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If BPD is ingrained into both the "hardware" (physical structure of the brain) and "software" (the learned, encoded experiences/meanings/beliefs/rules/values/interpretations/associations since infancy), to what degree can DBT change that?

Where I've read DBT produces measurable change in those afflicted, my understanding is that the "improvement" is a statistical reduction in overt crisis-type behaviors: hospitalizations, suicide attempts, completed suicide, or overt/obvious self-injury.

If a person's psyche and neurological development have been grotesquely deformed from the earliest of days (possibly as early as gestational days?) due to neglect, invalidation and/or horrific sexual abuse, further exacerbated by genetic or biological predispositions, how can even dedicated DBT "heal" that?

How can DBT, even for a very high functioning "quiet" BPD waif who has the financial means and is deeply committed to it (the commitment is an assumption on my part), viscerally teach that monumentally core-wounded BPD to trust, to be vulnerable, to be deeply intimate, to be selfless, to have empathy, to not continuously catastrophize?

I am confused about this panacea of an All Powerful DBT.

Any insights that could help me possibly understand would be greatly appreciated.

I asked a psychotherapist about DBT success & his frank & honest answer was this.

"If someone is truly desperate to heal it can move a mountain. If they're anything less, it won't even touch the sides!"

Quite chilling I thought.

Sometimes the question we ask tells us far more than the answer ever could.  


Would this apply to us, too?

Yes, you have to want change very badly.

DBT actually talks about willingness-being prepared to take the action needed to recover... . that you can't just sulk and say "this is not fair" but rather say "look these are the cards dealt to me-what am I going to do about it?" 12 step recovery programs talk about the necessity of willingness too-they actually say that "half-measures availed us none"... that if you want to recover, then you have to be prepared to work on it really hard.

I'm not saying that I've applied willingness in my life all the time-indeed, there are people that call me very stubborn but that's all the more reason why I need to keep working on willingness. It's not something that comes to me naturally (if only!)

I like the way you linked this right back to us nons here Skip by the way... . basically asking yourself "what can I learn from this?"

Being involved with this board, and with the broader community relating to borderline personality disorder, I have come across people who have gone through the DBT process and, save for being a bit more shy or sensitive than the average person on the street, are otherwise functional human beings.  They have the same interests, loves, hates, passions, weaknesses and the like as anyone else.  I've even interacted with a few, and if it wasn't for the fact they identified themselves as BPD, I couldn't really tell the difference.

The key thing with the people who got right through DBT is that they hit some sort of a bottom.  It seems like BPD is very similar to addiction in that someone has to hit bottom before they go through the process of DBT effectively.  So long as they feel there's someway out of their misery besides DBT, it isn't going to work.  Sadly, a lot of pwBPD commit suicide before they reach that point.  It's only once they feel that there's no escape but through DBT that they actually use the tools within to get better. 

I like the question you added at the end.  When I was going through my own period of therapy, it was rough.  I was in this sliding scale program at the same teaching facility that my wife was going through DBT at.  Going to therapy, I saw surrounded in the waiting room by people who clear had capital-I Issues, with bipolar and schizophrenia rampant.  A few times I asked myself what did I have common with these people.

That said, I knew "something" wasn't right, especially thanks to the support I got on here.  I was willing to give it a shot, no matter how weird it made me feel to be there or how stressed out therapy made me.  I thought of it as something I just had to keep working on over time, and slowly, I started breaking through to getting somewhere.  You're right Skip about us nons just needing to have that desire to get better.  When I started therapy, all I had is a desire to get better and a willingness to try.  Unfortunately, not every non is in that same space mentally.

You are right, it does seem like a long shot... . DBT and therapy basically aims to rewire a pwBPD's brain. To teach healthier coping strategies. It is a hell of a tall order... . I don't know that I would use the word "heal".  I don't know that BPD is something that can be healed... . it is something that is very fundamental to who the person is... . you are trying to change the way someone thinks and how they see the world.  That goes beyond healing.

My BPDex was in DBT while I was with her... . about a month after we split for good she shared with me that she had graduated from group and that she was just ready to start a new chapter in her life. 

While I was with her, she would commonly fill out the card on which she recorded her use of strategies taught in DBT (like wisemind) as well as whether she had any thoughts of self harm, suicide, risky sex, drug use, etc and how much she drank throughout the week the day before her therapy sessions, as opposed to every day like she was supposed to.  She would also commonly lie about how much she drank.  She skipped her group session more than once as well.

My BPDex has always seen relationships and partners as the thing that is going to "save" her I think... . like someone is going to be able to make all of her pain and shame go away, and it is just a matter of finding that right person.  It is a fruitless search... . She cheated and lied the entire 9 months we dated.  She may have "graduated" from her group therapy, but that does not mean anything when she is not able to put into practice what she has supposedly learned.  I hope she can truly find happiness... . but she has a long ways to go and a hell of an uphill climb before she gets to a place where she can live with some stability and security.