What's the most effective therapy for BPD?

[Loosestrife]

Hi

I'm interested in hearing from anyone whose SO has improved significantly with therapy:

What kind of therapy was it (I.e method and group/individual)?

How long did it take for things to improve?

Did things get worse initially?

Thanks

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[maxsterling]

I've only known my wife for just over two years.  She clearly meets all 9 BPD criteria, even though she tells me she used to be much worse.   From what I have observed, and from what she has told me:

1 - medications have never really done much good.  She takes Xanax now and that helps her function, and I think most of her higher functioning periods of her life involved Xanax.  But that is a relative thing - it's not like it has come close to solving the problem.  When I have seen her on mood stabilizers or antidepressants, she's still depressed, but less volatile. 

2 - She went through intensive DBT about a dozen years ago, and since then she has stopped cutting, and stopped drug abuse/drinking.  But her behaviors have still been self-destructive and her interpersonal relationships still very bad.

3 - 12-step programs helping her stay away from substance abuse have probably been the biggest help for her.  I truly believe without the 12-steps, she would be dead.

4 - she did EMDR for trauma therapy.  She claims it helped for one particular trauma incident, but I saw no change in her overall mood.

My feeling is that right now her best shot is multiple therapy sessions per week involving some kind of behavioral therapy, plus some anti-depressant medications for the short term.  Xanax is bad. 

[Reforming]

 

I don't have BPD, but after coming out of long relationship with a suspected BPD I wanted to work with a T who understood the disorder. I also wanted a therapy that would give me the insight and the tools to tackle my owns issues. I did quite a bit of research and decided to start seeing a Schema therapist last year.

I chose a therapist who is highly qualified - she was trained by Young (who developed Schema therapy) and now trains and assesses other schema therapists in the country where I live.

She  had also trained in DBT - though we've only used Schema in my treatment.

Thinking of my ex I asked her the same question about the best therapy for BPD

She felt that DBT is very effective at treating the more extreme symptoms and getting BPDs into a place where they could really benefit with Schema which she felt had the potential to really heal them.

I should add that she has treated a lot of borderlines with considerable success and initial research on Schema Therapy's effectiveness is pretty impressive.

As I said her primary speciality is Schema, so she may have a slight bias but she also practices DBT

Hope this helps

Good Luck

Reforming

[Oooohm]

Just looked this up... .(Cut and Pasted from the web):


The four main concepts in the Schema Therapy model are: Early Maladaptive Schemas, Core Emotional Needs, Schema Mode, and Maladaptive Coping Styles.


The 18 Early Maladaptive Schemas are self-defeating, core themes or patterns  that we keep repeating throughout our lives.


Early Schemas relate to the basic emotional needs of a child. When these needs are not met in childhood, schemas develop that lead to unhealthy life patterns.  Each of the 18 schemas represent cpecific emotional needs that were not adequately met in childhood or adolescence.


Maladaptive Coping Styles are the ways the child adapts to schemas and to damaging childhood experiences.  For example, some children surrender to their schemas; some find ways to block out or avoid pain; while other children fight back or overcompensate.


Schema Modes are the moment-to-moment emotional states and coping responses that we all experience.  Often our schema modes are triggered by life situations that we are oversensitive to (our "emotional buttons".  Many schema modes lead us to overreact to situations, or to act in ways that end up hurting us.


The main goals of Schema Therapy are: to help patients strengthen their Healthy Adult mode; weaken their Maladaptive Coping Modes so that they can get back in touch with their core needs and feelings; to heal their early maladptive schemas; to break schema-driven life patterns; and eventually to get their core emotional needs met in everyday life.

[maxsterling]

Wow, that schema therapy sounds like what would really help my wife.  My impression of her is that her coping mechanisms are all self-destructive, and she's incapable of breaking the cycle. 

[Reforming]

Hi Ooohm

Young's book for the layman is well worth reading

www.amazon.com/Reinventing-Your-Life-Breakthrough-Negative/dp/0452272041

I also found the practitioners guide surprisingly accessible too.

www.amazon.com/Schema-Therapy-A-Practitioners-Guide/dp/1593853726

Both are filled with really powerful tools and ideas

There are also various Schema resources on this site that are worth exploring (do a search)

Max I'm sorry that you're having a tough time at the moment. I enjoy reading your posts and I admire your courage and honesty.

I think Schema Therapy can be powerful tool for lasting change, but no therapy is a magic pill. You need to be willing to commit and do the work.

Change is hard for all of us - not just BPDs. I was shocked at how resistant I am to change and for most of us it's a very stop start process

However if your partner has already done DBT and she's willing to commit to therapy then she might really benefit from Schema

If you are interested in finding a good schema therapist it's worth checking this list of fully trained and accredited Schema Therapists in the US

isstonline.com/united-states

Spring is on the way and I hope things get brighter for you and your partner

Reforming

[Riverrat]

Very good question, on something I am researching right now.

I was even able to find a Schema therapist in my area.

SO seems at ease with her T right now, if I can get her to go back to sessions.

But, as we know, that could always change overnight.

Thanks for all the hopeful insight and shared experiences.

Rat

[Loosestrife]

Thanks all. I am going to look at schema and DBT success rates.