Resource Library
DBT and Borderline Personality Disorder
By J. T. (Tom) Kenneally, III, Psy.D., L.P.
If your child is suffering from borderline personality disorder (BPD), you may find that traditional psychotherapy has not worked well. Clinicians have struggled to understand and treat BPD, since it is resistant to talk therapy and introspective approaches. At InnerChange, we have had great success with an eclectic and highly structured approach called Dialectical Behavioral Therapy, or DBT.
Since BPD sufferers often see the world in black and white, the goal of treatment is often to help the sufferer better tolerate the grey areas of the emotional world-i.e. to accept that life is neither all okay nor all terrible. For traditional therapies, this is a difficult treatment objective to achieve with BPD clients. Unpleasant emotions can quickly reach an overwhelming intensity, automatically triggering reactive behaviors. Negative emotions can create a fight or flight panic response that renders logical thought virtually impossible. The sufferer fights with friends, family, coworkers and professional caregivers, or they attempt some form of escape.
DBT is a therapy designed to address the challenges traditional therapies have faced in addressing this intense emotional disorder. Traditional therapies have relied on emotional introspection which is actually a trigger for most people with BPD. Not only do introspective therapies typically not help, they often make things worse. Therapists have discovered that very few patients with BPD can tolerate traditional therapy and stay involved, but they can tolerate, engage and remain involved with DBT.
DBT uses a highly structured approach to treatment. It involves the systematic learning of new emotional coping skills along with a gradual challenging of the negative, fallacious thoughts or beliefs that are the source of emotional turmoil. DBT is an empirically validated therapy that is effective in treating BPD. DBT, however, requires that the patient commit a minimum of one year to the therapeutic process, which is often best achieved in a residential setting. The emotional dysregulation experienced by people with this disorder requires repeated applications of new coping skills over an extended period of time. As emotions begin to stabilize, patients are able to gradually build an understanding of their interior world, allowing them to better tolerate and manage their emotions. In a sense, DBT allows patients with BPD to exercise their emotional muscles to build emotional strength. This takes practice, commitment and time!
J. T. (Tom) Kenneally, III, Psy.D., L.P., is a therapist for Fulshear Ranch Academy, a treatment and transition program located in Needville, Texas, for young women seeking a life of healthy independence. Dr. Kenneally may be reached at KenneallyT@InnerChange.com.
