Home page of BPDFamily.com, online relationship supportMember registration here
April 29, 2017, 02:27:43 AM *
Welcome, Guest. Please login or register.

Login with username, password and session length
50% rate of personality disorder in intimate partners of women with BPD Read here
Administrator: heartandwhole
Moderators: Meili, once removed
Member support team: gotbushels, Tattered Heart, Turkish, wendydarling, Woolspinner2000
  Directory Guidelines Glossary   Boards   Help Please Donate Login Register  
THE PSYCHOLOGY OF PERSONALITY DISORDERS
26
Pages: 1 ... 5 [6] 7   Go Down
  Print  
Author Topic: Can BPD be cured or go into remission?  (Read 57646 times)
Skip
Site Director
***
Offline Offline

Person in your life: Ex-romantic partner
Posts: 5771


« Reply #50 on: November 03, 2014, 04:15:12 PM »

If those people studied on those papers were borderlines who recognized their problem to the root, looked for help and really committed to it i would agree that such a high treatment success rate would be probable.



Wasn't anything like this.  

These were 290 people that had a crisis/meltdown large enough to end up at McLeans Hospital in Boston. They might have been brought there by police after attempting a suicide or brought in by a family members because they were melting down, etc.  Where they went after that fateful night was random and not controlled.

This was not a study of a regimen of  therapy or of dedicated individuals.  

She lacked insight... And it's horrible not to have insight for a disease she had, that hurted her and the ones closest to her so badly.

There are other mental disorders which give the person affected a lack of insight. If this lack of insight is bypassed i agree there must be an extremely high percentage of borderlines on the way to their cure.

We talk about anosognosia, abnegation, and minimisation here and we have a good video of how to approach a person in denial:

https://bpdfamily.com/content/how-to-get-borderline-into-therapy
Logged



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).

Junknown
**
Offline Offline

Gender: Male
Person in your life: Ex-romantic partner
Posts: 116


« Reply #51 on: November 03, 2014, 05:41:11 PM »

If those people studied on those papers were borderlines who recognized their problem to the root, looked for help and really committed to it i would agree that such a high treatment success rate would be probable.



Wasn't anything like this.  

These were 290 people that had a crisis/meltdown large enough to end up at McLeans Hospital in Boston. They might have been brought there by police after attempting a suicide or brought in by a family members because they were melting down, etc.  Where they went after that fateful night was random and not controlled.

This was not a study of a regimen of  therapy or of dedicated individuals.  

She lacked insight... And it's horrible not to have insight for a disease she had, that hurted her and the ones closest to her so badly.

There are other mental disorders which give the person affected a lack of insight. If this lack of insight is bypassed i agree there must be an extremely high percentage of borderlines on the way to their cure.

We talk about anosognosia, abnegation, and minimisation here and we have a good video of how to approach a person in denial:

https://bpdfamily.com/content/how-to-get-borderline-into-therapy

In that case those are quite surprising results, as its a really high success rate. Im surprised they got so favorable results on that study as the mental health professionals i contacted with so far had such a negative view on the prognosis of this personality disease. Ill read the whole study as this seems quite interesting. Thanks for sharing.
Logged
Junknown
**
Offline Offline

Gender: Male
Person in your life: Ex-romantic partner
Posts: 116


« Reply #52 on: November 03, 2014, 07:15:37 PM »

Finished reading it. Its an interesting study that seems to have obtained some quite interesting results. They explain well the tools used for assessment, the sample size, points of measurement and their results.

I just didnt find very elucidative the kind of intervention on these patients. It seems they didnt use a protocol of some sort on their treatment or did they? I dont understand if this institution has some sort of standard of care on the treatment of those patients or if the treatment plan is left to the criteria of the professionals who work there. Just found there a reference about the percentage of patients on psychoterapy and or medication after six years (70%). They also dont specify the kind of psychoterapy applied to them (i guess it probably was dbt but no reference there).

If they got these results with a study where they simply measured the end points with follow up using the standard of care provided by the mental health professionals on that institution i wonder what a more structured intervention couldnt do.

I just question if this study couldnt be prone to biases as the patients at the beginning and six year measure point fill out a self report. As we discussed above they lack insight. And use psychological tools to defend theirselves by denying their disease. If they get to a point in time where they feel "better", they could mask their disease by denying some symptoms that would constitute the core of the disorder. I guess they should also interview their closest relatives to try to get over this possible bias. Im sure if, for example, they were evaluating my girlfriend and they asked me or my GFs husband about some of her behaviours it would be totally different than just interviewing my GF and applying some measurement tools to her. Dunno about the reliability of the tools used tough and if they already have some sort of counter measure for a bias of this kind.
Logged
Skip
Site Director
***
Offline Offline

Person in your life: Ex-romantic partner
Posts: 5771


« Reply #53 on: November 03, 2014, 08:29:45 PM »

I just question if this study couldnt be prone to biases as the patients at the beginning and six year measure point fill out a self report. As we discussed above they lack insight.

This type of questionnaire has to be demonstrated as reproachable when compared to a face to face interview and history.  They do comparative check studies to rove reproducibility.
Logged

antonio1213
**
Offline Offline

Posts: 158


« Reply #54 on: January 29, 2015, 05:03:28 PM »

My T told me that there is nothing that can be done about BPD and that the pwBPD never change, stay the same, never get better, and she really emphasized this. And she has worked with BPD for 20+ years. And on the other hand some pretty reliable sources on the web say that people with BPD normally don't meet all the symptoms within 2 years of being diagnosed. And paints a much more optimistic picture for BPD sufferers.

So which is true?

And for the Nature vs Nurture argument here is why I am confused. My mother is a suspected BPD and had a terrible childhood with a drunk abusive father. And she is very BPD. My exBPDgf is relatively young but she said that she had, in her words "always been a b**ch and emotional" ever since she was tiny. But she also had a abusive childhood too. And her father has problems too. So it seems like BPD is based off of both and not just one.
Logged
enlighten me
*******
Offline Offline

Gender: Male
Person in your life: Ex-romantic partner
Posts: 3087



« Reply #55 on: January 29, 2015, 05:16:42 PM »

In the majority of cases I would say nature is the underlying factor. Depending on the severity of the genetic side depends on how large a trigger is needed to set it off. If they have a severe genetic predisposition then something as minor as the parents having another child can trigger their abandonment fears. If they are genetically predisposed but not as severe then a more severe trama can kick it off.

I do also believe that due to nurture someone can develop BPD as being in a prolonged abusive situation can rewire the brain into a BPD brain.

There is no real evidence of hoa a pwBPD's brain develops as you would have to have scans from birth to show if the abnormality was present at this time. Brain scans of pwBPD do show there is a difference.
Logged
Tim300
****
Offline Offline

Person in your life: Ex-romantic partner
Posts: 557


« Reply #56 on: January 29, 2015, 05:36:02 PM »

There are some nature versus nurture threads on here.  I think it's nature.  

Regarding recovery from BPD, I lean heavily towards the viewpoint of your T.  This is based on (1) my experience in dealing with a couple pwBPD, (2) my understanding of how the disorder works, and (3) all the BPD stories I've read.  

I haven't seen these 2-year studies.  I've read about the 10-year study, which noted that half of observed patients did not display symptoms after 10 years.  There are some significant potential shortcomings with any such studies.  For example, consider how high the percentage on non-recovered pwBPD there is (50%!); consider that the pwBPD in the study were open to acknowledging their illness and trying to change (which is not so for all pwBPD); consider that the study likely relies on observable measures like suicide attempts and cutting, but that other symptoms of BPD would be much more difficult to measure.

I suspect that DBT could at times marginally help in low-stakes/low-stress situations for a pwBPD, perhaps in fleeting moments of self awareness (this is how DBT seemed to help my BPDex-fiancee).  I would not bank on DBT actually preventing the self sabotaging of an engagement, marriage, etc.    
Logged
BPDTransformation


Offline Offline

Person in your life: Friend
Posts: 10


« Reply #57 on: January 29, 2015, 05:53:21 PM »

Hi Antonio,

First of all I'm very surprised that an experienced therapist would say people with BPD cannot change or get better. That is a pretty ridiculous, overgeneralized statement if you think about it, to say that a whole class of people cannot change or get better.

In my opinion and based on a couple of people I've known, borderlines can definitely recover and get better, if they are willing to seek help, which a good number are. If you'd like to read some good case studies, you could check out books by authors like Jeffrey Seinfeld (The Bad Object) or Helen Albanese (The Difficult Borderline Patient - Not So Difficult To Treat) or Donald Roberts (Another Chance to be Real). I got these books used and read them when I wanted to get a sense of how long-term therapy could work for a borderline individual, when they are willing to seek treatment.

My T told me that there is nothing that can be done about BPD and that the pwBPD never change, stay the same, never get better, and she really emphasized this. And she has worked with BPD for 20+ years. And on the other hand some pretty reliable sources on the web say that people with BPD normally don't meet all the symptoms within 2 years of being diagnosed. And paints a much more optimistic picture for BPD sufferers.



Regarding nature or nurture, the way the question is asked really makes it impossible to answer. The dynamic interaction between the internal and external world of a person are so complex that the proportion of contribution from each really can't be measured meaningfully. Matt Ridley wrote well about this in "Nature Via Nurture" and Evelyn Fox Keller wrote a beautiful little book about the distortions around this issue, in her book "The Mirage of a Space Between Nurture and Nature."

Nevertheless, if I had to answer this question, I would say that nurture and life experience is far more important than nature, in most cases. Of course, both nature/nurture contribute in every case, in the sense that every person has a level of vulnerability to stress that can be set off by sufficient traumatic or neglectful experience. But, that is different than BPD being caused by genes, which there is as yet no convincing evidence for, despite many years of research. That may relate to how BPD itself is not a reliable construct, being subjective and based on descriptive observations, rather than physical evidence.


The Bad Object: Handling the Negative Therapeutic Reaction in Psychotherapy

By Jeffrey Seinfeld

The Difficult Borderline Personality Patient Not So Difficult to Treat ...

By Helen Albanese

The Mirage of a Space Between Nurture and Nature.

Evelyn Fox Keller

Nature Via Nurture

Matt Ridley

Another Chance to be Real

Donald Roberts

Logged
Skip
Site Director
***
Offline Offline

Person in your life: Ex-romantic partner
Posts: 5771


« Reply #58 on: January 29, 2015, 06:15:16 PM »

I got these books used and read them when I wanted to get a sense of how long-term therapy could work for a borderline individual, when they are willing to seek treatment.

What did you learn?
Logged

Reforming
Ambassador
*****
Online Online

Gender: Male
Person in your life: Ex-romantic partner
Posts: 760



« Reply #59 on: January 29, 2015, 06:45:13 PM »

I think it's fair to say that historically many therapists have struggled to treat BPD.

However over the last twenty years it seems that  newer therapies, DBT, Schema and Compassion have proved much more effective at treating the disorder.

it's still worth considering what is defined as a successful outcome. Someone may no longer exhibit the required number of traits to be diagnosed as Borderline, but they can still struggle with intimacy - the primary trigger of the disorder - and this is bound to have a pretty profound effect on their romantic relationships

They've also missed out on years of emotional development which present another challenge.

I also think many if not most BPDs avoid getting help - one of the posters here described it as a disorder defined by denial.

The ones who get help are at least willing to acknowledge the problem but I wonder what is the real percentage of BPDs out there who actually diagnosed and treated.

If you are in a relationship with a BPD who is willing and committed to getting the right treatment it's still seems to be an incredibly challenging and difficult process without any guarantee that they will still want to be with you at the end.

And to have any real chance of success both of you need to change so you need to be willing work on yourself as well.

Some of the traits that drew you to them are shaped by their disorder and you may find yourself with a very different person who wants to be with someone different too

There some members here who have worked through this successfully but from what I've read it took huge amount of courage, effort and commitment from both partners.

As far as the nature v nurture debate goes I believe that the truth is somewhere in the middle. There seems to be a very high incidence of childhood abuse in many of those suffering from BPD

BPD, Adverse childhood experiences

There is a strong correlation between child abuse, especially child sexual abuse, and development of BPD. Many individuals with BPD report a history of abuse and neglect as young children.Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically or sexually abused by caregivers of either gender. They also report a high incidence of incest and loss of caregivers in early childhood.

Individuals with BPD were also likely to report having caregivers of all sexes deny the validity of their thoughts and feelings. Caregivers were also reported to have failed to provide needed protection and to have neglected their child's physical care. Parents of all sexes were typically reported to have withdrawn from the child emotionally, and to have treated the child inconsistently. Additionally, women with BPD who reported a previous history of neglect by a female caregiver and abuse by a male caregiver were significantly more likely to report experiencing sexual abuse by a non-caregiver.

It has been suggested that children who experience chronic early maltreatment and attachment difficulties may go on to develop borderline personality disorder."


www.en.wikipedia.org/wiki/Borderline_personality_disorder

According to Jeffrey Young - the inventor of Schema Therapy which was primarily developed to treated PDs - 70% of those he treated with BPD had suffered childhood abuse but he also noted marked lability of temperament which probably has a genetic cause.

Wiki "Emotional dysregulation (ED) is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response. ED may be referred to as labile mood (marked fluctuation of mood)[1] or mood swings."

www.en.wikipedia.org/wiki/Emotional_dysregulation

I think it seems reasonable that those with a genetic disposition towards emotional volatility are more vulnerable to the disorder, but nurture certainly plays a big part.

I'd recommend reading up about the disorder as well as reading the posts of those who chose to stay

Good luck

Reforming

Logged

Links and Information
CLINICAL INFORMATION
The Big Picture
5 Dimensions of Personality
BPD? How can I know?
Get Someone into Therapy
Treatment of BPD
Full Clinical Definition
Top 50 Questions

EDITORIAL DEPARTMENTS
My Child has BPD
My Parent/Sibling has BPD
My Significant Other has BPD
Recovering a Breakup
My Failing Romance
Endorsed Books
Archived Articles

RELATIONSHIP TOOLS
How to Stop Reacting
Ending Cycle of Conflict
Listen with Empathy
Don't Be Invalidating
Values and Boundaries
On-Line CBT Program
>> More Tools

MESSAGEBOARD GENERAL
Membership Eligibility
Messageboard Guidelines
Directory
Suicidal Ideation
Domestic Violence
ABOUT US
Mission
Policy and Disclaimers
Professional Endorsements
Wikipedia
Facebook

Google+(Member)
Google+ (Professional)
BPDFamily.org

Your Account
Settings

Moderation Appeal
Become a Sponsor
Sponsorship Account


Pages: 1 ... 5 [6] 7   Go Up
  Print  
 
Jump to:  

Powered by MySQL Powered by PHP Powered by SMF 1.1.21 | SMF © 2006-2017, Simple Machines Valid XHTML 1.0! Valid CSS!