Friday, March 23, 2012

Borderline Personality Disorder: Current Treatments, Part 2


Since those with Borderline Personality Disorder (BPD) frequently have wild emotional vacillations, odd black-and-white thinking, and scary disruptive behavior, it is commonly believed that they must have different type of emotions than everybody else. This, however, is a myth. Their emotional experience is the same as other people’s, they just struggle to have adequate internal coping mechanisms to handle their emotional pain or strong impulses.  As mentioned in the article of Borderline Personality Disorder: Definition, it is their difficulty to regulate emotional challenges and impulses that causes their dysfunctional and erratic behavior.

Medication is only one part of an effective treatment plan.  Psychotherapy is also a necessary critical component to achieve lasting improvements in those diagnosed with BPD.

Currently the gold standard in counseling modalities for BPD is Dialectical Behavior Therapy (DBT) developed by Dr. Marsha Linehan, Professor at the University of Washington. DBT is most often conducted within a group setting and teaches clients how to take better control of their lives through the use of increased personal awareness (mindfulness), improved emotional regulation, and cognitive restructuring.  It urges clients to accept themselves while encouraging them to make healthy changes. 

Many clients find the strategy of using multiple treatment modalities to be very helpful. It is not unusual for someone with BPD  to be receiving DBT group therapy, individual counseling, drug treatment, and couples therapy concurrently. The most important aspect of  an effective treatment plan is that it provides a structured therapeutic setting. People with this disorder often experience severe, unpredictable emotional swings with erratic, dangerous behaviors. They experience strong urges to harm themselves, such as cutting or suicide attempts. A structured setting with a strong therapeutic alliance with the treating professional(s) is necessary to ensure safety.

 How does one find a DBT-training counselor?

The best way to find a trained provider is to contact Behavioral Tech. This organization was founded by Dr. Linehan and educates mental health care providers in  the use of DBT.  It has a comprehensive listing of mental health specialists who have completed its educational program..  Another website, called “liquic,” also has small list of DBT providers. It may also be beneficial to contact your insurance provider, your local psychiatrist, or the nearest psychiatric hospital to obtain contact information about local therapists who have experience working with BPD.

Self-harming behaviors frequently occur in the lives of those struggling with BPD. The next article will discuss the ins-and-outs of voluntary and involuntary psychiatric hospitalizations.

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