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Academic research can be hard to understand. SANE's Plain English research series translates important research into everyday language, to connect you with the latest information from the psychological field.
One of the most persistent myths about borderline personality disorder (BPD) is that it can't be treated. In fact, BPD can respond well to evidence-based treatments, and those treatments are improving.
But how do you define recovery from BPD? Is it just not having symptoms anymore? Or are there more useful ways to think about recovery?
Researchers from the University of Wollongong looked at how recovery is currently defined, and how thinking about it differently could help improve treatments and outcomes for people experiencing BPD.
Here's the research itself, our plain-English explanation and how you can add your voice to a new approach to BPD recovery.
By Fiona Ng, Marianne Bourke and Brin Grenyer. Published in August 2016 by PLOS ONE.
This research is about recovering from BPD. How do the clinicians who treat people living with BPD define what it means to recover? Is that a useful definition, or is there a better way to think about BPD recovery?
This paper is a review of existing BPD research. The researchers looked at existing studies on recovery from BPD, to see how recovery was defined.
The researchers limited their review to studies that had run for at least five years and focussed on recovery rather than the specifics of treatment methods. They searched the psychological literature and found 19 research studies like this.
In each of these studies, people who had been diagnosed with BPD had their symptoms measured again after periods of time, to investigate some aspect of recovery from BPD.
The current review put these 19 previous studies together to see how clinicians and researchers have defined what it means to recover from BPD.
The researchers noted that, in psychological research, there’s often a divide between two ways of thinking about recovery from an illness: clinical recovery and personal recovery.
Clinical recovery tends to be about measurement. Symptoms of an illness like BPD can be measured, usually by a mental health professional interviewing the person. After a period of treatment, they measure the person’s symptoms again, and also their ability to function in everyday life.
If their functioning has improved and their symptoms have dropped so they don't meet the criteria for having BPD anymore — and if the symptoms stay reduced over time — you can say the person has recovered from BPD.
Personal recovery is a much more individual way of measuring someone’s mental health journey. The researchers quote this description of personal recovery:
Recovery is described as a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness.
Personal recovery is much more defined by the people experiencing the illness and their family, friends and carers than by clinicians, so it tends to be more about improvements in the person’s whole life than strictly about measurable symptoms.
The researchers found that, even though BPD research has looked into personal experiences of diagnosis, treatment and stigma, the studies they analysed mostly defined BPD recovery in clinical terms.
But that might be too narrow a definition of recovery. People experiencing BPD might have a broader definition of recovery — it might include reducing symptoms, but have more to do with finding and keeping a job or relationship, or some other more personal measure.
Likewise, the friends, families and carers or people with BPD might have a picture of recovery that's different again.
The researchers conclude that including the ideas and needs of everyone involved — clinicians, people with lived experience and their families, friends and carers — could improve treatments and help people with BPD recover in a way that's more meaningful to them.
This SANE resource was created with support from The Vizard Foundation.