AAPEL
Borderline disorder, cure ?

Introduction:

Borderline personality and cure. In short term, the answer is "yes there is cure" and it is not only our vision, a lot of studies are saying the same thing. You will find on the last part of this document our vision which we hope comprehensive and listening to the suffering
Meme page en Francais / Same page in french
Data, studies
What they say ?
Aapel view
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Data, studies (statistics, prevalence, comorbidity, co-occurency)
* Zanarini MC, Frankenburg FR, Hennen J, ... - Laboratory for the Study for Adult Development, McLean Hospital
2OO3 Am J Psychiatry. 2OO3 - The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder.
OBJECTIVE: The syndromal and subsyndromal phenomenology of borderline personality disorder was tracked over 6 years of prospective follow-up. METHOD: The psychopathology of 362 inpatients with personality disorders was assessed. Of these patients, 290 met DIB-R and DSM-III-R criteria for borderline personality disorder and 72 met DSM-III-R criteria for other axis II disorders (and neither criteria set for borderline personality disorder). Most of the borderline patients received multiple treatments before the index admission and during the study. Over 94% of the total surviving subjects were reassessed at 2, 4, and 6 years by interviewers blind to previously collected information. RESULTS: Of the subjects with borderline personality disorder, 34.5% met the criteria for remission at 2 years, 49.4% at 4 years, 68.6% at 6 years, and 73.5% over the entire follow-up. Only 5.9% of those with remissions experienced recurrences. None of the comparison subjects with other axis II disorders developed borderline personality disorder during follow-up. The patients with borderline personality disorder had declining rates of 24 symptom patterns but remained symptomatically distinct from the comparison subjects. Impulsive symptoms resolved the most quickly, affective symptoms were the most chronic, and cognitive and interpersonal symptoms were intermediate. CONCLUSIONS: These results suggest that symptomatic improvement is both common and stable, even among the most disturbed borderline patients, and that the symptomatic prognosis for most, but not all, severely ill borderline patients is better than previously recognized.

* Paris J, Zweig-Frank H. - Department of Psychiatry, McGill University, Montreal, Canada.
 2OO1 Compr Psychiatry. - A 27-year follow-up of patients with borderline personality disorder.
Sixty-four (64) patients with borderline personality disorder (BPD) were followed up for a mean of 27 years. Outcome was assessed using the Diagnostic Interview for Borderlines, Revised (DIB-R), DSM-III-R Diagnosis (SCID), etc. Most patients showed significant improvement... with only five (7.8%) currently meeting criteria for BPD... Fourteen subjects met SCID criteria for dysthymia, and this subgroup had a significantly poorer outcome on all measures. The total percentage of suicides from the original cohort has reached 10.3%, with 18.2% of all patients now deceased.

* Paris J. - Department of Psychiatry, McGill University Montreal, Quebec, Canada.
2OO2 Harv Rev Psychiatry - Implications of long-term outcome research for the management of patients with borderline personality disorder.
Fifteen- and 27-year follow-up studies of patients with borderline personality disorder show that most of them no longer meet full criteria for the disorder by age 40, and that even more show improvement by age 50. The mechanisms behind remission could include maturation, social learning, and the avoidance of conflictual intimacy. Affective instability is slower to change than impulsivity. Suicide rates in patients with this disorder are close to 10%, with most completions occurring late in the course of illness; early mortality from all causes exceeds 18%. All of these findings have clinical implications. Although treatment effects must be assessed in the context of naturalistic improvement, therapy can hasten remission.

Please read other data in therapy page, for example bipolar follow up, recurrence


BPD and cure, what they say
"Can BPD be cured? Is the word "cure" relevant? I talk about the fact that I have recovered from BPD, therefore it can be overcome. Learning to identify one's choices and to take responsibility for them is the way to "the cure".
There *is* a cure, so to speak. Of course you knew I was going to say this right? I have recovered from BPD. This means I'm "cured". Mind you I have always thought that when it comes to personality disorder's and mental illness we usually use the terms recovered or healed. Cure seems, to me, to apply more to physical diseases.
I know that there is a way to get better and leave BPD behind. However, I wouldn't think of it as one singular cure but rather a series of thousands of cures. By this I mean it is up to each individual to undo the relational - emotional damage which is largely responsible for the reactions = defense mechanisms and cognitive rigidity of BPD. Thousands of "cures" because BPD is such a layered disorder encompassing so many issues. All of these issue have to be adquately addressed in order for one to recover...
Many don't appreciate when I talk about choices but when we are young and either abused or not having our needs met, or both, we make choices, subconscious choices that then become patterns and habits
...
In my recovery process I didn't think about being or getting cured I thought about getting better, feeling better, working out my pain and learning to relate to others in an age-appropriate and consistent way. I had to work through and let go of the pain of a child in order to "grow up". If you hold on to the pain of your (inner) child and you don't heal it, it will hold you back and keep you stuck in the patterned-behaviour of BPD.
Recovering from BPD is a long process of untangling issues, distorted-thoughts, reactions and misperceptions. It is a matter of undoing choices that were made either at a very young age or as the result of pain felt, needs not met, some physical and or emotional threat or trauma. Learning to understand how you make choices, and why will enable you to then take responsibility for yourself, your choices and your actions no matter what the reason you perceive as the cause of them. This is the cornerstone to healing from BPD put simply - PERSONAL RESPONSIBILITY.
...
Recovery has more to do with it in my opinion. No one "cured" me. Though I worked with therapists etc it was, in the end, me that got to know me, me that forged a relationship with me. It was me that took personal responsiblity (and continues to) for me. It is me that does the thinking and the feeling and so forth in my life now that is "averagely-normal" and no longer borderline. I found myself. I learned to understand all about my past choices and how I am responsible for the choices that I have made, am making and other choices I will make in the future.

Recovering from BPD (or not) is a choice. For most borderlines the issue that need to be worked through are numerous, interwoven and interconnected. These issue may not all have the same cause. Therefore the best way to heal from BPD is to adapt an ecclectic approach. Find what works for you, what has meaning for you and allow yourself to continue to challenge your pain and perceptions.

BPD cannot be cured with a pill. BPD cannot be cured by therapy alone. BPD is overcome, or defeated and rendered in one's past when one emotionally matures to the point of meeting his/her own needs, taking care of him/herself, owning personal responsibility and when one is re-parented to the point of finally being able to nurture and or soothe him/herself.
...
Don't wait for someone to cure you to make your life, your problems, your world better - the answers that you NEED ARE inside of you. Work with your therapist but understand that while others may assist you, it is you that is in charge of your own recovery." (Ms. A.J. Mahari - December 23, 2OOO www.borderlinepersonality.ca/borderthecure.htm )


Aapel view of Cure and Borderline Personality Disorder
Here is our feeling

Is there a cure ?
Yes, there is a cure in the sense of it will be then impossible to diagnose a bpd disorder. That's mean bpd traits we be lowered enough to not being diagnosed
Many studies are saying that
Of course the treatment's goal (willing, help, medication, therapy, ...) is not to make you another person. It is not to change your "nature" but to lower suffering.
It is not because you have a bpd disorder that you are hypersensitive, no ! It is because you were hypersensitive that you were "at risk" for bpd !
Then, if we cure bpd, we don't "cure" sensitivity !
When we have bpd, hypersensitivity serve self-destruction and when bpd is cured, hypersensitivity can serve others...

Please read therapy and bpd and "emophany, positive borderline disorder's view ?"

AAPEL - Back to BPD Borderline page
 

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Warning:
All the information in this site is aimed at helping people understand a "rather particular" and puzzling kind of disease
But more especially, to support everyone affected by it, sick or not.  In any case, it is ESSENTIAL to see a therapist who specialises in this field they can confirm or give an alternative diagnosis
The name of what you’ve got doesn’t matter so much, getting the right treatment for the right patient does

last update  2007
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Author,  founder president of the Aapel