TREATMENT: Cures and remission?

[BPDFamily.com]

Hi Skip et al,

First let me say I read through the whole thread now and like a lot of the thoughtful responses.

My approach from reading these books is not scientific and can be considered opinion. But, over the years I've read many books which each include several long case studies of people diagnosed with BPD. Some other examples would be James Masterson (Treatment of the Borderline Adult), Gerald Adler (Borderline Psychopathology and Its Treatment), Jeffrey Seinfeld (The Bad Object - this one has the best case studies, IMO), Vamik Volkan (Six Steps in the Treatment of Borderline Personality Organization), Peter Giovacchini (Borderline Patients, The Psychosomatic Focus, and the Therapeutic Process), David Celani (The Treatment of the Borderline Patient), and the books by Helen Albanese and David Roberts already mentioned.

These writers are in the psychodynamic camp of psychotherapy. They have worked a lot with borderlines, and they are realistic and pragmatic about how difficult therapy can be and how long the process can take. But they are also mostly optimistic, that if the person is willing to seek help and has the resources, outcome can be very good. I like their writing because there are many case studies, often about 10-20 pages long, where you get an individual borderline's full life-history, details on the course of treatment, analysis of their functioning socially and in work toward the end of treatment, and you really get a feel for the "borderline" as a person (in these books alone, there would be several dozen of these cases). Since these cases usually involve borderlines being in therapy for several years, it's hard to study things scientifically as with shorter term treatment. But, these writers have many cases which show borderlines, both lower and higher level, improving to the point that they are no longer remotely diagnosable as BPD - they often come to have good relationships, to stop being difficult and manipulative, to be able to regulate their mood pretty normally, to function well, etc. In medical language, they are cured, or in normal language, recovered and well.

I also know that this is possible (at least in my experience) because I was once borderline myself, but am not any longer. I went to intensive therapy for 6 years to get better, and I function and feel much better now than I used to, have better relationships, and am no longer manipulative or difficult to around (most of the time!). I have two friends who have severe BPD symptoms and who I try to help (and they found me because they were looking for help), and that's why I sometimes come onto online forums like this, to see what people are saying about the condition. I still feel there's a lot of misinformation out there, and a lot of pessimism that is unwarranted (in my opinion), although in some cases, yes the person is not willing to get help or acknowledge the problem, and at that time nothing can be done. But for BPD people who want help, I certainly would say the condition is fully curable, although those are overly medicalized terms. In the way I think about it, a borderline can gradually emotionally "grow up" and become an adult in an adult's body, rather than a child in an adult's body.

[BPDTransformation]

Hi Skip et al,

First let me say I read through the whole thread now and like a lot of the thoughtful responses.

My approach from reading these books is not scientific and can be considered opinion. But, over the years I've read many books which each include several long case studies of people diagnosed with BPD. Some other examples would be James Masterson (Treatment of the Borderline Adult), Gerald Adler (Borderline Psychopathology and Its Treatment), Jeffrey Seinfeld (The Bad Object - this one has the best case studies, IMO), Vamik Volkan (Six Steps in the Treatment of Borderline Personality Organization), Peter Giovacchini (Borderline Patients, The Psychosomatic Focus, and the Therapeutic Process), David Celani (The Treatment of the Borderline Patient), and the books by Helen Albanese and David Roberts already mentioned.

These writers are in the psychodynamic camp of psychotherapy. They have worked a lot with borderlines, and they are realistic and pragmatic about how difficult therapy can be and how long the process can take. But they are also mostly optimistic, that if the person is willing to seek help and has the resources, outcome can be very good. I like their writing because there are many case studies, often about 10-20 pages long, where you get an individual borderline's full life-history, details on the course of treatment, analysis of their functioning socially and in work toward the end of treatment, and you really get a feel for the "borderline" as a person (in these books alone, there would be several dozen of these cases). Since these cases usually involve borderlines being in therapy for several years, it's hard to study things scientifically as with shorter term treatment. But, these writers have many cases which show borderlines, both lower and higher level, improving to the point that they are no longer remotely diagnosable as BPD - they often come to have good relationships, to stop being difficult and manipulative, to be able to regulate their mood pretty normally, to function well, etc. In medical language, they are cured, or in normal language, recovered and well.

I also know that this is possible (at least in my experience) because I was once borderline myself, but am not any longer. I went to intensive therapy for 6 years to get better, and I function and feel much better now than I used to, have better relationships, and am no longer manipulative or difficult to around (most of the time!). I have two friends who have severe BPD symptoms and who I try to help (and they found me because they were looking for help), and that's why I sometimes come onto online forums like this, to see what people are saying about the condition. I still feel there's a lot of misinformation out there, and a lot of pessimism that is unwarranted (in my opinion), although in some cases, yes the person is not willing to get help or acknowledge the problem, and at that time nothing can be done. But for BPD people who want help, I certainly would say the condition is fully curable, although those are overly medicalized terms. In the way I think about it, a borderline can gradually emotionally "grow up" and become an adult in an adult's body, rather than a child in an adult's body.

[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).

[Reforming]

Hi BPDTransformation

I don't know your circumstances, but from what you've said you deserve huge credit and respect for what you have achieved.

I think it takes great courage and effort to face up to a disorder like BPD and really work to overcome it.

Speaking for myself, and I think there are others here who have similar experience, being in a relationship with a suspected but undiagnosed BPD partner exposed my own issues and weaknesses and ultimately made me realise that I need to work on myself.

Over time I've come to realise how difficult it can be to take responsibility for my behaviour and do the work on changing myself.

Change is not impossible, but it's hard and frustratingly slow at times

I cannot really imagine how difficult it must be to live with a disorder like BPD, but I do feel real sympathy for sufferers.

i do have some experience of how devastating it can be for partners and family members and I think one of the things which makes it so heartbreaking is it is often untreated, whether through inaccurate diagnosis or resistance from sufferers to getting and persisting with an appropriate therapy.

I think the new therapies offer more hope because they have a lower fall out rate and they seem to be more effective over shorter time scales, though Young reckons that it takes 2-3 years of schema therapy to treat the disorder and also suggests that some patients may need to continue therapy for longer

As you're probably aware this site is a resource for partners and families so you'll probably read posts that you may find distressing

I would also say that I think one of BPD Family's greatest strengths is the objectivity and quality of it's information and resources. I think it works very hard to educate its members about BPD and avoiding stigmatising the disorder.

Reforming