Have Mental Health Questions? Ask a Psychiatrist Online
Hello, I am Rafael. Thanks for asking your question - I'm here to support you. (Information posted here is not private or confidential but public).
BPD as other similar disorders are seen as chronic conditions, what means there is no healing but only rehabilitation - recovery from them, and this means that a person suffering of it, does have more or less chances of improvement depending on different factors. First we need to consider if there are any other personality or mental health disorder also present affecting the person's mood, psychological processes, functioning and relationships. In the mental health filed we know how most times people with BPD do also present other disorders, from depression to anxiety disorders, poor coping, and more, many times associated with past issues around abuse, neglect and trauma. Thus any effective rehabilitation process should address every core issues behind BPD, and other possible disorders associated to it.
This is why I said that rehabilitation process would be different depending on specific circumstances and reality. Each person is unique, and when we talk about BPD this is very obvious to clinicians. In my professional experience, I have seem many people with BPD totally reluctant to even acknowledge the disorder, or to commit to regular psychotherapy, what for sure just makes impossible any family or professional effort to promote some positive changes or rehabilitation.
My recommendation is for the person to to start with at least a 90 minutes session per week, and then change to sessions every other week depending on progress. Again, it depends on how well the person works on her-his process, and how effectively clinician offers support, constantly reassessing client's needs, improvements, challenges and needs for further treatment at any other area.
People with BPD do require a healthy and effective support system in order to have better chances for rehabilitation. It would be unrealistic to expect recovery if the person's family is dysfunctional, non supportive or has serious codependency issues. No matter how many hours a week a client could have of therapy, it would not help if his-her support-family system is dysfunctional.
Good support from competent, ethical and experienced mental health professionals, plus a healthy support system, and a healthy life style, would allow good psychotherapy to be effective as much as possible depending on the person's commitment and level of severity around mental health issues. Finally, I want to say that individual psychotherapy is very good but needs to be complemented with group psychotherapy, and once it is completed, with regular participation at a local support group. This approach would bring the best potential results. Psychotherapy should be consistent as long as necessary depending on level of functioning and recovery. Staying active in a support group should be considered as an ongoing process that would always benefit the person, preventing deeper relapses and crisis.
Does it make sense?
You're very welcome.
I cannot define a specific number of years since it totally depends on multiple factors specific to the client's reality. I have seen people getting significant initial improvements after a couple of years in therapy, while others showing no major improvement after 3+ years in therapy. It all depends on the person's real willingness and accountability to work on him-herself, their support system, life circumstances and the presence of any other comorbid mental health issues.
Yes, BPD is one tough disorder affecting the very person and those close to her/him.
You're welcome. Thank you for your trust.