What is Borderline Personality Disorder (BPD)?
According to the National Institute for Mental Health (NIMH) “Is marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships… may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.”
It is a complex mental health condition that is characterized by patterns of interpersonal difficulties, intense mood swings, Chronic feelings of emptiness, fear of abandonment and rejection, intense emotions that may not fit the event or are disproportionate to the event, episodes of dissociation.
BPD may also be characterized by engaging in risk and impulsive behaviors, threats of suicide, suicidal ideation and engaging in self-harm behaviors such as cutting or burning.
What is the root cause of BPD?
BPD has been shown to have a high correlation with trauma (Go see our specialty page on PTSD/C-PTSD for a more indepth view of trauma). DBT furthers this theory via use of the biopsychosocial model in explaining why BPD develops in someone. The biopsychosocial model posits that biology, psychology, and social structure interacts with each other in unique ways and influences our development and mindsets.
For example – Someone who has experienced the same trauma as you, but may not have a genetic predisposition for low threshold distress tolerance, may not develop the same level of PTSD from it.
BPD has been seen as a tough condition to treat in the therapy world.
DBT & BPD Treatment
It comes with a variety and complexity of symptoms, causes, and behaviors that previous therapies were not adapted enough to handle. However, DBT is different.
Not only does a DBT clinician look at BPD differently – BPD treatment using DBT was crafted specifically to meet the needs of clients suffering from borderline personality disorder.
Marsha Linehan created DBT in order to meet the needs of a population that was severely misrepresented, misunderstood, and under treated within the therapy field.
DBT has 4 modules that specifically work towards finding balance, viewing different perspectives, and loving yourself as well as accepting reality around you.
These 4 modules are designed to teach the skills necessary to help someone with BPD manage the intensity of their emotions and engage in effective behaviors while learning to validate themselves and heal from their trauma.
Mindfulness
In BPD, as we touched on earlier, a big part of this condition is that there is judgment on ourselves, others, and the world around us. There is an emptiness sometimes, and a pervasive sense of “being on autopilot,” especially when experiencing dissociation.
Mindfulness in DBT is focused on learning to be present focused and most importantly, nonjudgmental of ourselves and others – while remaining aware of the facts and the situations. It allows us to combat dissociation with being present focused, and reminds us that we are connected to the world around us in small and big ways.
Distress Tolerance
Because BPD is also characterized by intense emotions, mood swings, instability, inconsistency and fear; which leads to the feeling of “unrelenting crisis.” This also leads us to engaging in behavior to cope that may not be effective and may cause us or others harm.
Distress tolerance helps us learn how to handle life’s distressing moments and difficulties WITHOUT engaging in behaviors that would harm ourselves otherwise physically or emotionally.
Emotion Regulation
A key difficulty in BPD is emotion dysregulation. The feeling can be described as “feeling as if your emotions control you, rather than you control them.” This leads us to engage in behaviors that may harm us or others.
Emotion Regulation is about learning how to better handle our emotions so that we have more control over our thoughts, feelings, and behaviors.
Interpersonal Effectiveness
Since BPD is also characterized by interpersonal instability and ineffective communication, we focus on how we can effectively communicate in different ways.
With Interpersonal Effectiveness we challenge ourselves to learn better ways to navigate our relationships. This includes skills related to communication, building relationships, setting boundaries, and better advocating for our own needs.
DBT is a direct approach that values honesty, collaboration and feedback in order to give power back to its clients, and model healthy boundaries. We work with people who suffer from Borderline Personality Disorder, not to or against them to find their life worth loving within this world.
As Marsha Linehan says:
“Pain is inevitable, suffering is not.”
DBT is here to help client’s decrease suffering and accept pain without self-harm, engaging in destructive behaviors, or dissociating.
We do this by creating attainable SMART goals, working in stages of treatment, validating you along the way and by working on a team to receive creative ideas on next steps.
If you or someone you know is struggling with symptoms of BPD or other Mental Health concerns, please contact us.
We offer a comprehensive DBT program and specialize in treating BPD and other mental health concerns.
