Relatively stable, yes. Personality structure doesn't change dramatically, but the maladaptive behavioral patterns can change. In long-term studies of BPD, for example, more than 80% of people no longer meet criteria over 15-20 years, but their Big 5 traits probably haven't changed that much.

>> they respond generally to appropriate clinical care and competent psychotherapy, one that is empathetic, compassionate, and attuned to relational difficulties.

Some relevant thoughts in this post:
www.psychiatrymargins.com/p/borderline...

A lot of controversies around BPD are about a) the best way to frame, label, or talk about the relevant experiences and behaviors, b) the misuse, stigmatization, and weaponization of the BPD label. There is no doubt that the experiences exist (regardless of what label you use) and >>

Consider, for example, the psychotherapies that have empirical support for borderline personality. They are generally long-term, and they focus on things like transference, mentalization, dialectical behaviors, etc. [The table is from here: psychiatryonline.org/doi/10.1176/...

So psychotherapy isn't really a unitary thing. While different types of psychotherapies are generally similar in benefit for depressive episodes or anxiety exacerbations, it appears that the core features of personality disorders are fairly unresponsive to short-term CBT or supportive therapies. >>

The 4 classes:

* Detransitioning with regret (Class A)
*Identity evolutions (Class B)
* Transition ambivalence (Class C)
* Interrupted gender transitions (Class D)