"If you don't have a word for something, you may doubt whether it's even real" - how individuals with borderline personality disorder experience change

• Published in: Psychotherapy research Vol. 31; no. 8; pp. 1036 - 1050
• Main Authors: Koivisto, Maaria, Melartin, Tarja, Lindeman, Sari
• Format: Journal Article
• Language: English
• Published: England Routledge 17.11.2021; Taylor & Francis Ltd
• Subjects: Borderline personality disorder; Change agents; cognitive behavior therapy; Community mental health services; Content analysis; Disconnection; Emotional responses; Emotions; group psychotherapy; Group therapy; integrative treatment models; Intervention; Interviews; Mental health care; Metacognition; Personality disorders; Personality tests; process research; qualitative research methods; integrative treatment models; qualitative research methods; process research; personality disorders; cognitive behavior therapy; group psychotherapy
• ISSN: 1050-3307; 1468-4381
• DOI: 10.1080/10503307.2021.1883763

This study explored how psychological change was experienced and what treatment-related factors or events were perceived as supporting or hindering their process by individuals with borderline personality disorder. Eight BPD sufferers attended a 40-session psychoeducational group intervention at a community mental health care center. At intervention end, personal experience of meaningful change was explored in an in-depth interview and data were content-analyzed. Change in BPD symptoms was assessed by the Borderline Personality Disorder Severity Index IV interview. The qualitative content analysis on subjectively perceived meaningful change yielded three core categories: (1) improved ability to observe and understand mental events, (2) decreased disconnection from emotions, emergence of new or adaptive emotional reactions and decrease in maladaptive ones, and (3) a new, more adaptive experience of self and agency. Accordingly, (1) learning and (2) normalizing emerged as the main categories of helpful treatment factors. In turn, treatment-related factors perceived as obstacles were: (1) aggression in the group, and (2) inflexibility. With respect to symptom change, four participants were considered clinically as remitted, and two showed a reliable change. Long-term psychoeducational group therapy seems to enhance mentalization / metacognitive functioning and promote self (or personality) integration in BPD patients.