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Movie Review: Back from the Edge (2006)

April 12, 2010 3 comments

Summary:
This is a documentary produced by New York-Presbyterian Hospital on Borderline Personality Disorder (BPD).  BPD is an Axis II personality disorder that generally first shows up in teen years or young adulthood.  According to the DSM-IV-TR, to be diagnosed, a person must have 5 or more of the following 9 symptoms:

  1. frantic efforts to avoid real or imagined abandonment (some clinicians expand this to include fear of abandonment)
  2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
  3. unstable self-image or sense of self (identity disturbance)
  4. impulsivity in at least two areas that are potentially self-damaging (such as sex, spending, substance abuse, reckless driving, etc…)
  5. recurrent suicidal behavior, gestures, threats or self-mutilating behavior (such as cutting, burning, head banging, etc…)
  6. a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  7. chronic feelings of emptiness
  8. inappropriate, intense anger or difficulty controlling anger
  9. transient, stress-related paranoid ideation or severe dissociative symptoms (from page 710 of the DSM)

BPD affects approximately 10 million Americans or about 2% of the population.  It is more prevalent than bipolar disorder or schizophrenia.  75% of those with BPD are female.

This documentary features interviews with people who have BPD, their families, and leading clinicians specializing in BPD such as Dr. John Gunderson, Dr. Marsha Linehan, and Dr. Perry Hoffman.

Review:
This documentary is divided into sections starting with each of the symptoms then leading through causes, treatment options, and hope for remission.  Each section start with a quote directly from a person with BPD.

This documentary is beautifully done.  We see pictures of the people with BPD from their past including both the good times and the bad.  We also see excerpts from their journals and letters sent to others.  The clinicians all display evident empathy and desire to help not only the patients but their families, friends, and other loved ones.  The family members are given the space to express their confusion over their loved ones’ behaviors before they were diagnosed and relief after.

It’s not common to see a documentary of a mental illness that does such an excellent job of humanizing an illness that can be scary both to those who have it and those who don’t.  The clinicians carefully explain in clear terms the causes behind the most frightening BPD symptoms–self-injury, clinging, and suicidal ideation (a lack of caring whether or not you die).  They show real brain scans comparing BPD brain activity with that of non-BPD brain activity.

My only complaint is that they do not discuss the fact that numerous studies have shown a marked prevalence of abusive childhoods among people with BPD.  They are far more likely than the non-BPD person to have been abused physically, emotionally, or sexually by at least one caregiver.  I believe they generally left this out from a desire to create a welcoming atmosphere for family members, but it is important for people to know that it takes both a certain environment and the BPD-specific brain chemistry and pathways for BPD to develop.

That said, this is still a very important documentary.  It offers so much hope for both those with BPD and those who care for someone with BPD.  The filmmakers obviously want the public to know that BPD is treatable, contrary to the stigma attached to it.  Most people with BPD who get treatment go into remission (most of the symptoms are gone) in about 2 years.  It is so important for everyone to understand mental illnesses.  I highly recommend this documentary.

4 out of 5 stars

Source: library

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