Region Västra Götaland, Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, National Specialized Medical Care Unit for Severe Self-Harm Behaviour, Journalvägen 5, Gothenburg, 416 50, Sweden.
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SU/Sahlgrenska, Blå Stråket 15, Gothenburg, 413 45, Sweden.
BMC Psychiatry. 2023 Nov 14;23(1):838. doi: 10.1186/s12888-023-05357-9.
Dialectical Behaviour Therapy (DBT) is recognized as a leading evidence-based treatment, effective in reducing symptoms of borderline personality disorder (BPD), as well as co-occurring clinical syndromes. However, symptom remission may not be the same as a life experienced as worth living. The purpose of the study was to understand, from the perspective of individuals with lived experience, the concepts of recovery, life experienced as worth living and flourishing after treatment for BPD, and to describe the pathways to wellness after symptom remission.
Semi-structured interviews were conducted with nine adult women previously diagnosed with BPD, co-occurring clinical syndromes and severe self-harm behaviour who self-identified as recovered for a minimum of two years, recruited from a network for individuals with lived experience. The average duration of recovery was 5.7 years with a range from 2 to 10 + years. Data were analysed using thematic analysis.
Four main themes and 14 subthemes were generated from our analyses. Main themes indicated that loved ones helped recovery and to create a life worth living, that participants identified as recovered and as healthy and beyond, and that becoming well is a long process associated in part with reclaiming a healthy identity. Participants defined recovery as separate but related to a life worth living, which in turn was separate but related to being healthy and having lives they described as being beyond health and well-being. The wellness process was described as lengthy and non-linear, including setbacks that with time no longer derailed daily life. A proposed theoretical model depicting the wellness process over time from symptom remission to the experience of a life beyond health and wellness is presented.
This qualitative study contributes knowledge of what a life experienced as worth living means, as well as how wellness progressed into flourishing for some participants within a sample of individuals with lived experience. Our findings may inform treatment development that targets more than symptom reduction, which in turn may shorten trajectories from symptom remission to health, wellness, and flourishing.
辩证行为疗法（DBT）被认为是一种领先的循证治疗方法，可有效减轻边缘型人格障碍（BPD）的症状，以及同时存在的临床综合征。然而，症状缓解可能与有意义的生活体验并不相同。本研究的目的是从有过生活体验的个体的角度理解 BPD 治疗后康复、有意义的生活体验和繁荣的概念，并描述症状缓解后的健康途径。
对 9 名以前被诊断患有 BPD、同时存在临床综合征和严重自残行为的成年女性进行了半结构化访谈，这些女性自我认同至少康复了两年，她们是从一个有生活体验的个人网络中招募来的。平均康复时间为 5.7 年，范围为 2 到 10 年以上。使用主题分析进行数据分析。
从我们的分析中产生了四个主要主题和 14 个子主题。主要主题表明，亲人帮助了康复和创造有意义的生活，参与者认为自己已经康复并健康和超越了，并且康复是一个漫长的过程，部分与重新获得健康的身份有关。参与者将康复定义为独立但与有意义的生活相关，而有意义的生活则独立但与健康和幸福相关，他们的生活被描述为超越了健康和幸福。康复过程被描述为漫长且非线性的，包括随着时间的推移不再使日常生活脱轨的挫折。提出了一个理论模型，描述了从症状缓解到体验超越健康和幸福的生活的整个康复过程。
这项定性研究为有意义的生活体验意味着什么以及一些有生活体验的参与者的健康状况如何向繁荣发展提供了知识。我们的发现可能为治疗发展提供信息，目标不仅是减轻症状，这反过来可能会缩短从症状缓解到健康、幸福和繁荣的轨迹。
