BPD and Recovery

On Wednesday I attended a Youth Leadership in Mental Health Forum, in which I was one of the presenters. I spoke about using my lived experience of being hospitalised under the Mental Health Act for anorexia to advocate for eating disorder services and rights of consumers, and also being a student occupational therapist who has BPD. It’s always a bit of a rollercoaster of emotions when speaking about your own experiences. There’s the anxiety and lead up to the event, the initial high and sense of relief immediately afterwards, then the coming down and self-doubt about whether you actually did a good job or not. My emotions were complicated even further by the fact that eight other students from my OT course were in attendance, and now all eight know that I’ve been hospitalised involuntarily and have had anorexia and have BPD. Which I guess isn’t a huge deal given I am somewhat open about my mental health issues and most OT students are quite open minded. I got some nice feedback from a few of of the OT students, which was nice. Though it felt a bit awkward when I was sitting with them at lunch time and one person asked the group which speakers were their favourite. Me being sensitive and self-critical, when they mentioned other speakers who they enjoyed listening to, it made me think that compared to the other speakers I must be really substandard. Hmm.

One of the points I raised in my talk is the way that BPD has been taught in the OT course. BPD has tended to be painted in quite a negative light, without being very recovery focused. One of the OT students said that she also noticed this in class, and actually asked the tutor why it wasn’t more recovery focused. She said that the tutor told her it’s because “Most people with BPD don’t recover.” Umm, WHAT?!! Excuse me?! No, no, no, no, no! It was really quite upsetting to hear that my OT tutor has this belief and attitude, especially as I had raised the issue last year of the prognosis of those with BPD being portrayed as being very dire in class and with that had revealed to her that I myself have been diagnosed with BPD. It also made me very frustrated and angry. It’s so incorrect that people with BPD don’t recover. There is research that shows people with BPD can and do recover. One famous example is of course Marsha Linehan, the woman who created DBT. I’ve seen anecdotal evidence from people I know online who have recovered from BPD and I know even more who may still struggle with BPD, but are able to live a functional and meaningful life. It is so sad when I see mental health clinicians harbour this attitude and I just hope that those of us with BPD again and again prove them wrong.

Recovery?

Recovery. It’s the word of the moment with mental health services. They’ll tell you they operate from a ‘recovery framework’. Recovery as the ultimate goal, it’s what we’re all supposed to be aiming for.

I don’t understand the concept.

When I think of the word ‘recovery,’ I think of someone ceasing to have the symptoms of an illness they previously had and are no longer ill. As in someone recovering from an infection, recovering from a bout of gastroenteritis, recovering from the flu. Or if we’re talking mental health issues, recovering from an eating disorder or recovering from depression. As in, they had that illness but do not have it any more, nor do they have any lingering symptoms.

According to the lecture notes from my neuropsych tutorial though, some of the principles of recovery include;

  • Recovery can occur even though symptoms reoccur or remain.
  • Recovery can change the frequency and duration of symptoms.

So then I was just confused.

I Google searched ‘mental health recovery’ and came across a government document entitled Principles of recovery oriented mental health practice. Maybe I’m just slow, but I still don’t understand this elusive concept of ‘recovery’.

But perhaps it doesn’t matter, seeing as whatever this word means, it doesn’t feel attainable, achievable or realistic anyway. I may achieve periods of ‘doing better’ but I don’t expect to be completely free of depression and anxiety any time soon, or possibly even ever.