Borderline Personality Disorder (BPD) is a disorder that is characterized by a high level of emotional sensitivity, intense emotional reactivity to “being triggered,” and a calming down process that takes considerably longer than most people. People with BPD also struggle in interpersonal relationships. They can often be sensitive to actual or perceived abandonment or rejection and react to such triggers in ways that push others away. Hence, these relationships are often intense and marked by instability. 

Individuals with BPD are in a great deal of emotional pain and seek various ways to manage their pain- sometimes resorting to impulsive behaviors that can be dangerous to themselves or reckless in order to feel better. Along with the emotional difficulties and unstable relationships there can also develop a strong sense of self-hatred and chronic state of emptiness which may be related to an underdeveloped or confused sense of identity.

BPD does not always manifest itself in the same way for each person. There are varying degrees of intensity and traits combinations that may differ by individual. However, even if an individual does not meet every one of the DSM-listed criteria for BPD, intense emotion dysregulation combined with one or more  of the aforementioned traits can make life especially challenging. 

For more information about borderline personality disorder, visit the National Education Alliance for BPD at www.borderlinepersonalitydisorder.org.

Why DBT for BPD?

DBT is a highly effective treatment for those with BPD, teaching new ways of thinking and acting that allow people to respond more effectively to stressful situations.   

DBT is based on the principles of the behavioral theories that underlie other forms of therapy focused on change, as well as principles of dialectics. A dialectic is the coexistence of two seemingly opposite ideas or concepts. One important dialectic in DBT is that of accepting ourselves and situations as is AND working toward change. Another is recognizing and validating emotions AND holding onto an objective reality that transcends what we feel in the moment. Thinking dialectically helps people suffering from BPD to move away from rigid black-and-white thinking patterns and toward a more balanced view of reality.  

The DBT Toolkit

In addition to dialectical ways of thinking, DBT also teaches 4 sets of skills to help people with BPD better learn to regulate their emotions and interact with others more effectively. For more information on the DBT skills modules, see “What is DBT.”  DBT skills are best taught in skills training groups, a class-like atmosphere where individuals can receive important feedback from other participants and can learn the skills in a collaborative and interactive manner. These skills are then applied to the unique circumstances of the client in individual DBT therapy. After-hours “skills coaching” support is given within limits in real time by the therapist, who can be reached by phone.