It used to be seen as incurable - but BPD can be treated.
The term "Personality Disorder" implies something unchanging. Something that makes us fundamentally broken or defective.
It's not a diagnosis that most people want to identify (or live) with.
The idea of being broken or "wrong" goes against the notion of recovery, and makes us feel that we are the "problem" and that we won't be able to change, no matter how much we work on ourselves.
Its definitely time to change this idea.
most Personality Disorders are caused by trauma.
They are usually the result of experiences of intrusion, neglect and physical or emotional abuse in infancy and childhood.
The abuse doesn't need to be extreme or life-threatening for it to be traumatic. It just needs to be ongoing and intense enough for us to be unable to integrate the experiences into our developing self. Sometimes it can boil down to what is referred to as a "bad match" between parent and child, where parents might unwittingly encourage or persuade their child not to feel what they are actually feeling. (For example parents may subtly undermine a child's sadness or frustration by indicating that it is unwelcome or inappropriate or by overtly disapproving of certain emotions.)
For people with BPD, these childhood experiences were often invalidating, causing them to lose touch with their real feelings. They grow up not being able to understand or keep "a hold of" themselves in the context of their relationships.
With the increase in knowledge and understanding of BPD and its origins in traumatic childhood experiences such as these, there have been many advances in research and treatment of the illness.
"What was once considered an untreatable illness is now treatable... Psychotherapy is the crucial component of treatment.... [and] remains the treatment of choice, as indicated in many guidelines for the treatment of patients with BPD as well as recent Cochrane reports." Robert S. Biskin 2013 Aug; 22(3): 230–234 Treatment of Borderline Personality Disorder in Youth
The trauma at the heart of BPD is relational.
That is, it originates in the relationship between the caregiver and the child. Psychotherapy for BPD is designed to provide a reparative experience of relationship and allow people to rediscover themselves and their emotional core in the context of the therapeutic relationship.
A caring, empathetic therapist will give someone with BPD the space to be themselves.
Through therapy, the client experiences a new way of relating. They also learn new skills. Deeper than this though, they learn to understand themselves, so instead of being lost or empty, they can regain the things that most people take for granted - stability and groundedness, self-knowledge and awareness and more importantly, the ability to enjoy life without pain, shame and fear.
A personality disorder is not like anxiety and depression.
Nor is it something than can be cured with medication.
Illnesses like Borderline Personality Disorder are not a quick fix.
Although skills training, support and coaching are very important, they don't treat the underlying problems with identity. For recovery to take place, the trauma at the heart of the illness needs to be addressed. The work of therapy is to bring this, slowly and carefully, into conscious awareness so that we have some hope of processing it.
A good therapist will allow the trauma to be touched on gently and will remain an understanding and containing presence in the face of difficult emotions. They will sit with you while you re-experience some of the intense, unverbalised emotional pain that remains inside you, allowing you to slowly heal.
Skills based treatment such as DBT can help treat BPD by giving people the tools to manage relationships and everyday life, but individual psychotherapy helps heal at a deeper level by addressing the underlying trauma.
Download my free guide to BPD for young people and parents here.
Sign up my Free ebook for Daughters of Narcissists here.
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