The National Institute of Mental Health states that “Borderline personality disorder has historically been viewed as difficult to treat. But, with newer, evidence-based treatment, many people with the disorder experience fewer or less severe symptoms, and an improved quality of life.”[i]

Aside from Dialectical Behavior Therapy discussed below, there is not currently a wide body of research on recovery and remission. A 2016 research paper analyzed the results from 19 studies involving a total of 1,122 individuals with BPD. The researchers concluded, “Symptomatic remission from BPD is common. However, recovery including capacities such as engaging in meaningful work was seldom described. Future research needs broader measures of recovery as a sub-syndromal experience, monitoring consumer engagement in meaningful vocation and relationships, with or without the limitations of BPD.”[ii]

There are no medications specifically for BPD, though some are effective in dealing with common co-occurring disorders such as mood swings and depression. The primary treatment for BPD is psychotherapy, often Dialectical Behavior Therapy (DBT). Marsha Linehan Ph.D. developed DBT in the early 1990s specifically for treating BPD. She based DBT on the dialectics (“the balance of opposites and the coming to a synthesis”) of simultaneously accepting who one is while working to change.[iii]

The National Institute of Mental Health explains that “DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help: control intense emotions; reduce self-destructive behaviors; and, improve relationships.”[iv] The specific DBT skills include:

• “Mindfulness: the practice of being fully aware and present in this one moment

• Distress Tolerance: how to tolerate pain in difficult situations, not change it

• Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others

• Emotion Regulation: how to change emotions that you want to change”[v]

Dr. Linehan’s The Linehan Institute reports that “more than 30 randomized controlled trials (RCTs) produced by nearly 20 independent research groups in nine countries have demonstrated the effectiveness of DBT for certain populations”, especially people with BPD.[vi] Their compilation of research further shows that DBT is effective for people of all ages, including children and adolescents, and a range of conditions that now extends beyond just BPD.

The challenge with BPD - and any other psychotherapy - is that the participant has to really be a “participant”. Therapy doesn’t work if an individual refuses to attend therapy sessions or is dragged to a therapy session but doesn’t actively participate. The National Alliance on Mental Illness provides sound advice about how to encourage someone to see a therapist: show support, be sensitive to timing and place, prepare for resistance, and offer to help.[vii] In our case, Taya ultimately refused to participate in any treatment options no matter how much we tried to show support and offered to help.

This is an ongoing challenge for many of the families of loved ones struggling with BPD. And, this challenge must be overcome in order to reap the rewards of DBT and recover from the ravages of BPD.

[i] https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml

[ii] Ng FYY, Bourke ME, Grenyer BFS (2016) Recovery from Borderline Personality Disorder: A Systematic Review of the Perspectives of Consumers, Clinicians, Family and Carers. PLoS ONE 11(8): e0160515. https://doi.org/10.1371/journal.pone.0160515

[iii] Linehan, Marsha, Building a Life Worth Living (Random House, 2020), 7-8.

[iv] https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml#part_145390

[v] https://linehaninstitute.org/dbt/

[vi] https://linehaninstitute.org/dbt/

[vii] https://www.nami.org/Blogs/NAMI-Blog/November-2017/How-to-Encourage-Someone-to-See-a-Therapist