Recovery in Borderline Personality Disorder (BPD): A Qualitative Study of Service Users' Perspectives

Abstract

BackgroundSymptom improvement in Borderline Personality Disorder (BPD) is more common than previously hypothesised. However, it remains unclear whether it reflects service users' personal goals of recovery. The present study aimed to explore what service users with BPD view as recovery.Methods48 service users were recruited from secondary mental health services and their views on their personal goals and the meaning of recovery were explored in in-depth semi-structured interviews. The study drew on grounded theory and thematic analysis.ResultsService users believed that recovery involved developing self-acceptance and self-confidence, gaining control over emotions, improving relationships, employment, and making progress in symptoms like suicidality and self-harming. They felt that psychotherapies for BPD often had an extreme focus on specific areas, like self-harming or relationships, and that some of their goals were neglected. Although full recovery was seen as a distant goal, interviewees felt that they could learn how to deal with their problems in more effective ways and make meaningful progress in their lives.ConclusionsSpecialist therapies for BPD explicitly address some of the recovery goals that are important to service users, whereas other goals are only indirectly or poorly addressed. Professionals might need to work with service users towards devising comprehensive individualised case formulations, including all treatment targets that are important to service users, their priorities, and long-term plans on how their targets might be met and which services might be involved.

Personal recovery in personality disorder: Systematic review and meta-synthesis of qualitative methods studies

“…Reasons for exclusion of papers following full-text review included the following: case study presentation only, not focussed on the experience of those with a personality disorder diagnosis and representation of personal recovery through quantitative scale definitions only. Three papers were therefore identified for inclusion in the meta-synthesis analysis (Castillo, Ramon, & Morant, 2013;Holm & Severinsson, 2011;Katsakou et al, 2012). Study characteristics are summarised in Table 1, and appraisal findings according to CASP criteria are shown in Table 2.…”

“…Illustrative quotation (first order) Source 'I think recovery is a very difficult word particularly with mental illnesses and I think you can recover, but I suppose I'm naturally worried that if I go and recover, I would be worried that I could think I'm wonderful now and then all of them fall from the rails, cause I'm not keeping a check of myself …' Katsakou et al (2012) How recovered do people feel?…”

Comparison of Objective and Subjective Life Balance Between Women With and Without a Personality Disorder

“…The findings in this study tend to point to an overall lack of meaning in the activities accomplished and this justifies the importance of client-centred interventions to better understand the values, the interests and the types of meaning derived from activities experienced by clients with personality disorders and then, to enable accomplishment of meaningful activities in their daily life considering facilitators and obstacles. This was identified as a dimension of recovery in persons with borderline personality disorders [42,43]. As both groups of women felt imbalanced in every category of needs assessed in the subjective life balance questionnaire, it would be useful to provide opportunities and tools, such as the Life Balance Inventory or the Occupational Questionnaire, to reflect on use of time and on quantity and variety of activities one experiences in order to improve overall global health and quality of life.…”

ThisGoffmanian Conundrum: Supporting the Status Quo or Forced to Manage Societal Ramifications?

“…[5] There are a number of individuals in the general population with BPD. Reviewing five studies, Katsakou et al (2012) estimate between 1% and 5.9% of the general population have BPD, while Leichsenring et al (2011) report a nonclinical study in which 5%-9% of the population exhibited Borderline Personality Disorder, meaning a large number of people with this disorder do not seek clinical treatment. Thus, 1 to 9 out of every 100 people may have BPD.…”