Dialectical Behavior Therapy for Borderline Personality Disorder

Borderline personality disorder (BPD) is a severe mental health condition marked by symptoms such as highly unstable moods and lack of a consistent or stable self-image. People affected by the condition also frequently have additional serious mental health challenges. One of the forms of psychotherapy commonly used to help individuals with BPD is dialectical behavior therapy, or DBT. This treatment uses several techniques to improve control over the volatile, black-or-white emotional responses that often characterize BPD.

Understanding Borderline Personality Disorder

Borderline personality disorder does not sit “on the border” between other types of personality disorders, as its name might suggest. Instead, it’s a distinct illness that can seriously interfere with your ability to do such things as feel a strong sense of self, maintain stable relationships, avoid impulsive or dangerous behavior, control outbursts of anger, avoid involvement in self-harming or suicidal behavior, or avoid feeling paranoid or detached from reality in stressful situations. Experts believe that roughly 1.6% of all U.S. adults have BPD. However, the number of those affected may be much higher, since the condition often gets misdiagnosed or goes undiagnosed altogether. No one really knows why borderline personality disorder occurs, although the condition appears to have its roots in separate or overlapping genetic, biological, social and environmental factors.

Basics of Dialectical Behavior Therapy

Unlike some other treatments, dialectical behavior therapy was specifically developed to help people affected by borderline personality disorder. Participants meet with their therapists weekly in one-on-one sessions. They also attend weekly group sessions and receive over-the-phone coaching whenever necessary. There are four basic skills taught during DBT:

  • Mindfulness of what’s happening internally and externally in the present moment
  • An improved ability to tolerate stressful situations
  • An improved ability to take part in interpersonal interactions, and
  • An improved ability to regulate emotions

In order to provide the most effective treatment possible, therapists place a priority on addressing BPD-related behaviors that could threaten your life or the lives of others. They also target behaviors that could interfere with the course of therapy and behaviors that damage your general quality of life, in addition to encouraging the development of healthy replacement behaviors.

Does the Treatment Work?

DBT is viewed as an evidence-based treatment for borderline personality disorder. This means that current research supports the therapy’s usefulness for people affected by BPD. Studies have shown that DBT participation can help reduce risks for some of the most severe BPD symptoms, including dangerously impulsive behavior, self-harming behavior and suicidal behavior. In addition, people who take part in DBT tend to stay in active treatment substantially more often than people who take part in other forms of psychotherapy.   Sources: National Institute of Mental Health: Borderline Personality Disorder The Linehan Institute: What Is DBT?  Psychiatry: Dialectical Behavior Therapy

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