• 19 Nov
    Shiva Raman Pandey

    Dialectical Behaviour Therapy for Borderline Personality Disorder

    Dialectical Behaviour Therapy for Borderline Personality Disorder


    Borderline personality disorder is a major concern and affects much more women than men. Having BPD can wreck havoc because untreated it can lead to many problems, including suicidal behaviour.

    The person’s mood is horribly affected, and they flit from one mood to another in a matter of seconds. They themselves keep feeling extremely out of control and this affects their happiness and self-esteem.

    Maintaining relationships and keeping employment become very difficult. Criminal records are also likely as some moods lead to rash and impulsive behaviour.

    Dialectical behaviour therapy is based on a school of thought that believes that dialectics, or wanting/feeling/being two opposite stakes and oscillating between the two is okay.

    This kind of a paradigm assures that the afflicted person is not continually forced to think ‘which of my two versions is the real me?’ Therefore, it gives the person the chance to accept dual realities, not only with themselves and of their own personality, but also within others, within life situations etc, even with the therapist.

    One of the falls of having BPD is that one has a black and white view of life. Either things are all good, or all bad. Therefore, even a single fault by a person would colour their entire personality in their eyes. With DBT, this black and white view of the world is challenged.

    Mindfulness techniques are built into DBT and this makes sure that the person slowly embraces the ideology of acceptance. DBT was propounded by Marsha Leinehan when she worked with women with suicidal and parasuicidal behaviour, but she saw that it also helped with the mood and acceptance part of BPD along with self-harm.

    Now, there is a huge body of research supporting the efficacy of this treatment model not only with BPD but also with other personality disorders. Along with mindfulness and dialectics, another important aspect of this therapy is the behaviour therapy. Within that, a predictable structure is given because wildly varying routines from day to day also add to mood issues. Tasks are assigned in the form of hierarchies from the easiest step to the hardest step, and timelines are assigned to it. Many other behaviour techniques like relaxation and contingency management are also taught.

    The behaviour therapy aspect makes sure that a person feels a sense of achievement as these tasks generate tangible outcomes. This increases their self-esteem which is a core problem in BPD. Slowly, the learnings from therapy are applied to relationships, employment and other concerns. It takes a while, but people with BPD benefit immensely from undergoing dialectial behaviour therapy.

    Image source-(http://www.ccdbt.com/)

    Responses 1

  • 17 Nov
    Shiva Raman Pandey

    Why is it that our heads ache after a fight or when we are stressed?

    How to know Somatoform Disorder


    Could it be that our minds and bodies are linked and therefore, our psychological tensions manifest as physical pains and aches? Turns out that that is what happens. A study claims that up to 70% of the cases that general physicians see in their practice have a major component of stress-induced pain. 

    There is also an actual psychiatric disorder called Somatoform disorder, where the chief concern is localized or spread body pains and aches without any apparent physical or biological cause. The treatment can be difficult at times, because when the person afflicted finally comes to a mental health professional, he has gone through rounds of the medical system and his resistance to doctors and professionals maybe high.

    Why does this disorder develop? There is some research which indicates that children learn when growing up that the sick sibling gets more attention and is given relaxation in terms of work or school. If a family does not spend quality time together, the only way for a child to have the attention of the parent that he craves is by being sick. This also saves the arduous work and school homework etc. Therefore, the child grows up learning to like the sick role.

    Another explanation is that of unawareness. In some cultures and families, psychological problems and issues are not considered as important or serious and are brushed away, saying that it is only the weak who have them. In such places, people are highly unaware of the psychological tensions generated by their life situations. Therefore, their psychological health does not get any attention at all. Thus, when this becomes too much for their mind, then it manifests the trouble in terms of bodily pain, so that the person takes some time off to rest, ponders and realizes something is wrong and tries to fix it.

    Regardless of whether the problem is physical or psychological, humans often heal when they have love, care and support. Research also shows that the prognosis for any disease is much better if the person has sources of joy and at least one fulfilling and connected relationship.

    Therefore, when we know this, it fits why the mind would transfer psychological tensions to physical pain. It makes sure that we get the love, support, care and rest we need. However, this becomes maladaptive when this continuous and when one takes no effort to resolve the psychological causes of pain and physical discomfort.

    In counseling and therapy, the therapist goes to these causes and slowly brings awareness to the person. The therapist also gives the client new coping skills, because their old coping skills are not good enough to address the psychological tension they face. Research shows that with an efficient therapist, one can see great improvement for somatoform disorder in 10 – 12 sessions.

  • 10 Nov
    Shiva Raman Pandey

    What Happens In Counseling?

    types of psychologists in india


    Counseling and psychotherapy for everyday concerns as well as mental health concerns has gotten a lot of attention from the media, especially from movies.

    The few that show it in good light also tend to show incorrect processes of therapy.

    Some psychiatrists and other doctors have a negative view of counseling and tend to present it in a bad light.

    Further, some therapists who are unprofessional, may conduct therapy badly and all of it gives counseling a bad name.


    So, what happens in therapy? And what should happen?

    It depends upon three things

    a) the issue you present,

    2)  the therapy format and

    3) the theoretical orientation.

    For example, counseling for academic issues is very different from counseling for impulse control issues.

    Further, the format can greatly differ as well. Individual therapy looks very different from couples therapy, group therapy and family therapy.

    When the people are more in number and/or share a relationship, the dynamics affect the healing process and a lot can be learned from the interactions itself.


    Theoretical orientation means the framework through which the therapist understands the problem, and more importantly, finds solutions from.

    For example, the same problem of relationship issues may be seen as an unconscious desire to rebel under Freud’s psychodynamic framework, and maybe seen as faulty learning in Behaviourist frameworks.

    Thus, the solution from the first framework would be to explore unconscious desires, but from the second would mean unlearning faulty patterns and learning new ones.

    Given these three aspects differ, there is also a sort of general structure to therapy.

    Usually the first session or two are where the client tells what’s bothering them.

    It may feel like nothing much happened as the counselor didn’t speak a lot, but if they did, you would feel interrupted.

    They will reflect and summarize and focus on your feelings and struggles, and that’s how you know that they heard you right.

    You can also correct them if they are wrong and add to their understanding.


    From the third session onwards, work begins as the counselor and you together work on suggestions and solutions.

    There can be a lot of back and forth discussion, in-therapy practice and roleplay as well as homework.

    Depending on the severity of the issue, therapy may be terminated in 6 sessions or may even go on for months.

    It is a collaborative process and the more participative and truthful you are, the sooner it gets over.


    A good therapist makes you feel heard and understood.

    They don’t impose and try to tell your fate.

    The whole relationship should have a feeling of positivity and hope, if the therapist is indeed good at what they do.

    Soon, your motivation to change old patterns will increase and you would be on your way to a better, more fulfilling life.

    If you do not see this happening, please inform your therapist.

    It is important that you as a client know what you are getting into and what you would get out of the process.



    Responses 2

  • 10 Nov
    Shiva Raman Pandey

    Psychotherapy for insomnia



    Insomnia or sleeplessness is a major problem these days. As we have more and more electronic devices to stimulate us, our quality of sleep seems to be getting lower and lower.

    There’s so much to do and that can be done, that people simply don’t stop thinking about their next day, as they lie in bed, languishing for hours.


    So how do you know if you have insomnia?

    If you’ve had three or more nights in a week for more than a month, where you slept less than 4 to 6 hours, and you had a hard time falling asleep or remaining asleep, then you should get checked for insomnia.


    But what if you have it? Are treatments available?

    Yes, they are.

    Majority of people with sleep issues can be helped quite easily if they asked for it.

    Sadly, people use that time of the night when they can’t sleep, in order to work even more – which makes it almost impossible to go back to sleep again because the brain is fully stimulated again.


    Treatments for insomnia include medications and behaviour therapy.



    Side effects of medications

    Possible side effects of these medications include:

    daytime sleepiness,



    and rebound insomnia.

    Sleep-walking, sleep-driving, sleep-eating, memory lapses, and hallucinations have also been reported.

    Added to this, there is always the risk of dependency and abuse of the drug.


    Psychotherapy for insomnia is better option rather than taking pills

    Keeping all this in mind, psychotherapy for insomnia seems like a better option.

    Therapy involves many approaches, but most of the research is showing that CBT or cognitive behaviour therapy for insomnia works well.

    The behavioural part of insomnia is treated by using sleep hygiene methods and correcting faulty sleep habits.

    This means that catering to the distractions available around bedtime, level of eating and activity, as well as not sleeping in the day.

    Sometimes, not sleeping in the day and also not sleeping till midnight can be very tiring, but after that one week of struggle, the sleep cycle usually fixes itself.


    The cognitive part involves working on thoughts about sleep as well as working on thoughts that may occur when one is in bed, and both these thoughts interrupt sleep.

    Further, the cognitive part of therapy also addresses concern about work, work-life balance, relationships and other concerns of life that may be leading to distress and sleeplessness.




    Responses 1

  • 10 Nov
    Shiva Raman Pandey

    What is a personality disorder?

    What is a personality disorder?

    Personality disorders are used as light terms in order to chide, tease or label people. However, having a personality disorder can be a huge problem as it can interfere in all areas of life.

    Personality disorder means having an enduring pattern of inner experiences and behavior that deviate markedly from the expectations of the individual’s culture. Pattern manifested in at least two areas:  

    • Cognition – ways of perceiving and interpreting self, other people, and events
    • Affectivity – range, intensity, lability, and appropriateness of emotional response
    • Interpersonal functioning  (relations with others)
    • Impulse control


    The following conditions have to be met in order for a certain pattern of communication, behaviour and internal state to be called a personality disorder. The conditions are:


    1. Enduring pattern is inflexible and pervasive across a broad range of personal and social situations
    2. Leads to distress or impairment in functioning  
    3. Pattern is stable and of long duration.
    4. Onset tracked to adolescence or early adulthood  
    5. Not due to any Axis I issues (other psychiatric disorders)
    6. Not due to substance use/General medical condition


    A few things are therefore clear:

    Firstly, it is an aspect, a pattern developed over the years and tends to show in all areas of life. Therefore, just a one-off incident of strange behaviour will not qualify as a personality disorder.

    Secondly, this means that this way of being is crystallized over the years, making it extremely difficult to change.

    Perhaps the most important point to note here is that when someone has a personality disorder, they have adjusted their lives around it. Therefore, they have already chosen jobs and life situations which either suit the dysfunction or is not actively harmed by it. Therefore, they are highly unlikely to come for therapy for it themselves. There is little or no medication available for this.


    If at all someone does show up at the therapist’s office, it is because their personality was becoming a problem at home or in the workplace. Therefore the client is very rigid when they come to the therapist and simply do not want to change.

    Many are also made to seek treatment because they engage in rash and needless criminal behaviour. Such individuals are all the more set against treatment and therapy. Therefore, success rate in the treatment of personality disorders is very low.

    One of the personality disorders which has a lot of research and a very successful rate of treatment (as compared to other personality disorders) is borderline personality disorder.

    Dialectical Behaviour Therapy, or DBT is very helpful with BPD. It can help the person control their mood as well as their all-or-none thinking, which is the main issue in BPD. Research is showing that DBT also looks promising for other personality disorders.

    Image source http://dearlavender.blogspot.in/2014/05/understanding-6-faces-personality-of.html


    Responses 1

    • sania khan
      sania khan   Dec 24, 2015 03:15 PM

      I am more than sure I suffer from

      personality disorder

       but my psyc won't listen to me and I can't handle my emotions anymore. Any words of advice?