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Borderline Personality and Treatment


Obscured person with hands on smoked glass

According to the National Institute of Mental Health, Borderline Personality Disorder is "an illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships.


People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days."

Some of the most common traits include:

  • Fear of abandonment.

  • Unstable relationships. Things can be really good or turn really bad suddenly in a dramatic manner.

  • Unclear or shifting self-image

  • Impulsive, self-destructive behaviors.

  • Self-harm.

  • Extreme emotional swings.

  • Chronic feelings of emptiness.

  • Explosive anger.

People with BPD struggle to maintain consistent relationships. They can at times feel very connected and then suddenly feel completely alone and abandoned. Often, it's their internal feelings that create conflict within relationships. Maybe they heard or interpreted something a friend or family member said that made them feel unseen, unloved or not heard. This can also be difficult for their friends and family who will often say they feel they are walking on eggshells in order to avoid upsetting their loved one. For some people, there can be a great sense of relief realizing through a diagnosis as they realize they are not alone and there are treatment options available to help them work with these at times debilitating traits.


The modality with the most empirically proven data demonstrating effectiveness in treatment is called: Dialectical Behavioral Therapy or DBT. DBT is related to Cognitive Behavior Therapy or CBT but where CBT focuses on thoughts, DBT focuses on feelings.


This type of therapy has many tools that help people begin to become more mindful over time about how they are reacting in situations. The main focus of DBT are the following:


1. Core Mindfulness-learning to become in tune and aware of what is happening in the present moment.


2. Distress Tolerance-helping people to feel the discomfort of an emotional charge within themselves without reacting impulsively or destructively. Helping people tolerate intense feelings without acting impulsively or with actions of self harm.


3. Interpersonal Effectiveness- helps people learn how to grow in their communication skills, including listening, asking for what you need in a receivable manner and even working through challenging situations.


4. Emotional Regulation- learning how to understand and interpret emotions from a non-judgmental perspective. Learning how your emotions shape your behaviors and what gets in the way of dealing with challenging emotions.


Developing skills in this area often allows people greater ability to see the ways they are being triggered and allows them some space to make choices that will be more productive. Learning how to regulate emotions can be life changing for people who suffer from extreme emotional swings. It can also help them avoid self destructive behaviors and stabilize their lives.


DBT is often done both in groups and individually. There are many programs available that offer this type of treatment and there are many individual therapists that offer this type of support.


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