BPD Treatment

March 17, 2005 7:51 AM

Has anyone had any success with treatments for Borderline Personality Disorder?
posted by eggerspretty to Health & Fitness (6 answers total)

I'm not a big fan of the diagnosis because it's not clear what it actually describes, and it can be used in the trade in a very stigmatizing way (and almost exclusively is applied to women). One of the most pernicious ideas floating around about Borderline PD is that it cannot be treated. I think that that is incorrect, and that psychotherapy is an effective treatment. I think almost any form of therapy will do.

There is a treatment called DBT-Dialectical Behavioral Therapy, which is basically just a branded blend of insight and behavioral therapies. I tend to be skeptical of branded therapies, not because they don't work, but because research shows that they work no better than any other kind of therapy. The important constituents of therapy are a good relationship with the provider, a plan for change, and hope that change can occur. All of these can be a challenge for someone with certain types of personalities, so sometimes structured therapies can be successful at instilling hope and providing a concrete plan. DBT can be one such therapy. DBT can also help therapists who have a hard time handling unusual treatment relationships and treatment boundary issues to maintain a positive stance toward their patients. But an experienced therapist should be able to do this without DBT.

It's hard to know what else to say, because I'm not sure if this is a diagnosis you've received, a loved one has received or what. I do have a lot more to say, though, and all of it is hopeful and positive. My email is in my profile.
posted by OmieWise at 9:07 AM on March 17, 2005

DBT (Dialectical Behavior Therapy) is supposed to be excellent.

One downside is that there are sometimes long waiting lists for getting into a DBT group.

Some more info:
http://www.borderlinepersonality.ca/dbt.htm
http://www.priory.com/dbt.htm

DBT http://www.palace.net/~llama/psych/dbtprog.html in the US:
posted by zerokey at 9:18 AM on March 17, 2005

Ditto on OmieWise's comments, including email address in my profile.
posted by zerokey at 9:21 AM on March 17, 2005

DBT...

I have known people professionally and personally with BPD who have been helped with this. As with any therapy there are people that it helps and people that it does not.

Good luck
posted by edgeways at 12:00 PM on March 17, 2005

I knew a girl in the hospital that was diagnosed as borderline, and the approach they were taking with her was mostly decision therapy. They were treating the symptoms (why are you doing these action? what are healthier actions? etc) and weren't medicating her.

Kind of along Omie's lines, BPD is often stuck onto patients that don't fit into other boxes. I was diagnosed BPD/severe depressive upon my exit from a hospital recently, but the borderline theory has now been ditched completely. Get a good therapist and really, really talk about what happens to you when you make "bad boundary decisions" or whatever they're calling it where you are, and make sure everything is explained to your satisfaction.
posted by honeydew at 1:29 PM on March 17, 2005

My ex fit the profile perfectly. I did a lot of research.

It was very useful for me to consider "BPD" as a made-up label for a pattern of behaviors that seem to be repeating across a lot of people.

It's not something you/they "have", but a set of behavioral patterns. I recognize that this is a semantic distinction, but it was critical for my understanding of this hard-to-grok "thing" called BPD.

Further, it was extremely helpful for me to perceive BPD thru this analogy: "forceful impact to flesh" is to "bruise" as X is to "BPD".

BPD is, IMO, the behavioral "limp" resulting from something.

This may or may not be "sound", according whothefuckever, but it makes sense to me... and might help you.

(Add "in my opinion" to everything that follows.)

Whatever changework is undertaken, the goal is to change internal behavior (feelings, thoughts) and external behavior. It's pretty fucking difficult to change behavior without changing the beliefs from which those behaviors spring. And it's hard to change those beliefs without addressing the experiences that formed them.

For those labelled as BPD, there is an astoundingly high co-incidence of sad shit in their history: abuse, alcohol, "severe" family dysfuntion. This means something.

What it means to me, is that the hackneyed idea of "it comes from your childhood" might actually apply for those behaviors we call BPD.

HTH, even though it's not an answer to the question you asked. Oops.
posted by Moistener at 1:45 PM on March 17, 2005