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How Does Dialectical Behavior Therapy Help People with Borderline Personality Disorder?

Mar 12, 2020

What Is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder (BPD) is a mental health diagnosis that involves difficulty regulating emotions. When someone with BPD experiences intense stress over an extended period, it can be tough for that person to de-escalate to a “normal” level of functioning. This feeling may express itself as self-harm, unhealthy relationships, and impulsivity. Individuals diagnosed with BPD are 75% female, though professionals suspect that men are often misdiagnosed.

What Are the Symptoms of Borderline Personality Disorder?

Characteristics of borderline personality disorder vary by the individual, but some are more usual than others, according to the Diagnostic and Statistical Manual (DSM). Here are some of the most common symptoms of BPD:

• Extreme mood swings
• Feelings of instability and insecurity
• Desperation to avoid abandonment, either real or imagined
• Unstable relationships that alternate between intense feelings of love and hatred
• Distorted and unstable self-image
• Impulsive and dangerous behaviors

What Are the Causes of Borderline Personality Disorder?

The definitive causes of BPD are not thoroughly understood, but experts agree that it’s probably multifactorial. Genetics likely play a role, as those with a close relative with BPD are more likely to be diagnosed themselves. Environmental factors, especially childhood trauma and being raised in an invalidating environment, seem to contribute to the development of BPD. Individuals with BPD may have neurological differences in the parts of the brain that control emotional regulation.

Because of the multiple factors that contribute to BPD, there is no single test to diagnose it or one single indicative symptom. Mental health professionals use a comprehensive assessment that includes a complete history of symptoms and functioning across areas.

How Can Dialectical Behavioral Therapy Help BPD?

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral treatment initially designed to treat those diagnosed with borderline personality disorder (BPD). It focuses on thoughts, beliefs, behaviors, and actions to reduce symptoms and enhance life functioning. DBT was the first form of psychotherapy that has demonstrated effectiveness in treating BPD through controlled clinical trials. It is now the preferred first-line treatment for this disorder with a broad base of evidence and documented success rates in reducing adverse outcomes such as these:

• Psychiatric hospitalizations
• Hospital stays
• Substance abuse
• Self-injury
• Suicidal behavior
• Severity of symptoms

While DBT cannot cure BPD, it is proven effective for reducing symptoms and helping with the management of them. Research finds that up to 77% of people no longer met the criteria for BPD after one year of treatment with DBT.

What Can I Expect from DBT?

DBT usually involves a combination of group and individual sessions, classroom training, and phone coaching. Patients track symptoms and the use of their new skills daily while receiving services.

The skills training portion of DBT includes four types of skills.

• Mindfulness skills focus on keeping a person fully present in the moment. Observation, description, and participation in daily experiences are all part of this learning. Patients learn to process thoughts, emotions, external responses to the environment, and sensations without deeming them either good or bad. These skills are needed to implement more advanced DBT skills successfully.
• Interpersonal effectiveness skills are those that help an individual assert his or her needs and manage relationship conflicts.
• Distress tolerance skills teach individuals to cope with stress without exacerbating it through negative means such as self-injury, impulsivity, and risky behaviors.
• Emotion regulation involves helping a person learn to identify and manage feelings and reactions to them.

Where Can I Learn More About DBT as a Treatment for BPD?

DBT can help clients with BPD reach positive long-term functioning. The best results involve a combination of psychotherapy, family and peer support, and medications. Reach out to Mental Health Systems (MHS) to schedule an evaluation to see if DBT can help you or someone you love.

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Image Credit: Getty/ Povozniuk