What improvement can be expected after therapy?

[Lifewriter16]

My pwBPDbf has had 2 years doing schema therapy. Despite this, he is still exhibiting strong signs of BPD. What improvements have other people noted in their partners after schema therapy?

[Loosestrife]

Hi I posted a similar thread re: therapy and effectiveness in general in the staying board  

[Tim300]

My BPDex-fiancee was in DBT.  Who knows, she might have tried schema at some point too.  In any event, her therapy could not prevent her from BPD chaos as our engagement became more and more intimate and we moved in together.  It seemed like sometimes she could have a clear moment of thinking and make DBT-related statements to me like "I am scared that I am pushing [girl friend X] away and I don't want to do that."  But then at other times she would just act like a nut towards her "friends" and she'd have absolutely no control over her behavior around me.  Unfortunately, I am a skeptic of the effectiveness of DBT during the intense moments when you'd really want it to help.  She clearly couldn't control herself (even though she wanted to), and DBT clearly couldn't help that.  I am sorry.

[Reforming]

Hi Lifewriter,

Sorry to hear that things are difficult for you.

I don't suffer from BPD, but to help my recovery from a long relationship with udpwBPDex and after doing quite a bit of research and reading I decided to work with a schema therapist.

From what I've read in the in practitioners guide www.amazon.com/Schema-Therapy-A-Practitioners-Guide/dp/1593853726, the schema bible for therapists, it can sometimes take up to three years of therapy to get results and Young also says that some patients may even need to remain in therapy for the rest of their lives

My schema T is highly qualified and very experienced and she is very positive about the effectiveness of Schema therapy. I specifically asked her how effective Schema T was at treating BPD. On her suggestion I recorded my sessions and I've found it very useful for future reference

She said, "There are some great therapies out there for personality disorders. Schema therapy I think is one of the best, DBT works very well at a symptom level, but it's really helpful for a lot of people and there are some others which have got some really good research results. But in any group study there are some that really do well and there's still those that don't even though they're given the same therapy.

So there's still other factors at play other than the therapy itself and in my experience it can be all sorts of things. The circumstances the person is in can keep reinforcing the disorder patterns or it could be something about the rigidity of their mind or it could be how wiling they are to access their emotions. There's all sorts of factors that determine whether one person can make progress."

I would have liked to explored this more with her, but we were focussing on my treatment and not my ex.

From what I've read in the practitioners guide in some of the research that you can find online there are a number of factors that can contribute to making personality disorders more resistant to treatment.  Age (getting treated earlier appears to be more effective), comorbidity with other mental health issues (bipolar, ADHD) and childhood sexual abuse often indicate a more negative prognosis.

Sorry if this doesn't help you much, but I really hope things get better and work out for the best

Reforming

[Reforming]

Lifewriter

I though this section for the Schema Therapy Practitioners Guide might be help

Schema Healing

"The course of schema healing is often arduous and long. Schemas are hard to change. They are deeply entrenched beliefs about the self and the world, learned at a very young age. They are often all the patient knows. Destructive though they might be, schemas provide patients with feelings of security and predictability. Patients resist giving up schemas because the schemas are central to their sense of identity. It is disrupting to give up a schema. The whole world tilts.

In this light, resistance to therapy is a form of self-preservation, an attempt to hold onto a sense of control and inner coherence. To give up a schema is to relinquish knowledge of who one is and what the world is like.

Schema healing requires willingness to face the schema and do battle with it. It demands discipline and frequent practice. Patients must systematically observe the schema and work every day to change. Unless it is corrected, the schema will perpetuate itself.

Therapy is like waging war on the schema. The therapist and patient form an alliance in order to defeat the schema, with the goal of vanquishing it. This goal is usually an unrealisable ideal, however: Most schemas never completely heal, because we cannot eradicate the memories associated with them. Schemas never disappear altogether. Rather, when they heal, they become activated less frequently, and the associated affect becomes less intense and does not last as long. Patients respond to the triggering of their schemas in a healthy manner. They select more loving partners and friends, and they view themselves in more positive ways."

Reforming

[Lifewriter16]

Hi Reforming,

My BPDxbf had his last session of a two year schema therapy group on 25th March 2015. We began our spate of 'break-ups' in response to seemingly insignificant things on 11th March and split up for the last time on 1st April. I can't help but thing these things are very connected. I know this won't bring him back though. I miss him terribly. We had a lot of times during which we were very close, but I think it's all got too overwhelming for both of us. I was feeling the urge to run and he accused me of pushing him away. In the meantime, he was getting triggered big time by things I did (or failed to do in the way he'd hoped). I feel so sad because we had such special times together and because he would try work things out between us and now he's decided there's no future for us. It seems to me that he is half healed and he 'knows' he has to pursue the rest of his healing elsewhere. That just leaves me with the pain of lost intimacy. I wish he'd come back and I dread him coming back at the same time. I so wish things could just miraculously get better but I know they won't and all I can do is face the pain.

[Reforming]

Hi Lifewriter,

I really feel for you and I understand what it like to really miss someone - even when you know that being with them is really hurting you

Like many others here I really there was an amazing cure that could obliterate this disorder, but at the moment it doesn't exist

I would mention one other thing I've read about Schema therapy. Apparently it is quite common for patients to find that their schema or rather their coping modes get particularly resistant when they are close to making a breakthrough. The coping modes almost have a life of their own for all the reasons that are mentioned in my previous post.

Whatever happens you both deserve credit for trying your best to make things work. Perhaps he may find it too difficult to heal and be with you right now, but if he sticks with his therapy this could change.

Have you considered getting some therapy yourself? I've found it a huge help and I wish I committed to it sooner. From what I've read here the chances of success are much better in these relationship if both partners are working on their own issues.

The fact that your partner has spent two years in therapy does credit to him

There are members some remarkable couples who have managed to work through their difficulties and find a way forward.

I'd really recommend the posts of Steph who is married to a healed BPD partner. Her story and her words are very inspirational

https://bpdfamily.com/message_board/index.php?action=profile;u=28800

Good luck

Reforming