What does BPD "recovery" look like?

[captain5024]

I wish my BPD would go to therapy regularly, she would see the need to work at it, develop accountability and awareness of her condition, etc.  It hasn't happened.

But if it did, what would recovery look like for a BPD?

Are there any real world examples?  What would a realisitic recovery be for a BPD and how much would eventually change?

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[CC43]

Hi,

I’d say that my stepdaughter has put BPD in remission, but she had to hit bottom in order for her to decide to make some changes with intensive therapy.

Before hitting bottom, she blamed everyone else for her problems, and she was largely dysfunctional in life. She couldn’t study or hold a job. She lived in a mess and spent most days sleeping. She’d spend most nights scrolling on social media. She smoked pot. She was miserable and attempted suicide multiple times. She hated everything and everyone, especially herself. She had out-of-control rages when she didn’t get what she wanted. Though she could « pull herself together » to do something she wanted, she’d typically have a meltdown shortly thereafter. When stressed, she’d become paranoid and delusional, seeming to lose touch with reality. She said so herself. She’d often feel hopeless, that her life was over. She spent a lot of time ruminating about her childhood instead of being in the present or looking to the future. She saw life as a never-ending string of traumas. And she would self-sabotage, typically by quitting school, jobs and friendships. She lost all her friends and was estranged from her entire family at one point.

Recovery started with residential, intensive therapy. Though she had participated in therapy programs before, this time she did the work and didn’t drop out. (Her dad said she could choose to drop out, but then she’d be on her own financially, and since she couldn’t keep a job, I think she knew that living on her own wasn’t a viable option).  When she was released, her main priority was to keep her weekly therapy appointments and start healthy living routines—sleeping at nighttime, eating regular meals, taking prescribed meds, quitting marijuana, showering daily, cleaning her room, getting exercise. Once she was stabilized, she took some baby steps. One was a transitional therapy program designed to get young adults back on track. Then she took a college course or two online—not a full course load so that she could continue to focus on therapy. Then she added part-time work. Over a couple of years, she gradually worked up to a schedule of maybe 30 hours per week, between academic work and part-time jobs. She also kept a stable living situation with roommates.

Emotionally, recovery looked really good. The first sign was seeing her awake at daytime and fully dressed, sometimes with makeup on. An early indication that things were getting better was making a new friend or two, and not blowing up the friendship. She’d get out of the house and meet a friend for dinner sometimes. She didn’t have out-of-control rages anymore. Of course, the real indication of remission was getting back on track in life. She was engaging with it instead of running from it. She started looking forward, instead of being stuck ruminating about a terrible childhood all the time. I will say that she’s still very sensitive, especially about feeling « behind ». She still is impatient, and she still has feelings of depression. But the intensity, frequency and duration of her negative feelings are much reduced. She has the ability to concentrate on something other than grievances. She can face setbacks and disappointments better, not allow them to completely derail her. She’s avoided lashing out at others. She might still want to lash out, but she sees it’s not helpful. She’ll say things like, « I’m afraid I’ll get mad, so maybe I’m not ready to face that situation right now ». Thus now she’s more thoughtful, and she’s managing her emotions better. It’s pretty amazing how much progress she made in a relatively short time, even if she started with baby steps.

[Notwendy]

CC43- that is impressive with your SD. Glad for all of you.

I don't have an example of recovery but I have examples of what I think makes a difference. My BPD mother could not realize that she had BPD. She thought issues were because of other people. Because she couldn't connect her own behavior to the responses, she was not able to work effectively with a therapist.

A while back, I worked with a young woman who had BPD. She disclosed this to me. She was also in treatment for it. She still had emotional challenges. I could see her get stressed and anxious and have her "moments". When she wasn't feeling anxious, she could accomplish the work. The fact that she "owned" the issue and was open about this made it easier for both of us in this work setting. Granted, this wasn't a close relationship like a family member so it's not an exact comparison.

Denial is a component to BPD. A skilled therapist might not use "BPD" immediately in order to have a chance at working with the person but eventually for therapy for BPD to be effective, I think the person with BPD needs to be willing to do that work.

I also think anyone in close relationship with someone with BPD has their own work to do. Close family members are part of the dynamics. It isn't just an issue with the pwBPD.

[kells76]

Deconstructing Stigma, which I think is a project of (or at least promoted by) McLean Hospital, has a good cross-section of BPD recovery stories.

What stands out to me is the broad range of what "recovery" looks like. Many stories there reflect that the pwBPD still faces immense internal challenges, but the difference is with having a strong support structure and new, effective tools and treatment. So the inner experience might not necessarily change, but the approaches to handling the inner experience do change.

The NEABPD's "lived experience" blog, This Borderline Life, also has real-life stories from persons with BPD (though not necessarily "recovery" stories).

[Pook075]

My daughter's BPD recovery involved a lot of small changes that completely changed her big picture in life.

For example:

1) She stopped hanging out with mentally ill friends who fed off of each other's drama.  This was her worst toxic trait and what ultimately led to her crashing over and over again.

2) She apologized to me for being so difficult to deal with in the past.  The apology was a minor thing, but it's what it did to change my heart that had such an impact.  It allowed me to forgive her and build an awesome relationship.

3)  She took responsibility for her life, including bills and spending.  This was huge for many different reasons...she was always broke 10 minutes after she got paid (and before paying her bills).

4)  She learned to step back before exploding...or choosing the nuclear option.  She's told me off only once in two years, which is a genuine miracle in my opinion.

5)  She makes mature decisions most of the time.

6)  When she's in trouble, she knows how to ask me (or her mom) for help in a productive way.

She's definitely not "cured" by any means, but she handles life so much better today.  Mostly she's a normal 26 year old that's a little extra sarcastic or moody at times.  There's still a meltdown once a year maybe, but she reacts appropriately and realizes the need for immediate help.

[CC43]

Pook, there are many similarities in your daughter's remission as with my stepdaughter.  I'd emphasize that she still has strong feelings and emotions, but she's not choosing the "nuclear option" anymore.  An example of this happened recently.  My BPD stepdaughter had a poor customer interaction at work, and her supervisor told her to go home on one of the busiest days of the year.

In the past, I suspect that my BPD stepdaughter would have quit the job on the spot, and then, reeling from shame and failure, she would have deflected her feelings by lashing out at a family member over some trivial thing that had nothing to do with the rebuke at work.  Then she'd retreat and avoid contact with her support system.  After ruminating in solitude for a few weeks, she'd feel like a complete failure, hit bottom and attempt suicide.

But now, she went home from work, and she immediately called her dad, who is her strongest supporter.  He heard about her issues and invited her over to dinner.  Then we talked about the situation, calmly!  We encouraged her to do some fact checking and context setting:  did she do anything patently rude to the customer, such as swear at them, or refuse to try to help?  Since it was a busy day at work, were there other extenuating circumstances that set her up for a poor customer interaction?  In other words, did she really perform so terribly that the manager is justified in sending her home?  Was the manager having a bad day too, and reacting poorly to the stressful situation herself?  Was it possible that the job itself wasn't a great fit for my stepdaughter, who has a serious aura rather than the bubbly personality that the manager wants?  Might the manager dislike her, and not give her the benefit of the doubt?  Hadn't she demonstrated success in similar job situations--could this be a fluke?  Did she misread the situation, not picking up on cues that the customer was displeased?  Was the customer unreasonable?  Did she apologize?  Might it come down to being a really bad day?  Did she have a hard time handling the extra-stressful day at work?  After doing the fact-checking, I think my stepdaughter realized that though she could have done better, the situation wasn't a total disaster, or an "end of the world" scenario.  She resisted the urge to quit on the spot or fire off a nasty message to her manager.  Rather, she sent a very mature message, apologizing for the tough situation and offering to discuss it further before her next shift, and expressing willingness to try to do better next time.  We helped her see that it's fairly normal to have bad days--even very bad days--at work sometimes, and that people make honest mistakes, too.  The key is that the situation didn't totally derail her, as it surely would have in the past.  Maybe it took some extra effort on her dad's and my part to support her through it, but since she's seeing it as a learning experience, we're happy to provide the support.  Now I'm willing to bet that she lost a night's sleep over the whole incident, but I think that's normal, too.  What's not normal is to totally self-destruct in such a situation, as would be typical for someone with untreated BPD.  In sum, I think "recovery" looks like not immediately self-destructing and self-sabotaging when faced with stress or disappointments.  The intense feelings are still there, but they aren't totally derailing her life like they used to.

[Pook075]

Those are my daughter's experiences as well, learning to better cope and diagnose where she might have made a poor choice.

For example, she was working at an oil change place.  Gosh, this story hurts to tell, major mistake incoming.  They were training my daughter on all the different stations at the oil change place and this day, she was down in the pit underneath the car.  She saw the oil plug and thought it was in kind of a weird place, but she pulled it and let it drain.

Next, they went to fill the oil and barely any would go in- the car was still full of oil.  My kid says, no it's not, there's a big bucket down here full of oil from this car.  So they top off the oil and send the customer on their way...with no transmission fluid in the car.

Now, to my kid's credit, she was being trained and someone was supposed to be supervising her and double-checking behind her.  There was also a final check that would have "saved" this experience before the car pulled out, and another team member failed to follow through.  Both of those employees were fired on the spot that afternoon.  My kid was suspended without pay though (they put her back on the schedule part time about a week later, but of course we didn't know this right away).

Of course, my kid knows she messed up badly but she also knows that it wasn't her responsibility to perform final checks and to train herself.  So when she started really leaning in blaming others, I was like...let's slow down here.  Who couldn't find the oil plug?  Who drained the transmission fluid?  Who didn't ask for help on their first day in that position?  Who screwed the plug back into the car?

It was dicey at first and my kid really, really wanted to bad mouth her co-workers...which I understand.  But I wanted to make sure she felt some of the burden as well, even if she wasn't held accountable for the mistakes.  That got dicey too because she felt like I was blaming her, but I continued to slowly explain that it wasn't her fault for not knowing, but she could learn from the mistakes and ensure it never happens again (by asking for help when you don't know what you're doing).