Borderline Personality Disorder Treatment
Effective borderline personality disorder treatment is challenging because people with the disorder have trouble seeing past their own misinterpretation of the world and their distorted thought patterns. Frequently, a patient will walk away from BPD treatment the minute some difficulty arises during therapy or in his or her life. Since they see everything in black and white, the patient may begin to think of the therapist as bad or evil. (See: Living and Dealing with Borderline Personality Disorder)
It’s important that therapists remain aware of the extreme all-or-nothing attitude held by those in treatment for borderline personality disorder and take care not to validate it. Clinicians must allow their strong and stable thinking to stand in contrast of the patient’s lack of stability and chaotic life.
One of the reasons successful treatment is difficult is because many clinicians do not want to work with people who have borderline personality disorder. Why? The patients’ erratic negative behaviors, threats, and inability to see themselves as needing help contribute to the reluctance of many therapists to treat them. (Read: Borderline Personality Disorder Relationships)
What Does Borderline Personality Disorder Treatment Consist Of?
Borderline personality disorder treatment typically consists of a combination of psychotherapy and medications. Clinicians may prescribe medications to stabilize mood and any co-occurring conditions. Individuals seeking help should make sure their therapist or doctor has experience treating borderline personality disorder.
Borderline Personality Disorder Therapy
The types of psychotherapy used to in borderline personality disorder treatment include:
- Cognitive behavioral therapy (CBT) – CBT helps individuals with BPD identify distorted beliefs and thought patterns. Once identified, the patients can change these core beliefs that contribute to their inaccurate self-perception and interpersonal relationship issues. CBT may also reduce the extreme range of mood swings and the frequency of suicidal or risky behaviors.
- Dialectical behavior therapy – This therapy approach focuses on increasing an individual's self-awareness and cultivating the concept of mindfulness. This helps the patient remain in the moment, so to speak, and become aware of the current situation. During DBT, the therapist teaches the client new skills for controlling the intense emotions and self-destructive behaviors associated with the disorder. The client can also use these skills to improve interpersonal relationships.
- Schema therapy – schema-focused therapy combines CBT with other psychotherapy approaches that work to reframe the way people view themselves. This type of therapy is based on the belief that borderline personality disorder arises from an unclear, dysfunctional self-identity. This poor sense of self is brought on by negative experiences during childhood. These negative childhood experiences affect how people react to their environment and cope with stress as adults.
Depending on the individual, the therapist may conduct sessions one-on-one with the client, in a group setting, or both. Therapists will typically conduct individual sessions at first to build trust with the client, and then add group sessions once they've established a good working relationship. Therapist-led borderline personality therapy in a group setting can teach clients how to better interact with others and express themselves appropriately.
Borderline Personality Disorder Medications
The FDA hasn't approved any specific borderline personality disorder medications. But, doctors frequently prescribe medications in combination with psychotherapy to their patients with BPD. These medications don't cure borderline personality disorder, but they do help manage certain BPD symptoms associated with the condition. For some individuals, medications may reduce symptoms of aggression, depression, or anxiety. Since medications cause different side effects in people, those with BPD should discuss what to expect in the way of side effects with their physicians.
Borderline Personality Disorder Self-Help
The first step in effective borderline personality self-help is realizing that you have a serious condition that needs attention. You can take a few steps to help yourself while undergoing formal treatment:
- Stick with the treatment plan developed by your therapist
- Maintain a stable schedule of meals and sleep time
- Get regular exercise
- Spend time with others so you can practice interpersonal skills
- Have realistic expectations about time it will take to reduce symptoms
- Continue to educate yourself about BPD
Borderline Personality Disorder Prognosis
Borderline personality disorder prognosis depends on the severity of the symptoms and each individual's commitment to getting better and improving his or her life. Some people do well in treatment, but others find themselves in an ongoing cycle of seeking help, then allowing negative thought patterns to cause them to reject the help.
Last Updated: 20 July 2016
Reviewed by Harry Croft, MD