Bpd Not Curable?

[sundries]

I just dont understand this. If bpd is a lack f knowledge on how to control emotions then surely that can be learnt? granted it takes kids about 10 years learning time - but then we are adults so arent having to learn loads of other stuff at the same time.

To me saying it isnt curable, you can just treat the symptoms, is a bit like saying that every adult never recovers from being a toddler, or perhaps it is like saying when people who as adults cant read are taught to read, they havent recovered from inability to read.

And if hte problem is objectively more powerful emotins (rather than emotions that appear more powerful because the person has mmissed out the emotional education clases that most people get informally from thier parents, then the objectively more powerful emotions/chemicals should be dealt with with medication - just like bipolar.

So im assuming im misunderstanding something about bpd?

[Lily-Bee]

From what I know opinions differ about wheter BPD can be cured or not. People/specialists seem to have conflicting opinions about that.

So your thinking isnt strange in the least.

My personal belief is that it can't be cured but that it can be managed. To a degree even that its not much of a problem anymore but personally I just don't believe it really goes away completely.

I think that if we do not learn certain skills like how to deal with emotions in childhood we can sort of learn them later but our brain hasnt developed the way it would/should have had we learned it as a child so I think it will always to a degree be an issue. It seems in people with BPD the part of the brain that deals with emotions(the limbic system) is not developed the way it should and you can learn how to deal with that but I don't think you can change it since you can't undo how the brain has developed itself.

But thats as I said a very personal belief there are many people that believe it can be totally cured.

So I could be wrong. I think in the future we will all learn much more about BPD and some questions will be able to be answered more properly then.

Lilly

[Betsy]

i agree with the first two sentences by lily. (and much more scattered through too. lily)

i have read articles that compair bipolar to bpd and say the only difference is that bipolar has a strong chemical componet to it and can be controlled with the right medications, bpd cannot. that being siad there are many people with bpd on medications.. why? it is bpd has so many co morbid diagnosis that can go along with it, depression, ptsd, ocd,did,gad, to name a few off the top of my head these can be treated chemically.

i don't think as adults we learn the same way as we do as toddlers. with toddlers there are new pathways built to transmit the feelings to proper ways of dealing with emotions. with todders there are certain things that if not learned developmentally will never be learned, or will be learned thru a very long roteprocess (such as learning mathmatical multiplication tables by parctice, altho i realize this is not a toddler task it is the only thing i can think of at the moment).

with bpd you can retun your brain to think correctly emotionally by practice. usually dbt is considered the most effective way. this has to be practiced over a long time period with the person not giving in to old thought patterns, old passage ways. but, at least in my own mind, it can never truely be cured because everyone encounters hight stress times, physical illness that weaken us, times of grief, etc. when the right combo comes along those old pathways start firing up again. things learned in dbt are not so easily and naturally performed. you have a breakthru of bpd symptoms. if you are strong enough it doesnt last long and you get your emotions that have been retrained to start thinking and overruling the emotions of the past. if you are too weak at the moment i think the old pathways take over and it is only by will and desire that you eventually over come those emotions and go back to the rational thinking that you trained yourself to feel. thus bpd is never cured although you may never see the symptoms again.

i dont want you to think all of this is scientific fact. lots of it comes from things i have read and believe to be true but the whole of it is my own synthizing of the facts i have read. others may have equally strong synthizations of their own or they may have better facts than i do. i guess for me at least it is up to each to draw their own conclussions for as lily said even the professionals cant agree.

thats my 25 cent worth,much more than my 2 cents worth! sorry it was so long!

bets

[sundries]

Its very intersting what you both say, and i liek long so dont worry about that!

With regards to Bpd symptoms becoming more obvious in times of stress, I suppose i wouldnt see that as a returning of BPD because id say that if you observed most people in times of severe stress, except for the most mature people a lot of people actually start behaving in 'BPD' ways. and 'regress' to much younger behaviour. If BPD is inflexible and pervasive behaviour, then if certain behaviours only occur at tiems of very stressful then its not really pervasive. Plus I suppose I wouldnt see cure as emotional perfection adn thining rationally all the time, id just see it as getting to the point of being as irrational as youre average football hooligan - and i htink a lot of BPDs get further in the maturity stakes than that.

does that make sense. Im not saying one way or another,- just thinking about it.

[Silkworm]

Great topic Sundries,

I would like to think that it's curable. Psychiatry is such a soft (and new) science ~ who can say what more research will unearth? Given that there has only been real forward progress in treating mental illness from the around the 1950's, I personally think that psychiatry is just beginning to come into it's own (just as an aside~ my paternal grandfather was mentally ill in the 1950's and all they could offer him was an archaic form of ECT, which he had for 6 yrs. I would really like to know what happened to him, so I'm currently searching for his medical records).

Fifty odd years of research is just a blip on the radar of real understanding of the human brain/mind. Lithium's mood stabilizing properties were discovered by accident, as an example of the hit'n'miss nature of psychiatry. Thankfully, the research into medications at least is becoming more targeted. As for an understanding of the brain changes in bpd...this is very new. Understanding what happens to the brain in someone with bpd..all this stuff is only in it's infancy. I'm encouraged that there is ongoing research into personality disorders, because it means better treatment and outcomes for us and hopefully less stigma attached to this dx by the health profession.

I could write more, but I have to skedaddle, so will leave it there.

I believe there is lots of hope...no healthcare professional has the right the say otherwise, because there is no-one yet in possession of all the facts.

Silkworm

[Amanda28]

some things are learnt like how to deal with emotions, others are chemically, but I don't need drugs as I have a better way, I have knowledge, I didn't learn how to deal in a healthy way, my emotions are strong, but I know how to bring these emotions(negative ones) down, I have learned tools to help me deal with everything in my life, medication isn't the only answer to all our problems, yes I have taking anti- depressants, but that was before I learned how to deal in a healthy way, eventually the skills learned in dbt just become like second nature, but if you don't keep at them than like everything one becomes the way they were in the beginning, so no not cureable but liveable, if that makes sense, if i keep practicing the skills i learned then I will stay healthy,

[Betsy]

lol sundries............ your average football hooligan! love it pml

bets

[sundries]

I think everyone has strong emotions. Its the not being able to control them that gets dx of borderline so when youve done dbt and have the skills to control them then youre just on hte same footing as everyone else.

silkworm, my gran was in hte hospitals in the 1950's. she eventually died in there in 1981. She first went in for post natal depression! Ive wondered if i could get her medical records so would be interested if you could let me know anything mroe about htis.

[Antari2012]

As a toddler, you have no knowledge of anything at all, and only learn, nothing more. You grow up with your environment internalizing in you and shaping you, becoming a permanent part of your future self. Those with BPD already have this permanent art of themselves, and thus cannot learn their way out of it.

All recovery is based on sense made of reality, or perception of the truth. If one's reality is far too warped, then they cannot learn from something they cannot even see.

It can only be numbed, never cured.

[samsung]

i want to know what this is about. but it is too much writing. can someone sum up the conclusion for me in two sentences

pllleeeeaaasssee..

[Joshua]

No u lazy thing

[violetloveheart]

one of my psychiatrists said to me i should show no symptoms of the condition by the time i'm 45 if i go through all the therapy and drug treatment. I'm 33 now!

I was like 'great, if i live that long'. But now i'm in a more positive and less chaotic state of mind, i can kinda see where she was coming from.

Do we know of any celebrities with the condition? I truly believe that Courtney Love is a sufferer. Just look at her behaviour and the stuff she says in interviews.......

[rebeccaborderline]

this is what my T has told me;

that I probably have identifiable brain "damage" related to BPD/abuse (ie shrinkage amygdalla/hippocampus) which leads to abnormal processing of emotions/emotional memory. However with long-term work that Im doing now new "pathways" can be made for processing so that reactions can become more "normal", which will mean to me that I will not be so oversensitive and not keep re-experiencing uncontrollable surges of emotions.

He also says that I will probably always be super-sensitive to emotional states but will learn how to better manage and regulate this, and perhaps it can become a gift rather than a burden (eg just being empathetic rather than constantly triggered)

Dont know about anyone else but this information has given me hope; its concrete facts that I can understand, and I can see something to work towards (its already having beneficial effects)

So I believe its possible to learn to manage BPD, to become fully functional,live up to our potential and have acceptable social interactions. In medical terms this probably counts as a "cure" as you will n longer be accessing mental health services, or rarely.

rebeccaborderline

[samsung]

No u lazy thing

you bastard.. you sum it up for me plllleeeeeaaaaaazzzzzzzzzzeeeeeeeeeee.

[Vorpalblade]

Rach, they debating bout whether BPD can be recovered from.

my 2 penneth is that well, we all know that the prognosis is that we grow out of BPD in our late 40s, but i am 31 and have managed to get this label removed. I did 2 years of DBT and worked my fucking socks off at it, and continue to do so. 3 months ago my psych reassessed me, said that he was removing the BPD label as i wasnt presentin enough symptoms.

However, since then ive gotten the DID label..a condition that my BPD was masking,

[samsung]

thanks blade

nope i dont think it is curable.

i think you can learn to live with it.

[violetloveheart]

i fully agree with rebecca. that opinion is very logical.

I don't think it can be cured, but you can learn to live with it.

[arwentheelfqueen]

I once asked a p-doc this very question and he said you can be symptom free but the history of what you went through will always be with you, so in a sense you are always just recovering from BPD. This seems comparable to drug addicts, they are never recovered but always recovering. Since I derive most of my identity from having BPD (though this sounds sad, it's all I've got), I find this thought comforting.

[becsnoamp]

I've been told by my psych centre that yes BPD is curable. Well, you still have the emotions a bit, but you have better coping strategies which therefore make you feel better. But to get your diagnosis officially removed, you have to be tortured by my ex cpn first, for at least 3 years. I asked on Friday if mine had been removed and my psychiatrist laughed and said "Not likely dear! It can be removed though!" I said "Oh yeah, how much are you asking for?" He said "No no, you can get it removed if you go back to your ex cpn's DBT!" I said "Thanks for the offer but I think I'd rather have *bpd* written on my epitaph than go back to my ex cpn, but appreciate your sentiments!"

[anotherexborderline]

Do we even know?

Back in the 80's, it was generally agreed BPD was *untreatable*, let alone curable. Now we have DBT, Mensalisation, Self-Psychology, and so many of us here no longer even fit the diagnostic criteria, although I think we would debate whether we are "cured"...

Remember, 25 years ago this was generally agreed to be impossible. And yet here it is.

. . . . . . .

If we don't know how to, is it just that we don't know *yet*? The leading researchers in the field don't seem to think it's worth throwing in the towel just yet, e.g.:

"Once it is known that a treatment is efficacious, the next task it to improve the treatment further" -- Marsha Linehan (DBT "inventor"), 1999

"Over the last 15 years, the application of various treatment approaches to the management of borderline personality disorder (BPD) has led to a “guarded optimism” that such personality conditions are “changeable and treatable -- A. Bateman and P. Fonagy, Psychotherapy for borderline personality disorder, Oxford University Press, New York (NY) (2004)

. . . . . . . .

For me, I wonder the same question. Here I am, post-therapy, seemingly post-borderline and nowhere near meeting diagnostic criteria, and yet.... I don't feel so good. In fact, I would say for me the core feelings that the DSM-IV talks about, of feeling "abandoned" and "bad", are still there... Just that they have been plastered over with a whole lot of affect regulation, mindfulness, self-controls, acceptance, and new skills.

In this way, I think Dr. Linehan is right to say that dysregulated emotion is the primary controlling variable for "psychopathology" in BPD - that is, if you CAN control your feelings, then you stop acting crazy - and voila! no more "BPD" ....technically speaking that is.

But the emotions are still there and I think that this represents an enourmous blind-spot in the research that is causing us all a lot of heart-ache. For example:

in Lynch, Chapman, Rosenthal, Kuo and Linehan (2006, Journal of clinical psychology, 62, 459-480), the authors state: "The core deficit of BPD is not an excessive intensity of emotional responses, but rather, the fact that BPD individuals experience a breakdown of their cognitive, emotional, and behavioural emotional systems when they experience intense responses". -- I think this is exactly half-right. BPD hurts - I know it hurts more than tearing a disk in your spine, and I have heard that it hurts more than childbirth... but it doesn't hurt quite as much as the death of a loved one. Nor have I noticed that losing a loved one hurts BPD people more than it hurts others. What I do notice, and what the quote above completely misses the point of, is the *frequency* with which these high-order distressing emotions are felt. Most people only give birth or do their back in ever now and then. BPs confront equivalent levels of pain over and over *every single day*.

. . . . . . . . . . .

It seems to me that current research into DBT, CBT, Mentalisation, Mindfulness, Self-Psychology etc. etc. could be summed up under the broad headings of self-control and self-awareness. These are wonderful things. They keep me safe and make my life a lot better. But they completely miss the point of why there should be any frequent and distressing affect to be aware of and control in the first place.

So, on the one hand I keep hoping for new and better treatments... and on the other hand, "if you want something done right, do it yourself" - I am not quite ready to give up trying to figure it out for myself :)

[Amanda28]

'It seems to me that current research into DBT, CBT, Mentalisation, Mindfulness, Self-Psychology etc. etc. could be summed up under the broad headings of self-control and self-awareness. These are wonderful things. They keep me safe and make my life a lot better. But they completely miss the point of why there should be any frequent and distressing affect to be aware of and control in the first place. '

I 100% disagree with what you have said here, because self control and self awareness only get a person so far, I think you do not have an understanding of what dbt provides, I have been through dbt, my emotions have come down to that of normal, yes I still have as I call them flare ups but not to the same extant, I have come along way, I know why i'm bpd and why my emotions were so high, I use the skills repeatedly everyday in every situation I face, I always known why I'm the way I am, I just had to have someone explain a few things about that, it's just like alcoholism, you can know all you want about why you have it and how it affects you but that doesn't mean you are going to be able to control it, I don't control my emotions, I acknowledge them and know how to 'deal' with them, because I practice a lot of mindfulness and a lot of other skills I have managed to overcome how I feel- and what to do when I feel certain ways. I do take offense to what you are saying, but at the same time I said what I feel and now I'm done

[rebeccaborderline]

anotherexborderline,

thanks for that, your reasonings made a lot of sense to me

rebeccaborderline

[anotherexborderline]

Hi Amanda28,

I 100% disagree with what you have said here, because self control and self awareness only get a person so far, I think you do not have an understanding of what dbt provides

No I don't have an understanding of it, that's why I am interested in posting my thoughts to get feedback.. so, thanks for taking the time to reply to me . I am intrigued by what you have written and would like to find out more - I have not had DBT (yet) myself, but would love to give it a go to find out more about it. It sounds like for you it actually makes you *feel* better - is that the case?

I do take offense to what you are saying, but at the same time I said what I feel and now I'm done

I so didn't mean to offend anyone - please accept my appologies!!

[Amanda28]

i took offense yesterday but left it here, that is one thing you learn in dbt in order to go through difficult groups i have learned to let things go, thanks for the apology, but as I have stated that was just me, anyways with dbt you learn different ways to help 'cope' through situation that may trigger, and with using these techniques after a period of time emotions no longer come to the severity that one may be use to, these techniques or skills help one manage through every day events, not only do they work for bpd emotion they also help with not bpd emotions, such as stress or anxiety. for example I could only see the negative emotions I had and only experience these, anger, sadness, depression, I couldn't see how I could be happy and sad at the same time, now I can have different emotions at once, and the level of all my negative emotions have come down to a bearable level, for example when I got downtown today nobody on the train would move down and I ended up missing the train, I was peeved but that had only lasted a few minutes and that was about an hour and a half ago time now is 7:18, well I can write about it now and it doesn't bring up the same levels of emotions anymore, lets say last year for example, I would be furious then and also now, again this has nothing to do with self control, I realized I was a bit angry but instead of sitting on that fact I picked up a book and distracted myself, it worked, this is one of the skills I have learned,

sorry for such a long reply, I hope this explains my feelings a little better

[thatguy]

I just dont understand this. If bpd is a lack f knowledge on how to control emotions then surely that can be learnt? granted it takes kids about 10 years learning time - but then we are adults so arent having to learn loads of other stuff at the same time.

To me saying it isnt curable, you can just treat the symptoms, is a bit like saying that every adult never recovers from being a toddler, or perhaps it is like saying when people who as adults cant read are taught to read, they havent recovered from inability to read.

And if hte problem is objectively more powerful emotins (rather than emotions that appear more powerful because the person has mmissed out the emotional education clases that most people get informally from thier parents, then the objectively more powerful emotions/chemicals should be dealt with with medication - just like bipolar.

So im assuming im misunderstanding something about bpd?

This is my basic problem with DBT as a therapy. DBT treats BPD as if it WERE really only just "a lack f knowledge on how to control emotions..."

That's simply not true. If that were thecase, there really wouldn't be a genetic component in it (one would think). You may be able to learn to control your reactions to certain emotions after awhile but I think that's just a band-aid. To FIX the problem, you need to get to the CAUSE and change whatever you can, INCLUDING how you react AND medications. Changing your reactions without exploring WHY you react that way has a great potential for recurrence imo.

I think BPD has a great chance to be "curable" at least to the extent that the patient doesn't show enough symptoms to be classified BPD. But it takes a LOT OF WORK. The Unfortunate thing is that (according to the books I've read), most folks with BPD don't stck around treatment long enough to find out if it's curable or not.

I plan on sticking around.