Are my expectations of recovery too high?

Last week I attended at conference in London titled ‘The Management and Treatment of Personality Disorder: Evidence Updates’.  Perhaps it wasn’t the intention of the esteemed panel but it came across to me as though the expectations of recovery and what that recovery would look like was rather low amongst panel members and not at all comparable to my own expectations of ‘recovery’.

I got the impression at this conference that recovery was about learning to make friends, being able to join a social group and the reduction in ‘depression’ (which isn’t even a part of Borderline PD).  This is obviously my broad impression and the reduction of depression point was as a result of needing a specific measurement in a study undertaken by one of the panel members (Professor Kate Davidson of the University of Glasgow), however, there wasn’t mention of people with personality disorder having meaningful employment or a “a life worth living”.  One of the panel members (Dr Birgit Vollm of the University of Nottingham), during a question time with the panel, said that the reality is that Borderline PD is a “lifelong condition”.  Further, it was explained by Lou Morgan of Emergence Plus that there is inbuilt within their organisation an assumption that at any one time, there will be a need for some of their employees to be on reduced hours or having time off due to PD difficulties.

All of this was uncomfortable to hear and at complete odds with my own expectations of recovery., which has led me to ponder whether my expectations of recovery are too high compared with the ideas and experiences of esteemed professionals with the PD field.

  • Have I been deluded to believe getting back into a professional environment (i.e. using my previous legal training to re-train as an IMHA and gain paid employment in that role) is a real possibility when I shouldn’t be aiming to do that?
  • Should I be happy that I am no longer self-harming or chronically suicidal and attempting suicide nor having lengthy hospital admissions? Perhaps, that combined with me currently undertaking undergraduate short courses in archaeology together with meeting up with friends is what I should be seeing as ‘recovery’?
  • Am I deluded to think that undertaking the KUF awareness training this summer so as to be able to go on to undertake the “train the trainers” course and deliver the course in future is a realistic path?
  • Am I deluded to think that this recovery of mine is going to be sustainable?  Maybe I’ll be unable to continue my current voluntary work with the CAB and I should be joining a social group and treating myself as fragile, someone who is unable to manage the harsh realities of being (once again) a more fully integrated member of society?

Dr Paul Moran of the Institute of Psychiatry at King’s College London did say that education was a good predictor of recovery so perhaps I’m lucky and my Cambridge University degree and subsequent training and qualification as a solicitor gives me a better chance of recovery.  Even so, there remains the idea that ‘recovery’ for that panel appears to be far removed from that of my own.

But even within an organisation of people with lived experience of personality disorder there is a built-in safety system to allow for reduced hours and time off due to PD difficulties.  I don’t see myself taking time off for PD difficulties.  I’ve had such struggles during my time at a placement with former colleagues at a national law firm last summer and as a volunteer this year at the CAB. Those difficulties haven’t led to me taking time off.  Now I understand those difficulties and how to manage them, I don’t see myself as needing time off for those difficulties.  Again, am I expecting too much of recovery?

As an aside, in individual DBT session this week it was brought up the reality of having a co-existing condition – statistically given the number of episodes of depression I have had, I’m pretty much guaranteed further episodes (as well as hypomania).  This is what I see as potentially necessitating time off work or reduced hours in the future due to how it can incapacitate me in terms of concentration etc.

The conference also made me wonder if the attitudes of professionals can actually hinder the expectations and therefore achievements of recovery for those with a diagnosis of PD. Are there people with a diagnosis of PD out there that could be doing so much more and having a far more fulfilling life but their expectations and goals have been lowered by the expectations of the professionals with whom they come into contact?

Finally, the conference was interesting in a number of aspects and has sparked a few blog post ideas in me so please bear with me whilst I work through these thoughts over the next few blogs.


About Carrie Quinn

I'm a former solicitor whose life was turned upside down due to problems with my mental health. I'm now aiming towards recovery, which to me means rebuilding a meaningful life - not necessarily disorder free.
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4 Responses to Are my expectations of recovery too high?

  1. Clare Bare says:

    Sorry Carrie, I’m just going to have to stick my oar in all over your blog now..

    This is something I get really annoyed about. I’m sure you know that I consider myself fully recovered from BPD, it could be argued that it’s early days yet and things may still go pear-shaped but I can feel the changes in myself and I can see them in my life, it’s not a delusion. The people who know me well, including professionals, also see these changes and remind me of them in my moments of self-doubt. But what really gets to me is, if I’d been aware of all the received wisdom about BPD back then I might never have got as far as I did. And I do think that many people are held back by the notion that only management is possible. Is it me, or is it all very patronising? I really don’t want anyone telling me what my limitations are. Perhaps if they stopped telling everyone else what their limitations are there wouldn’t be so many people thinking there’s no point in even trying to recover if they’re just going to have to live with it their whole lives.

    Maybe education is important, I left school at sixteen and I’m only just going back to formal education now but I am self-educated, in the proper sense of the word, I know how to think for myself. Is that the key do you think?

    • Carrie Quinn says:

      No apologies necessary. It’s nice to get some friendly feedback. I’m still a very tentative blogger.

      I think that’s similar with me – I feel so much different and more like ‘me’ before services. I’m not doing the whole ‘feelings are facts’, I can’t really explain but I know things are different. I know things will still be difficult because I am highly sensitive (and have a co-morbid condition) but having learnt so much about my problematic thought processes/patterns in individual DBT sessions, I know there are some beliefs/ideas that I will either no longer be entertaining or am aware of so that it won’t lead me too far down a difficult path. I too, have good friends (and professionals) that have pointed out the change.

      It was the thought of ‘managing’ that got me so angry about the idea of recovery. I don’t want to ‘manage’ but my idea of management has changed. Before I think I bought into the doing OK but not really living whereas now ‘managing’ means recognising and understanding my sensitivities whilst still having a fulfilling life. Does that make sense?

      Maybe education (formal or otherwise) allows a person to question and think outside of the limitations being set for them and therefore feels able to aim for more than an existence?

  2. Al says:

    People don’t like changing their opinion about someone. It is less risky to predict the worst about BPD ( and maintain professional credibility) because it will probably come true (forgetting professional ethics it seems and the creation of a self-fullfilling prophecy.) Of course statistics do not elucidate mechanisms of cause. Being a graduate of cambridge university, one of the best in the world, I would expect you to be able to achieve a high level of insight, and acheive a senior professional role.
    Incidentally, there was talk of changing BPD to a symptom disorder. What do you think?

  3. Carrie Quinn says:

    Hi. I’m not sure I understand what you mean. Are you saying that you believe that it is likely that people who had a diagnosis of BPD to struggle with the disorder again at some point?

    I’ve not heard talk of a symptom disorder. What are they suggesting?

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