Borderline Personality Disorder (BPD) is notoriously difficult to treat, but there are several therapies that are successful when it comes to managing BPD symptoms. Here is a look at three of the primary BPD treatment therapies and how they compare.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) was specifically created to treat Borderline Personality Disorder. It is based on the biosocial theory of BPD, which supposes that BPD results when certain biological predispositions meet with a dysfunctional or invalidating environment.
Dialectical Behavior Therapy is comprised of several components, including individual therapy, DBT skills groups, and phone coaching sessions with a DBT therapist. Throughout all of these, people with BPD are taught skills in mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance.
Turbulent relationships are a prominent characteristic of Borderline Personality Disorder. Transference-Based Therapy helps people struggling with BPD improve their relationships by developing a healthy relationship with their therapist.
Transference is the process by which emotions are transferred from one person to another. Using Transference-Based Therapy, a patient projects their feelings about the important people in their life onto their therapist, giving the therapist a chance to observe how the individual relates to the important relationships in their life. Therapists use this information to help people with BPD improve their relationships by experiencing what it’s like to relate to them.
Schemas are defined as deep-rooted patterns of thinking that people use to define their own selves and the world around them. Schema-Based Therapy is developed around the idea that when people are deprived of their basic childhood needs (like the needs for love, acceptance, and security), they form “maladaptive early schemas” – unhealthy ways to interpret and interact with their surroundings. When events similar to ones that lead to the formation of unhealthy thought patterns recur, people are often unable to respond in a responsible manner.
Using Schema-Based Therapy, a therapist and patient will work together to confront a patient’s emotional trauma. This type of therapy has been shown to help people with Borderline Personality Disorder become more stable and institute lasting personality changes.
Comparing the BPD Treatment Therapies
When considering options for Borderline Personality Disorder treatment, it’s important to look at how these therapies compare. While all three therapies ultimately get to the same root issues, there are differences in the way they approach BPD treatment.
For example, “unlike DBT and TBT, Schema-Based Therapy offers a structured integration of the techniques of psychodynamic, supportive, and cognitive behavioral therapies,” says Ellen Golding, MFT. “Once I have determined what schemas a patient has, I use a range of techniques for changing these schemas. These include: changing schemas as they arise in the therapy relationship, intensive imagery work to access and change the source of schemas, and creating dialogues between the schema side of patients and the healthy side.”
“While DBT helps reduce destructive behaviors by teaching healthy ways to adapt to and cope with challenges and feelings of frustration or lack of power, Schema-Based Therapy focuses on changing schemas to control the symptoms of a condition,” she continues.
Not every BPD treatment will work for everyone with Borderline Personality Disorder, and each has its pros and cons. Discuss the different Borderline Personality Disorder treatment options with your therapist to determine which would work best for you.