Tag Archives: Treatment For Bpd

Should BPD Treatment Be More Individualized?

should BPD treatment be more individualized?

Problems Relating To The Diagnosis Of Borderline Personality Disorder (BPD):

In order to be diagnosed with borderline personality disorder (BPD) an individual must suffer from AT LEAST FIVE SYMPTOMS out of a total of NINE listed in the DSM V (The Diagnostic And Statistical Manual Of Mental Disorders, Fifth edition). These nine symptoms are listed in the table presented below :

symptoms of BPD DSM 5

It logically follows, therefore, that two individuals could BOTH BE DIAGNOSED WITH FIVE OF THE ABOVE SYMPTOMS, YET HAVE ONLY ONE OF THESE SYMPTOMS IN COMMON WITH ONE ANOTHER.

However, despite the fact that BPD can manifest itself in very different ways in different individuals, when it comes to therapy we often find that a ‘one-size fits all‘ approach is taken.

Should BPD Treatment Be More Individualized?

 

Furthermore, the different therapies available for the treatment of BPD tend to focus upon a presumed, single, fundamental, underlying ‘core feature’ of the disorder, yet these features differ depending upon the selected form of therapy. In other words, different types of therapy for BPD are predicated upon differing theories the disorder. In his excellent book, Integrated Modular Treatment For Borderline Personality Disorder, Livesly, a leading expert in the treatment of borderline personality disorder, provides the following examples :

DIALECTICAL BEHAVIOR THERAPY – this therapy focuses primarily upon the symptom emotional dysregulation or, in other words, the inability to control intense, volatile and quickly fluctuating emotions. (To read my article about dialectical behavior therapy, please click here).

MENTALIZATION BASED THERAPY – this therapy assumes the main difficulty that BPD patients suffer from is a marked impairment of their ability to ‘mentalize’ –(To read my post explaining what ‘mentalization’ is, and what may cause impairment to a person’s ability to mentalize,please click here).

TRANSFERENCE-FOCUSED THERAPY – this therapy is predicated upon the notion that the BPD sufferer’s primary problem is a disturbance in his/her fundamental personality structure

SCHEMA-FOCUSED THERAPY – this therapy assumes that the BPD sufferer’s main underlying problem is his/her maladaptive schemas which s/he developed as a result of a dysfunctional childhood. (Click here to read my previously published article entitled : Childhood Trauma Leading To The Development Of Negative Schema.)

And, of course, Livesly points out, the ‘core features’ / symptoms that these different therapies focus, and the different theories that underpin them, dictate the ‘modus operandi in relation to the forms of treatment they provide.

Conclusion :

Because BPD is a multifaceted disorder and those who suffer from it will present with different constellations of serious symptoms, treating them with therapies that focus primarily on just one core feature (as in the case of the four therapies described above) may be inadequate – instead, more holistic forms of treatment may be appropriate that integrate methods from an array of therapies relevant to the unique pattern of symptoms manifested by each individual ; this is the main thesis Livesly’s book which can be purchased by clicking the image below :

eBook :

BPD eBook

Above eBook now available on Amazon for instant download. Click here for further information.

David Hosier BSc Hons; MSc; PGDE(FAHE).

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Copyright 2017 Child Abuse, Trauma and Recovery

Study Shows 73% Recover from Borderline Personality Disorder (BPD)

 

Until recently, it was frequently suggested that borderline personality disorder (BPD) was very difficult, if not impossible, to treat. During my research for this article, I have been disturbed to discover, also, that in the recent past some clinicians did not regard BPD as an illness at all – instead, they put forward the view that those diagnosed with BPD were not mentally disordered, but, rather, simply ‘bad’ and ‘manipulative’ people!

This reminds me of a time I made a very serious and determined suicide attempt and the psychiatrist I saw afterwards (who knew very little about me) tried to make the case that I had not really intended to kill myself but was seeking attention and sympathy. When I protested and tried to explain the attempt had been made very much in earnest (one might even say, ‘deadly earnest), he responded (and I quote him verbatim) : ‘It sounds like you’re talking bullshit to me!’

Highly professional.

In connection with the cynical and deeply insulting attitude that my psychiatrist displayed, I would also point out that, in my own personal view, some individuals (in my case, certain family members and former friends) like to take the view the BPD sufferer is not really ill as this, in their minds, absolves them of any responsibility to provide help and support.

Despite such pessimism, a study funded by Columbia University found that 73.5% of the participants who took part in their study recovered from BPD within 6 years. Even more encouragingly, it was found in the same study that more than half actually recovered within just 2 years.

Another encouraging finding of the study was that only 6% of those who had recovered relapsed (and, even if they did, this was mainly due to the effects of an extremely stressful event/s).

FURTHER RESULTS FROM THE STUDY :

– 1.4% of the participants commited suicide in the first 2 years of the study

– 1.7% of the participants commited suicide in the next 2 years of the study

– 0.7% of the participants commited suicide in the final 2 years of the study

(This gives a total of 3.8%, or about 1 in 25, who commited suicide during the study).

– 65.9% achieved good psychological functioning by the end of the study (32.4% after 2 years, 48.3% after 4 years, 65.9% by end of study).

SPECIFIC SYMPTOMS THAT IMPROVED IN THE INDIVIDUALS IN THE STUDY :

– Impulsiveness (this symptom improved best of all)

– Mood/affect (although this improved leat well)

– Interpersonal functioning

Self-mutilation

– Suicidal behaviors

Psychotic symptoms

The study also showed that the two factors which most helped the individuals to recover were :

1) Ending a destructive relationship

2) Determination to get well.

BPD eBook

 

Above eBooks now available for immediate download on Amazon. CLICK HERE.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Click here for reuse options!
Copyright 2013 Child Abuse, Trauma and Recovery