Despite suffering from a greater narcissistic disturbance, the prognosis for successful treatment of a patient with BPD is better than that of a patient with NPD. Those with BPD are more likely to be referred for help based on their self-harming behaviour and thanks to their guilty feelings in periods of regret they are more inclined to look for a recovery than those with NPD. In addition BPD is in part attributed to chemical imbalances in the brain which can be treated medically.
However, like other Narcissist’s those suffering from BPD can be the barrier to their own recovery. Not all will admit they have a problem – they may even claim that people they interact with are in need of help not them. Sufferers have a tendency to go in and out of therapy rather than working through the treatment long term and often expect special treatment from their Therapist wanting attention at a moments notice regardless of if it is convenient e.g. the Therapist is with another patient or on holiday. Some will verbally abuse their Therapist and may use emotional blackmail to get the attention they crave e.g. threatening to commit suicide – even making an attempt where the Therapist has not met their needs.
Whilst those with BPD can be intelligent and accomplished members of the community it is the degree of disturbance that determines the effectiveness of treatment and their ability to stick with it.
The two most successful treatments used to help treat people with BPD are Dialectical Behaviour Therapy (DBT) and medication.
Dr Marsha Lineham has pioneered the DBT treatment for BPD. Indications show that it is successful in helping those with BPD to change their behaviour with many going through treatment not exhibiting any symptoms of BPD afterwards.
The treatment uses four techniques; individual therapy, group skills training, telephone contact and Therapist consultation. The process is not quick, it often takes years to benefit from treatment and it requires the patients continued commitment to treatment.
Medication can be used to help stabilise the chemical imbalances in the brain. Prescriptions are usually for antidepressants like Prozac which helps to regulate serotonin levels thus improving their mood and alleviating some of the symptoms of BPD. There are, however, a wide variety of pills that can be used to treat the condition and can include Antipsychotic Medications (for treatment of hallucinations and delusions), Atypical Antipsychotic Medications (to reduce psychosis and improve overall functioning), Mood Stabiliser’s and Antianxiety Medications (Bockian, pg. 121). These pills do of course have side effects which need to be considered before treatment begins.
Most likely a combination of therapy and medication is used to treat BPD.
While reportedly less effective, other therapies can also be used in treating BPD:
- Psychodynamic Psychotherapy – a talking therapy where the Therapist attempts to get the patient to recognise parallels between the patients current issues/behaviours and their past experiences.
- Cognitive Behaviour Therapy – used to change the way the patient processes their thoughts and behaviours in reaction to external and internal stimuli.