“One of the most harmful misconceptions about BPD is that it is a life sentence—that people with BPD will struggle with the disorder for their entire lives, and that little can be done about it. The term “personality disorder” does not help the situation, as it implies that there is something fundamentally flawed with an individual’s personality, or who they are as a person.
In fact, there are many reasons for hope. First and foremost, studies have found that rates of recovery from BPD are much higher than previously thought. In one of the longest studies on BPD, Dr. Mary Zanarini and colleagues found that, over 10 years following hospitalization:
• 86% of people with BPD stopped meeting criteria for BPD for at least four years.
• 50% of people recovered completely (as shown by no longer meeting BPD criteria and having good social and work functioning)
Many of these people were receiving some kind of treatment, but some were not. Although many people with BPD clearly struggle for a long time, BPD is not a hopeless diagnosis, and many people recover.
A second reason for hope is that treatment works. The most extensively researched treatment for BPD is dialectical behaviour therapy (DBT), developed by Dr. Marsha Linehan at the University of Washington in Seattle. DBT involves the following:
• Weekly individual therapy sessions aimed at helping clients reach their goals, reduce self-destructive behaviours and move forward on a path toward a more fulfilling life.
• A weekly training group that teaches skills in the areas of mindfulness (paying attention to the present), emotion regulation (understanding and managing emotions), interpersonal effectiveness (dealing with relationships and acting assertively), and distress tolerance (surviving crises, and accepting yourself for who you are)
• Availability of the therapist by phone, e-mail, or other means in between sessions when help is needed.
Several rigorous clinical trials have shown that DBT works. In my own experience, I’ve seen clients improve their lives and relationships, achieve goals they never thought they could achieve, reduce their suffering, and even use what they’ve learned to help others in their lives and in the mental health community.
Aside from DBT, other promising psychological treatments have emerged in recent years, further showing that there is hope for recovery from BPD: mentalization-based therapy (MBT), schema-focused therapy (SFT) and transference-focused psychotherapy (TFP).
Medication also can be helpful for people with BPD (especially mood stabilizers, atypical antipsychotic medications, and selective serotonin reuptake inhibitors, or SSRIs). Experts caution, however, that treatment by medication alone, without any psychological treatment or therapy, is not advisable.
The bottom line is that BPD is not a life sentence: Many people recover and sustain their recovery, and effective treatments exist.”