrist and take treatment. I can say that with proper medicines she will definitely improve, we see such cases getting better everyday. Donot loose Hope. Feel free to ask more questions related to this. Dr. Manisha Gopal