BPD: Treatments, Cures, and Recovery

[SunflowerFields]

When we change our reactions to their dysfunctional ways of behaving we are breaking our end of the cycle, thus forcing them to respond in different ways.  

Great post, United.

[sixspeed]

One of the most painful (and difficult) facts to accept - that "our" response typically enables the pwBPD to stay sick and not seek treatment.

~ Our perpetual forgiveness after they hurt us sends the message that it is OK for them to hurt us.

~ Since their unhealthy ways of coping (emotional blackmail, raging, playing the victim/waif, etc) work, they continue to use them.

We teach people how to treat us by the behavior we accept from them

Well written;
Yes this was 100% my side of the equation, I had no idea what sort of cycle I was working with until after our last split (finding this resource)


Sometimes it appeared  we were making communication progress after I was setting a boundary, we made a plan to avoid the conflict we both agreed on but when she would steer back into that behavior and not respect our plan of action my response would be based upon frustration (doesn't this girl respect me, we had an understanding!),  we'd have a fight (by email) then I would suggest a break, then  she would use a waif/victim/sexual promises tactics to lure me back in and my biggest mistake was to think the coast was clear then and not stick to enforcing the boundary and plan, I was expecting her to be a full adult partner and honor our arrangements for my part my angry responses to her breaking the deals (pulling myself away) activated her victimization.

The hardest thing to admit about myself and now try to correct in me is that because she often used sex as the conflict point and also the lure back (which was usually unfulfilled), I acted like a textbook male stereotype and blindly enforced bad behavior. Why, because I was afraid I wouldn't get the intimacy I wanted with her, motivated by personal desire and not the best interests of us both.




So you say "We teach people how to treat us by the behavior we accept from them"
Yes, we also teach them how we can be manipulated.

I think I could have had different not guaranteed success but better results if I followed these thoughts you've outlined.

[Skip]

Sometimes it appeared  we were making communication progress after I was setting a boundary, we made a plan to avoid the conflict we both agreed on but when she would steer back into that behavior and not respect our plan of action my response would be based upon frustration (doesn't this girl respect me, we had an understanding!),  we'd have a fight (by email) then I would...

This is a not an uncommon problem in many marriages when the relationships is breaking down.  

Have you seen the "four horsemen" article on our blog:

Predictable Patterns of Marriage Breakdown
Mark Dombeck, Ph.D.

Source: http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=9457&cn=289

According to Mark Dombeck, Ph.D., Director of Mental Help Net and former Assistant Professor of Psychology at Idaho State University, there is no single reason why a relationship begins to break down. However, once a relationship does start to break down, there is a predictable sequence of events that tends to occur. Highly regarded psychologist and researcher John Gottman, Ph.D. suggests that there are four stages to this sequence which he has labeled, "The Four Horsemen Of the Apocalypse".

Stage One The first stage of the breakdown process involves intractable conflict and complaints. All couples have conflicts from time to time, but some couples are able to resolve those conflicts successfully or 'agree to disagree', while others find that they are not. As we observed earlier, it is not the number or intensity of arguments that is problematic but rather whether or not resolution of those arguments is likely or possible. Couples that get into trouble find themselves in conflicts that they cannot resolve or compromise upon to both party's satisfaction. Such disagreements can be caused by any number of reasons, but might involve a clash of spousal values on core topics such as whether to have children, or how to handle money.

Frequently, couples assume that misunderstandings are at the root of their conflicts. "If my spouse really understood why I act as I do, he or she would agree with me and go along with what I want", is a commonly overheard refrain. Acting on this belief, spouses often try to resolve their conflicts by repeatedly stating and restating their respective rationals during disagreements. This strategy of repetition usually doesn't work because most of the time couple conflicts are not based on misunderstandings, but rather on real differences in values. When this is the case, stating and restating one's position is based on a mistaken premise and can only cause further upset.

Stage Two In the second stage of the breakdown process, one or both spouses starts to feel contempt for the other, and each spouse's attitudes about their partner change for the worse. For example, initially each spouse may have mostly positive regard for their partner and be willing to write off any 'bad' or 'stupid' behavior their partner acts out as a transient, uncommon stress-related event. However, as 'bad' or 'stupid' behavior is observed again and again, spouses get frustrated, start to regard their partner as actually being a 'bad' or 'stupid' person, and begin to treat their partner accordingly. Importantly, the 'bad' behavior that the spouse demonstrates doesn't have to be something he or she actually does. Instead, it could be something that he or she doesn't do, that the spouse expects them to do (such as remembering to put the toilet seat down after use).

Conflict by itself doesn't predict marriage problems. Some couples fight a lot but somehow never manage to lose respect for each other. Once contempt sets in, however, the marriage is on shaky ground. Feelings of contempt for one's spouse are a powerful predictor of relationship breakdown, no matter how subtlety they are displayed. In a famous study, Gottman was able to predict with over 80% accuracy the future divorces of multiple couples he and his team observed based on subtle body language cues suggesting contemptuous feelings (such as dismissive eye-rolling). Contempt doesn't have to be expressed openly for it to be hard at work rotting the foundations of one's relationship.

Stage Three Most people find conflict and contempt to be stressful and react to such conditions by entering the third stage of breakdown, characterized by partner's increasingly defensive behavior. Men in particular (but women too) become hardened by the chronicity of the ongoing conflict, and may react even more acutely during moments when conflict is most heated by becoming overwhelmed and "flooded"; a condition which is psychologically and emotionally quite painful. Over time, partners learn to expect that they are 'gridlocked'; that they cannot resolve their differences, and that any attempts at resolution will result in further overwhelm, hurt or disappointment.

Stage Four Rather than face the pain and overwhelm they expect to experience, partners who have reached this third 'defensive' stage, may progress to the forth and final stage of breakdown, characterized by a breakdown of basic trust between the partners, and increasing disengagement in the name of self-protection. Like a steam-valve in a pressure cooker, the partners start avoiding one another so as to minimize their conflicts. Gottman calls this final stage, "Stonewalling", perhaps after the image of a partner hiding behind a stone wall designed to protect him or her from further assault. Unfortunately, there is no way to love your partner when you are hiding behind a wall to protect yourself from him or her.

The "four horsemen" breakdown sequence plays out amongst the backdrop of partner compatibility. Basically compatible partners may demonstrate a whole lot of conflict, but they don't often become contemptuous and angry with their partners, because there are by definition few things that they will disagree upon. In contrast, partners who start out with incompatible goals, values or dreams are far more likely to get into seemingly irresolvable conflicts. Also, once the process of contempt, defensiveness and avoidance begins, small incompatibilities can become magnified as spouses pursue other interests as an alternative to conflict.

[GENERAL ANNOUNCEMENT]

GENERAL ANNOUNCEMENT This board is intended for general questions about BPD and other personality disorders, trait definitions, and related therapies and diagnostics. Topics should be formatted as a question. Please do not host topics related to the specific pwBPD in your life - those discussions should be hosted on an appropraite [L1] - [L4] board. You will find indepth information provided by our senior members in our workshop board discussions (click here).

[sixspeed]

This is a not an uncommon problem in many marriages when the relationships is breaking down.  

I hadn't seen the article thank you. I don't feel like it was contempt as described here though. I've certainly experienced those stages in the non relationships I've had. This was a different sort of feeling, like the key components, goals, values were there but an inability to execute on discussed and agreed upon resolutions.

[sixspeed]

Great post, United. I think we have all experienced what happens when we change reactions, expectations, and boundaries on our end. The problem becomes, the more we begin to enforce them, the worse it gets - and if we ensist on complete enforcement and complete stop of taking BS from them, they often can't take it.

That was my experience at the end too SunflowerFrields, I called out the boundary violations and how it hurt me very calmly, the return was "When I get what I want, you'll get what you want". Unfortunately her demand was a whole leap in return for the step I was requesting (to me at least). I think scale can be a factor, working toward a goal in small steps can trigger if there is expectation it's certainly against the impulsive nature on big decisions mine displayed (like marriage/kids).

That sort of reaction of "When I get what I want, you'll get what you want", makes the relationship seem all about ends to means rather a mutual journey.

I think only a therapist could step in as a third party to resolve this sort of battle of will and restore self & mutual respect. My pwbpd could outmanuever me emotionally anytime just like I could to her rationally, very different channels.

[Whatwasthat?]

Hi there

Forgive me if I am asking questions which have been covered elsewhere - and do feel free to point me to older threads - but I am curious to know if anyone has any practical or theoretical knowledge of the comparative benefits of contrasting therapeutic approaches to PDs. I had a brief relationship with a man with PD traits last year but also believe that I may have a family member who is dealing with this issue - that's where my own interest comes from.

I have read a little about DBT and my own limited understanding of it suggests that it is a form of 'deep CBT' - a kind of mental and emotional retraining that allows the brain to step in and check unhelpful emotional responses when they are triggered. But it also seems as if it works on quite a profound level and can help people learn to understand the negative emotional effects that their behaviours have on others.

I also have some acquaintance with long term analysis through the experiences of a friend. I gather that this is a process that requires multiple sessions each week - often for many years - and aims to help adults who may not have achieved full emotional development as children to actually unpick the 'false selves' that they have erected to protect their 'undeveloped' selves  - to relive their childhood emotions - and to slowly rebuild a stronger sense of adult self from that point.

I was then also musing on Buddhism. A philosophy which seems to encourage us all to let go of too strong a sense of 'self' and to engage rather in a wider 'universal' identity that goes beyond any sense of separateness.

I tend to believe that in most situations it's unwise to look for a 'one size fits all' solution to any problem. For example I gather there are as many 'ideal ways to teach literacy' as there are children in a class - we all have different 'learning styles'.

But I would be interested to know a bit more about how each of  these approaches (DBT, long term psychoanalysis and following Buddhism) have brought  help and relief to people suffering from a PD.

[patientandclear]

Thanks for kicking this off anew, WWT!

I would add to your questions: the issue of constructing a "self."  Buddhist approaches, on which aspects of DBT are modeled, seem to de-emphasize the self and the need to differentiate.  Whereas many analyses of BPD dysfunction emphasize the lack of a stable sense of self not derived from others; and when you read, e.g., The Buddha & the Borderline, it's clear that the recognition and building of a self that is generated from the inside & not borrowed from someone else is a key step toward the author's recovery (though she uses both DBT and Buddhist study).  Any thoughts on whether BPD recovery involves relinquishing the need for a separate self or defining one?  Or is there a third way?

[Elsegundo]

Great thread.  

[SeaCliff]

What do people here think of in regard to various ways for people with BPD and anxiety traits to best deal with their childhood traumas which may be the root cause of their unconscious fears today? What do you think of Hypnotherapy, ETF or EFT ("Emotional Tapping"), and / or Neuro Linguistic Programming (NLP) options?

[lbjnltx]

Hello Troyman,

In regards to hypnotherapy...   I did some research and read a book by a very successful hypnotherapist...   wondering the same things for the pwBPD in my life.  The bottom line as I understand it...   for hypnotherapy to work the patient must be willing and believe that the therapy will work.  If they do it with reluctance and faithlessly it won't be successful.

lbj

[SeaCliff]

Thanks, LBJ. Your points are quite valid. As with any treatment process chosen, the odds may be much higher if the patient believes it may work for them (aka "The Placebo Effect") since all forms of healing may begin first in the mind.

I have one more question in regard to this same topic:

If many top BPD specialists allege that childhood traumas (lack of bonding issues, emotional, physical, and / or sexual abuse, etc.) may be the true catalyst for a person's BPD traits later in life, then what percentage of people with ADMITTED BPD traits may truly recall their one or multiple childhood trauma events which impacted them so deeply at their core?

Obviously, we all repress conscious or unconscious childhood memories to varying degrees. I have yet to see a decent study on the percentage estimates of pwBPD traits who could clearly recall that their childhood traumas may be the true catalyst for their BPD traits as adults more so than their partner, children, parents, friends, co-workers, or others whom they "split" in present times. Are the figures closer to 25%, 50%, 75%, or higher?

[GeekyGirl]

If many top BPD specialists allege that childhood traumas (lack of bonding issues, emotional, physical, and / or sexual abuse, etc.) may be the true catalyst for a person's BPD traits later in life, then what percentage of people with ADMITTED BPD traits may truly recall their one or multiple childhood trauma events which impacted them so deeply at their core?

If I understand correctly, you're wondering how many people who have BPD traits can link them back to a definitive cause during their childhoods. Is that right? I haven't seen any studies, but I've seen many posts on the boards from children of BPD parents who can name many specific traumatic incidents that outline BPD behavior from their parents. It's more common for children of BPD parents to have BPD traits than to not have any BPD traits.

Keep in mind that even if people with BPD traits can recall single incidents where they were traumatized, for many of us who grew up with BPD parents, we were exposed to BPD behavior constantly. We may not have recognized this behavior as unusual. Some of us picked up these traits unknowingly as we grew up. It's possible that there was no single incident that brought on the BPD traits in us, but repeated and consistent BPD behavior.

I'm curious now--are you concerned about your sons' well-being?

[SeaCliff]

Thank you, Geeky Girl. You answered my question very well. I was wondering if a pwBPD traits today may recall their true childhood trauma event or events which deeply affected their Core Being even today as adults (i.e. one traumatizing abuse event, years of overwhelming anger and rage, etc.).

In regard to my own children, I have studied numerous ways to offset any anxious, controlling, blaming, or vindictive behaviors primarily to keep them healthy and happy.

Again, I help lead health support groups and my friends come to me for health advice on a weekly basis (which includes many friends with BPD and anxiety traits) as I have studied health topics in depth for well over 34 years. Since I am a lifelong "Bookworm" too who played lots of sports, I grew up reading lots of "Power of Positive Thinking" type books from people such as Norman Vincent Peale, Og Mandino, Dale Carnegie, Anthony Robbins (he uses a lot of NLP teachings), Dr. Wayne Dyer, and many others.

This positive mindset that obstacles are just temporary challenges which we either run over or around makes dealing with people with BPD traits so absolutely frustrating because I believe that ANYTHING may be cured or overcome by both our Immune System and our Mind. I know several terminal cancer patients who were cured back when their own Oncologists sent them home to die after they followed some of the natural health treatments which I base half of my diet on today for prevention and overall good health.

My Dad instilled in me as a very young boy to just "go for it, learn as I go, and that failure will just be a form of teaching for me" (or "I fail if I don't try something new") which is about the exact opposite of people with BPD traits.

Fortunately, I have yet to see any BPD traits with my children. Yet, I clearly see it in my ex's Family Tree. Ideally in a positive way, "For every action in life, there may be an equal and opposite reaction."

As I continually say and write quite often, we have but two core emotions in life - Love and Fear. All other feelings are just aspects of these two core emotions. Yet, Love is much more powerful than FEAR ("False Evidence Appearing Real").

Fear weakens us and zaps our energy while Love, in turn, energizes us to NEVER give up. Since we are primarily "Energy Beings" at our true core, then bet on the people motivated by the more energizing Love to prevail one way or another.

[IfOnlyIKnew]

Hi all,

Sorry I'm quite new here and I didn't have time to read many boards yet, but I just read this on another website :

Question: What is the Borderline Personality Prognosis
I have been diagnosed with BPD. Does this mean I will have it for the rest of my life?

Answer: Most likely, no, you will not have BPD for the rest of your life. At one time, experts did believe that BPD was a life sentence; they thought that BPD was not likely to respond to treatment and that BPD was always chronic and lifelong.

Now, we know that this is a complete myth. Research has shown that almost half of people who are diagnosed with BPD will not meet the criteria for diagnosis just two years later. Ten years later, eighty-eight percent of people who were once diagnosed with BPD no longer meet criteria for a diagnosis.

In addition, there are now a number of treatments that have been proven to be effective for reducing the symptoms of BPD. So, with treatment, the disorder may remit much more quickly."

This is VERY optimistic compared to what I read here. Could you tell me what you think about that cuz I'm a little bit lost now.

Thanks in advance.

[Rose Tiger]

Those stats are correct for someone with BPD who has been treated.  

[IfOnlyIKnew]

Thanks for the reply Rose Tiger.
It sounded too good to be true
Actually most of the stories I've read here so far don't give as much hope as this website unfortunately...  

[Rose Tiger]

You're welcome.    The coping mechanisms are dysfunctional but it works for them.  Gets them through the day, so to speak.  I wouldn't say no hope, I would say I hope someday they do get into treatment and learn better coping skills and have more fullfilling lives.  You never know, the only person we can control is ourselves, radically accepting their illness and working/growing on our own stuff.

[MammaMia]

I completed NAMI's Family to Family program several months ago.  This is an excellent program in which to learn about the more common "mental illnesses", i.e. bi-polar, schizophrenia, schizo-affective disorder, depression, anxiety, paranoia, etc.  However, I was the only person in a group of 20 with a BPD family member. When we had mental health professionals as guest speakers, and I would ask questions about BPD, they would just say something along the lines of...   "Oh that is really difficult.  Personality disorders deal with that part of a person that actually MAKES them WHO they are, although BPD is usually accompanied by associated disorders like anxiety, depression, schizo-affective traits, etc. which are more readily treatable.  Behavior modification MIGHT be the only treatment available."   ?

That was it.  They had little else to recommend and seemed uncomfortable discussing BPD. Perhaps they did not feel qualified to do so, I am not sure.  I got the message loud and clear that BPD IS unique...   it is very difficult to diagnose, very difficult to live with, and even more difficult to treat.   It is separate from other mental illnesses but is often combined WITH them, and the boundaries between them constantly blur.

NAMI helped me to understand the associated illnesses that often accompany BPD, but finding your website has been a Godsend.  These two resources have helped me so much.  I have read extensively, and sharing the real-life experiences of other BPD family members is very reassuring.  We are not crazy! We are dealing with a very serious, extremely frustrating illness in a loved one.  It affects not only the BPD sufferer but anyone who shares their life, regardless of whether the relationship is as an intimate soulmate or casual acquaintance.   

Thanks for being here.

[MammaMia]

PS   I just learned about another program through NAMI called Family Connections that deals SPECIFICALLY with BPD.  I will have to check that out.  I hope it is available in my town.