Validation within a hospital or therapy setting is important. However, if the patient's significant others are not educated about the concept of validation, a lot of hard work can be destroyed. The other pole of the overarching dialectic of "problem-solving" requires family support. The doctors, therapies, medications, and hard-working individuals make up the other pole—that can't stand alone.
A supportive, educated family or friend(s) can be, quite literally, a lifeline for a patient suffering BPD. It is unrealistic to expect the world to change to fit the borderline's sensitivities. Indeed, change on the part of the borderline is of paramount importance. However, if the borderline can find a source of validation, especially during initial treatment and difficult times thereafter, the success rate in treatment dramatically improves.
Oh and the title of the last chapter is just so apt... Chapter 9 RECOVERY: THE HELL OF GETTING WELL. In the section of this chapter on Self-Reinforcement, she concludes, "For the borderline, survival is a full-time job. People who have not experienced BPD do not understand the significance of this."
Off to do some homework, while I am still awake enough to focus on the paper...