4 Keys to Recovering from Borderline Personality Disorder

Borderline personality disorder (BPD) is a devastating condition. Difficulties with emotion regulation, impulsivity, self-image, identity, interpersonal relationships, and self-harm characterize it. Sadly, suicidal ideation and attempts are not uncommon. It is estimated that 1.6 percent of the general population struggle with this disorder, translating into millions around the world.

Given the seriousness and breadth of BPD, finding effective treatments is vital. But just how do individuals with BPD experience treatment interventions and the process of recovery? These questions were the focus of a study led by clinical psychologist Britt Kverme of the District General Hospital of Førde in Norway.

In order to pursue these lines of inquiry, Kverme and her team recruited 12 women who met their study inclusion criteria. Participants were women between the ages of 21 and 36 who had been diagnosed with BPD between six and 18 months prior to the study, were currently in treatment, and had not experienced psychosis. The investigators then conducted individual in-depth interviews with the participants about their experiences and analyzed them for themes.

The results were striking. The overarching theme of "Moving Toward Connectedness" emerged. This theme encompasses feelings of belonging, holding on to oneself, and being part of the world. The central theme of "Moving Toward Connectedness" is broken down into four sub-themes, outlined below.

1. Learning to Hold One’s Own

Being proactive agents of change was crucial for participants in their recovery journeys. Agency meant having the ability to take action and change longstanding patterns and habits. Of particular importance was being seen as a person “who could” by their therapist and, in turn, developing that same confidence in themselves. Participants who felt “they could” reported making in-the-moment choices to better cope with their feelings — and without self-harm. One participant shared:

"I don’t believe in myself, I have zero faith, but she believes. Oh my God, she believes! It’s like, “calm down, I’m not that good!” and she’s like, “You can do it!” And that’s just crazy, to have someone saying your words, the words you should be saying to yourself, and who will not be quiet about it. She will go on shouting, “You can do this! Don’t give up!” That means everything!"

Participants also had therapists who introduced them to new ideas about being in the world, which inspired hope and change.

2. Needing Honesty and Genuine Mutuality

Participants felt that having a therapist who validated them and viewed them as unique individuals fostered security in the therapeutic alliance. Since many women in the study had long neglected their true selves, working with a therapist who saw them not as a diagnosis but as human beings was transformative. Feeling seen, heard, and understood by their therapist allowed the women to find and connect with themselves in new ways.

However, not all participants had this experience, instead reporting that they were not seen or understood by their therapist. A participant remarked:

"I have told my therapist, and I feel that she doesn’t hear what I’m saying. That’s been really hard cause then I feel that she makes it into having something to do with my illness. She will say, “Yes, but a lot of people have difficulty with that, and relational issues and stuff.” But then I feel like she doesn’t even see me! My biggest problem is with myself and not other people!"

3. Daring to Belong

Learning to open up to others and participating in relationshipsgenuinelyr was hard — but essential for recovery. Of specific note, group therapy played an important role for these women. This treatment setting offered a “sanctuary” where group members shared their thoughts and feelings and felt embraced by their peers who could identify with their experience. One participant reflected that she felt at home at group therapy but felt separate from others in the larger world:

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"Group therapy probably helped me the most cause then I met people who struggled with the same… as I felt I was the only one in the whole world who struggled with. Then suddenly, I meet people with exactly the same thoughts and emotions as me. So that probably helped the most."

4. Making Room for Recovery

The processes of recovery rested on hope. Moreover, the women who felt they were making strides forward in their journey believed they could take active and deliberate steps to change their lives. They could also take stock of their life trajectory thus far — and how they wanted their future to be different.

In addition, recovery involves having self-compassion for making mistakes along the way and having patience with oneself in their struggle to progress. As one participant put things:

"To be satisfied with the little steps I take, or to me, they are really big steps, but to others, they might be: “Really, is that a problem?” I just have to be proud of what I accomplish. I have to try, and if I fail, well, that’s okay too."

Kverme and her collaborators concluded their study by stating that despite the small sample size, this study provides poignant and informative first-person accounts of what felt most helpful in recovering from the grips of BPD.