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/)

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