New Program Offers Hope for Borderline Personalities

Renowned psychiatrist to head treatment center for borderline personality disorder

May 17, 2003

Public Affairs

Belmont, MA - Fear of abandonment, inappropriate rage, impulsiveness, chronic feelings of emptiness and boredom-these are some of the symptoms of borderline personality disorder (BPD), an illness that affects an estimated six million people, mostly women, in the United States today.

Despite its prevalence in society, BPD is under diagnosed and when it is diagnosed, treatment is difficult. Now, McLean Hospital hopes to make recovery easier for those with BPD with the opening of The Center for the Treatment of Borderline Personality Disorder, one of only a few programs in the United States designed specifically to treat borderline personalities. John Gunderson, MD, one of the nation's leading experts on BPD, established, and will lead, the program.

"Our service offers a full continuum of care and is based on an innovative combination of psychoeducational, dialectical, behavior and psychodynamic therapies, plus medication management," says Dr. Gunderson. "There are few, if any, programs in the country where all these services are available and are provided by experiences clinicians with expertise."

Perry D. Hoffman, PhD, president of the National Education Alliance for Borderline Personality Disorder (NEA-BPD), says programs such as McLean's new center is "long overdue. People with BPD need to feel confident they will receive care from experts like John [Gunderson], who fully understand their needs and concerns. BPD is a complex and difficult-to- treat illness and it takes a knowledgeable individual and unique services to understand and treat it adequately."

Jennifer, 31, of Boston says she wishes such a program existed four years ago. "My life was a complete wreck," she recalls. "I had been successful in my life because I was able to channel a lot of my anger and focus it on my job, so I was a driven and strong business person. Eventually, that all fell apart and so did the rest of my life. That's when I made my first suicide attempt."

Jennifer's story is not an isolated one. Women are typically diagnosed with BPD 75 percent more often than men and like Jennifer, the illness affects every part of their lives. BPD is linked to high rates of divorce, substance abuse, child abuse, physical, sexual and emotional abuse, eating disorders and estrangement from family members. Individuals often engage in self-mutilation and approximately 10 percent commit suicide.

"People with borderline personality may look fine from a distance, but once you talk to them, it becomes clear there is a problem. They lead truly desperate lifestyles," explains Dr. Gunderson. "As a group of people, they are very involved in virtually all social public health problems. People with this illness are costly to society, not to mention the emotional toll they take on their friends and family."

Jennifer can attest to this. She recalls that while she was in the depths of despair, she appeared outwardly normal to others. Inside, however, she was miserable, classifying everyone in her life as good or evil, depending on the day of the week or even the hour of the day.

"Anything could set me off…a friendly glance was interpreted as a glare and that person immediately went from my loved list to the hated list. And I would retaliate in any way available to me," she explains. "Even the tiniest slight from someone would feel like a piercing blow that couldn't possibly be discussed or resolved, but had to be avenged."

After visiting a number of psychiatric facilities, Jennifer finally found the clinical services for BPD at McLean. By that time she was anorexic, bulimic and had begun a pattern of self-destructive behavior. Within months of beginning therapy, she started to see a difference in her life. Although she suffered a number of setbacks, including several suicide attempts, she has continued her therapy at McLean and has regained control of her life.

"When I arrived at McLean, I was looking at a pretty bleak future. Today, I have a life that is more promising and more fulfilling than I could have ever imagined. I am now in a doctorate program and engaged to be married. I see the world around me and the people in my life in a new and wonderful light."

Like Jennifer, Mary sought the help of Dr. Gunderson. After 10 years in therapy, she has become an advocate for those with BPD and the need for accessible and appropriate treatment.

"This is not an illness that you can get better from after a year or two of treatment. It takes many years for people with borderline to begin to trust and to learn to live their lives differently. Not all doctors, even psychiatrists, know this," says Mary. "Dr. Gunderson and his staff understand that people like me aren't just looking for attention. They know we're just trying to get through life the only way we know how and that with their support and help, we can get better."

The Center for the Treatment of Borderline Personality Disorder at McLean Hospital offers state-of-the-art expert care in a comfortable and caring environment, with a continuum of customized care, spanning residential, partial hospital, comprehensive outpatient and individual psychotherapy services.

Although the origins of BPD are complicated, both genetic and environmental causes are known to interact. Research has shown that 70 percent of women with BPD have been sexually or physically abused at some point in their lives.

Dr. Gunderson and colleagues are conducting research on BPD that examines how the illness responds to treatment, manifests and changes in individuals; why some people can get better and others cannot; and the genetic transmission of BPD in families.

Dr. Gunderson will be presenting on borderline personality disorder during the annual meeting of the American Psychiatric Association in San Francisco on Monday, May 19 from 11 am to 12:30 pm and 2 pm to 5 pm; and Wednesday, May 21 from 2 pm to 5 pm. All lectures will be held at the Moscone Center.

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