The lived experience of recovery in borderline personality disorder: a qualitative study

Abstract

Background The concept of recovery in borderline personality disorder (BPD) is not well defined. Whilst clinical approaches emphasise symptom reduction and functioning, consumers advocate for a holistic approach. The consumer perspective on recovery and comparisons of individuals at varying stages have been minimally explored. Method Fourteen narratives of a community sample of adult women with a self-reported diagnosis of BPD, were analysed using qualitative interpretative phenomenological analysis to understand recovery experiences. Individuals were at opposite ends of the recovery continuum (seven recovered and seven not recovered). Results Recovery in BPD occurred across three stages and involved four processes. Stages included; 1) being stuck, 2) diagnosis, and 3) improving experience. Processes included; 1) hope, 2) active engagement in the recovery journey, 3) engagement with treatment services, and 4) engaging in meaningful activities and relationships. Differences between individuals in the recovered and not recovered group were prevalent in the improving experience stage. Conclusion Recovery in BPD is a non-linear, ongoing process, facilitated by the interaction between stages and processes. Whilst clinical aspects are targets of specialist interventions, greater emphasis on fostering individual motivation, hope, engagement in relationships, activities, and treatment, may be required within clinical practice for a holistic recovery approach. Electronic supplementary material The online version of this article (10.1186/s40479-019-0107-2) contains supplementary material, which is available to authorized users.

Living with personality disorder and seeking mental health treatment: patients and family members reflect on their experiences

“…From the consumer perspective, importance was given to the therapeutic relationship with mental health professionals, including finding a clinician they can connect with who specializes in personality disorder. This finding is unsurprising given that a strong therapeutic alliance can facilitate recovery [42]. Consumers described how mental health professionals, such as medical registrars, often did not have sufficient knowledge and experience to support them, and they requested people with experience who had specialized knowledge of personality disorders.…”

“…For carers, importance was placed on early assessment and intervention, which is supported by evidence and treatment guidelines [10,45]. However, consumers did not discuss early intervention, although they have previously described delays in receiving a diagnosis [42]. Carers also focussed on being involved in the assessment and treatment of the consumers they support, although consumers did not mention this.…”

Social Cognition Capacities as Predictors of Outcome in Mentalization-Based Treatment (MBT)

“…As a specialized BPD treatment, MBT will address the relation self-other by work in therapy dyads, groups and direct exploration of significant interpersonal incidents, emotional reactions, and social interpretations (46). Several qualitative studies describing change processes among BPD patients have indeed highlighted the subjective impact of new relational experience, practice, and competence (47)(48)(49)(50). Positive patient-reported group experiences-learning to gain and lend perspectives are indeed emphasized in a qualitative study of MBT (51).…”

Using peer workers with lived experience to support the treatment of borderline personality disorder: a qualitative study of consumer, carer and clinician perspectives

“…Treatment outcomes may depend on a variety of factors including BPD severity, treatment length and treatment type. From a consumer perspective, recovery from BPD may involve symptom reduction, but also the generation of hope and participation in meaningful activities and relationships [5,6]. Services for consumers with BPD which focus on recovery oriented outcomes have been recommended [5,7].…”