Fountain House, 425 West 47th Street, New York City. Photo: Courtesy Fountain House.

The Fountain House Symposium and Luncheon, held each spring at The Pierre, is the go-to forum for those of us eager to learn the latest on mental health. This year, the event’s fourteenth, the intriguing topic was “Borderline Personality Disorder: Why It Matters & What You Should Know.”

New York, N.Y. The event drew an audience of nearly 600 and raised over one million dollars in support of the groundbreaking programs of Fountain House, founded in New York City in 1948 with the belief that people living with mental illness can be active participants in their own and each other’s recovery.

The three stellar symposium panelists who reported from the frontlines of the field were: John Gunderson, M.D., Professor of Psychiatry at Harvard Medical School and Director of the Personality and Psychosocial Research Program at McLean Hospital in Belmont, MA; Perry Hoffman, Ph.D., President and Co-Founder of the National Education Alliance for Borderline Personality Disorder (NEA-BPD); and Marie-Paule de Valdivia, L.C.S.W., M.B.A., Executive Vice President of the National Education Alliance for Borderline Personality Disorder (NEA-BPD), Assistant Clinical Professor of Social Work in Psychiatry at Yale School of Medicine, and Dialectical Behavior Therapy Program Leader at Yale-New Haven Intensive Psychiatry Day Hospital. Veteran business journalist and TV anchor Consuelo Mack was the superb emcee.

Panelist John Gunderson, widely recognized as the “father” of borderline personality disorder, published seminal studies that helped transform the diagnosis from a psychoanalytic construct into an empirically validated and internationally recognized disorder and wrote the major textbook on its treatment.

Borderline personality disorder (BPD) has been called the “leprosy of mental illnesses.” A serious psychological and psychosocial disorder that centers on the inability to manage emotions effectively, it was originally thought to exist on the “border” between other psychiatric diagnoses. Misunderstood – and stigmatized even among many mental health professionals – BPD was long considered untreatable. The symposium panelists dismantled that persistent myth.

Dr. Gunderson illuminated for us the hallmarks of BPD: intense and volatile emotions (such as shame, anger, sadness or anxiety), chaotic relationships, impulsivity, unstable sense of self, suicide attempts, self-harm, fears of abandonment, and chronic feelings of emptiness. Symptoms are often in evidence by adolescence.

The causes of BPD are not yet fully understood, but it is generally agreed that a complex combination of genetic, social, and psychological factors must interact with one another in order for the disorder to manifest. Dr. Gunderson said that BPD occurs in approximately 2% of the population and accounts for 20% of all psychiatric admissions. Although there is no medication specifically indicated to treat BPD, medication may help with conditions that often accompany it, such as depression and anxiety.

Panelist Perry Hoffman referred to BPD as the “good prognosis diagnosis.” Why? The success of innovative treatments — beginning with dialectical behavior therapy (DBT), developed by psychologist Marsha Linehan in the late 1980s — transformed the outlook from bleak to hopeful.

DBT teaches “life skills” for coping with sudden, intense surges of emotion. As there is a shortage of clinicians trained in this intricate therapy, Perry outlined an alternative approach pioneered by fellow panelist John Gunderson: His “Good Psychiatric Management” combines a number of the principles of other treatments in a streamlined format accessible to a far greater number of clinicians and their patients.

Data show that with effective treatment and support, over time 80% percent of people with BPD reduce their symptoms. Misdiagnosis is common; Perry stressed the importance of early intervention and accurate diagnosis as key to recovery.

Perry conducted the landmark study on families and BPD, which documented the importance of family emotional involvement in patient recovery. She co-founded the National Education Alliance for Borderline Personality Disorder (NEA-BPD) as a resource and support group for families dealing with the BPD diagnosis and co-designed the “Family Connections” program, a free-of-charge course that focuses on the needs of family members and is run by family members who have themselves been trained. Family Connections is available in locations around the U.S., in person or via teleconference, and in a number of other countries.

Family was front and center in panelist Marie-Paule de Valdivia’s riveting personal account. In seeking answers regarding her daughter’s disturbing behavior and rejection of family, it was Marie-Paule herself who arrived at the BPD diagnosis – via the internet! At that time, Marie-Paule had no previous experience with mental illness, but that was to change – personally and professionally. After two decades in the business world, this M.B.A. went back to school, secured an M.S.W. degree, and became a Licensed Clinical Social Worker trained in dialectical behavior therapy.

Now, less than a decade since she identified her daughter’s illness, Marie-Paule teaches at the Yale School of Medicine and works with patients and their families at Yale-New Haven Hospital. An astounding evolution. Her daughter, who benefited greatly from DBT treatment, has reconnected with the family.

What a panel this was! In addition to the treasure trove of information they imparted, there was an extraordinary interconnectedness among them. John and Perry are longtime collaborators on books on BPD (their latest is Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder). Perry and Marie-Paule work side by side in leading NEA-BPD, which holds an annual conference in conjunction with Yale, now Marie-Paule’s professional “home.” The commitment of these three to people with BPD and their families was palpable.

Such commitment mirrors that of Fountain House, dedicated to the recovery of men and women with mental illness by providing opportunities for its members to live, work, and learn, while contributing their talents through a community of mutual support. Members, in partnership with staff, operate employment, education, housing, and wellness programs. They perform all activities, including advocacy, administrative support, building maintenance, and food preparation that keep this community going. Members hold jobs, graduate from schools, develop social networks, and experience fewer hospitalizations and improved overall health. Increased fulfillment, sense of purpose, and stability inevitably follow.

Fountain House has inspired the creation of hundreds of similar programs in 34 countries that serve more than 100,000 people annually. In 2014, the Conrad N. Hilton Foundation recognized Fountain House’s global reach and the efficacy of its evidence-based model with the prestigious Conrad N. Hilton Humanitarian Prize.

The recipient of the 2017 Fountain House Humanitarian Award was Amanda Wang. Diagnosed with borderline personality disorder in 2007, Amanda founded the first in-person, peer-led support group for people living with the disorder. Her heartfelt remarks provided us with a window on the formidable challenges of navigating life with BPD. Amanda didn’t sugarcoat her story; she gave it to us straight. But there is so much more to Amanda, whose candor, strength, and resilience brought us to our feet. Bravo! See honoree Amanda Wang’s powerful presentation: https://youtu.be/UiigRQ1sWuU.

The date of next year’s Fountain House Symposium and Luncheon has been entered in my calendar: April 30, 201

With Camille Tibaldeo.

Fountain House Symposium Spotlights Borderline Personality Disorder (Originally published in The Huffington Post, May 30, 2017)

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