We can say with certainty that Rachel Reiland suffered from borderline personality disorder. In addition, she displayed significant elements of two other personality disorders: histrionic personality disorder (her dramatic behaviors may have been motivated by excessive emotional reactivity and a desire for attention) and obsessive-compulsive personality disorder (her rigid thoughts and behaviors may have been motivated by perfectionism). However, it is difficult to determine whether these aspects of her personality met the criteria for the diagnosis of comorbid personality disorders. Her symptoms of borderline personality disorder were so pronounced that they might have masked additional personality disorders.
What happened to Reiland? In her memoir, she notes that she was hospitalized three times; the first time because of significant suicidal impulses. After discharge from that first hospitalization, she spent 4 years in intensive outpatient therapy with a psychiatrist—three times a week during the first 2 years of treatment. She was hospitalized twice more over the course of her therapy and again developed anorexia for a period of time. Her symptoms were sufficiently severe that her therapist imposed strict limits on their interactions; for instance, he banned physical contact of any kind. Although her therapist used psychodynamic therapy, he also incorporated elements of CBT and DBT into the treatment: The therapist addressed Reiland’s black-and-white thinking and validated her experiences while trying to help her accept her feelings without judging herself. In addition to the hospitalizations and outpatient therapy, Reiland tried various medications, settling on antidepressants that she gradually stopped before her therapy ended.
Her treatment was successful. She wrote her memoir 8 years after her therapy ended; she developed and sustained the ability to regulate her moods, to control her impulses, and to have productive and enjoyable relationships.