If you or someone you care about has a borderline personality disorder (BPD), you’ve probably been exposed to false information about a situation that – frankly, made you angry.
There was a time in the not too distant past when most mental health providers believed that BPD was incurable. Fortunately, clinical trials testing intensive and specialized treatments have debunked this myth (although you can still find people promoting it on the Internet).
Now he has an advantage wisdom That said, BPD is treatable, but it’s likely to take years—and that’s only if you’re lucky enough to find a professional trained in one of the proven treatments for the condition.
Of course, for people with this diagnosis, learning that BPD is responding to treatment is a huge improvement over hearing that it’s a life sentence. Right now, facing years of treatment can feel a little daunting.
Here’s the part that gets the least air time: The “years of treatment” assumption is more of a commemoration of how BPD research began than a hard-and-fast rule about what everyone with the diagnosis actually needs.
Why many people believe that BPD requires long-term care
The most well-studied treatment for BPD is dialectical behavior therapy (DBT). It was developed in the late 1980s to help people with chronic illness suicide thoughts and behaviors—not specifically people with BPD, actually. To be included first study In testing this treatment, patients must have a diagnosis of BPD and have had suicidal behavior within the past 8 weeks.
Given the severity of the patients in these early DBT trials, this means that treatment was long (a year-long commitment), intensive (at least twice a week), and complex (many skills). And it worked.
In addition to DBT, we have three other proven treatments for BPD: psychotherapy, delivery– oriented psychotherapyand good mental management. The success of these interventions has changed the prognostic landscape of BPD.
But somewhere along the way, the intensity and duration of these programs were mistaken for the dose each person with BPD needs to recover.
Not all people with BPD are at high risk
When most people picture someone with BPD, including many providers, they picture someone who is in and out of the hospital. But epidemiological research tells us that more than 50 percent of people with BPD have not and will not attempt suicide.
These individuals may not need twice weekly maintenance for a year to see improvements. And the assumption that all people with BPD need specialist care has a real cost: Waiting lists for DBT programs are long, meaning that higher-risk patients who absolutely need this level of care often don’t have access to it.
That is why my team is one 18-week treatment for BPD which fits the traditional once-a-week outpatient model. Our intervention, the BPD Compass, was developed with the understanding that BPD varies among clients. Some people’s symptoms stem from emotional sensitivity, others struggle with interpersonal relationships, and others struggle with impulsivity.
Our customers see the wins quickly because we personalize treatment based on the underlying problem driving the symptoms. By zeroing in on the skills that are important to each individual, recovery can be much more effective.
You don’t always need a specialist
One of the most interesting things about BPD Compass, in my opinion, is that we developed it with general clinicians in mind. Most of our trial therapists were trainees with no in-depth clinical experience, let alone experience with BPD.
This is important because there are not enough professionals to help the estimated 4 to 5 million Americans with BPD. Waiting lists for long-term, name-brand programs run from six months to a year in many cities and longer in rural areas. If your only choice is expert or nothing, “nothing” is what many people are faced with.
The more general practitioners are equipped to treat BPD, the more the landscape of the condition will evolve—from incurable to treatable with long-term care to simply treatable.
This is BPD Awareness Month
May is BPD Awareness Month, and many good conversations this time of year focus on the seriousness of the diagnosis. This is important – BPD is associated with real suffering and real danger, and it should not be ignored.
But the rest of the picture is also important. BPD is one of the most treatable conditions in psychiatry. Most people who receive care no longer meet the criteria over time. And more than ever, this care doesn’t require you to find a specialist or commit to years of intensive treatment.
