Effective Therapies for Borderline Disorder

Therapeutic Options for Treatment of Borderline Personality (BPD)

Aug 25, 2007

Historically, diagnosis and treatment of BPD has been difficult, but there are now therapies designed specifically for Borderline Personality Disorder.

What Is Borderline Personality Disorder?

According to the DSM-IV-TR, psychology's premier diagnostic manual, BPD is a type of psychological personality disorder that interferes with an individual’s ability to regulate emotion. The characteristic emotional instability results in dramatic and abrupt shifts in mood, impulsivity, poor self-image and tumultuous interpersonal relationships. People with this disorder are prone to unpredictable outbursts of anger, which sometimes manifest in self-injurious behavior. Borderlines are highly sensitive to rejection, and their fear of abandonment may result in frantic efforts to avoid being left alone, such as suicide threats and attempts.

What Is Transference-Focused Psychotherapy?

This therapeutic approach was designed specifically to treat patients with Borderline Personality Disorder. The distinguishing feature of TFP is the theory that the patient's perceptions of self, and of others, are split into unrealistic extremes of bad and good. These conflicting dyads give rise to fragmented and extreme emotions, and are thought to result in the specific self-destructive symptoms of BPD.

The term “transference” refers to the patent’s perception of his or her moment-to-moment relationship with the therapist. The treatment focuses on transference, because it is believed that patients will display their unhealthy dyadic perceptions and behavior not only in day-to-day life, but also in the interactions they have with their therapist. TFP focuses on using the client-therapist interactions to help the patient integrate these different representations of self, and, in the process, develop better methods of emotional control (Yoemans 2002).

What Is Dialectical Behavior Therapy?

The name of this approach reflects its basic strategy as a therapy balanced between change and acceptance. Marsha M. Linehan, Ph.D. specifically designed DBT for treatment of chronically suicidal borderline clients.

The theory behind Dialectical Behavior Therapy is the belief that BPD is a combined result of the patient's emotional vulnerability, lack of skills in controlling emotions, and developmental background within an unsupportive, invalidating environment. These factors result in a person who is emotionally “dysregulated,” unable to trust and control his or her emotions. DBT focuses directly on helping the patient develop new skills for regulating emotion and reducing symptoms (Linehan 2003).

What is Supportive Psychotherapy?

This is a broad term describing therapy that emphasizes consistency, support from the therapist and an optimistic attitude designed to support the patient through crises periods and promote small gains over time. It is a more generalized therapeutic approach, not specifically developed for patients with Borderline Personality Disorder (Borderline Personality Disorders Resource Center).

Best BPD Therapy

A recent study appearing in The American Journal of Psychiatry compared the efficacy of each of these treatments. The results indicated that all three therapeutic approaches were effective in fostering global improvement in the symptoms of BPD. However, each approach was found to have specific strengths for treating different components of the disorder.

More Information on BPD

This article describes clinical tools used by professionals to diagnose and treat BPD. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional therapy and counseling.

Additional BPD Resources

Clarkin, J.F., Levy, K.N., Lenzenweger, M.F., and Kenberg, O.F. (2007). Evaluating Three Treatments for Borderline Personality Disorder: A Multiwave Study. The American Journal of Psychaiatry. Vol. 164, 6.

Yeomans, FE, Clarkin JF, & Kernberg, OF (2002). A Primer of Transference-Focused Psychotherapy for the Borderline Patient. Northvale, NJ: Jason Aronson.

Linehan, M. (2003) Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder. The Journal of the NAMI California, Vol. 8, 1.

American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)

The copyright of the article Effective Therapies for Borderline Disorder in Borderline Personality is owned by Tami Port. Permission to republish Effective Therapies for Borderline Disorder in print or online must be granted by the author in writing.