There are different types of therapy for borderline personality disorder (BPD).
Therapy may be given one-on-one and through support groups, enabling people with BPD to interact with others.
The most effective type of therapy appears to be dialectical behavior therapy (DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive to the current situation.
DBT seeks a balance between accepting BPD and changing beliefs and behaviors by teaching skills to:
With DBT, people learn tools, exercises, and concrete things they can do to manage their emotions when certain challenging situations arise and they are feeling unstable.
Diagnosis is often a relief when people with BPD realize others understand their experience and treatment options exist.
Other forms of therapy for BPD include:
This form of therapy is rooted in the patient’s confused and contradictory sense of identity associated with emotionally intense mental images of themselves and others. The therapist helps the patient unconsciously reassign extreme positive or negative images associated with one person to another person, such as the therapist. In that moment, the therapist talks with the patient to interpret and understand why the patient distorts his or her sense of self and images of other people. Therapy addresses intense shifts in emotions as patients learn to reflect and verbalize what they’re feeling, rather than acting out these emotions impulsively.
This type of therapy focuses on reframing “schemas,” or the ways people view themselves. This approach is based on the idea that BPD stems from a dysfunctional self-image – possibly brought on by negative childhood experiences – that affects how people react to their environment, interact with others, and cope with problems or stress.
This treatment consists of 20 two-hour sessions led by an experienced social worker. When used with other types of treatment (such as medications or individual psychotherapy), STEPPS can help reduce symptoms and problem BPD behaviors, relieve symptoms of depression, and improve quality of life.
DDT aims to help patients identify and verbally express their emotions, describe their interactions with other people, and talk about themselves and others. Patients are encouraged to express and think about their emotions and experiences with other people without resorting to negative or harmful behaviors.
Mentalization refers to the ability to focus and reflect on beliefs, intentions, feelings, and thoughts in oneself and in others. This ability is thought to be compromised among people with BPD; their capacity to “mentalize” can fluctuate and become impaired when they are under stress (particularly the stress of rejection or disappointing interactions with other people).
A form of psychotherapy in which consistency, support from others, and a hopeful attitude are used to sustain the patient through periods of crisis and encourage small gains over time. This approach encourages the transformation from acting out to verbalizing psychological conflicts and developing adaptive outlets for emotions.