“We are chaotic, aggressive, manipulative, and angry at the world. But look inside the soul of a borderline (if you can get there) and you’ll find something very different. Fear. Desperation. Abandonment. Incredible sensitivity.” –From The Angry Heart
Borderline Personality Disorder (BPD) is a personality disorder that includes the following symptoms:
The treatment of BPD is challenging. Therapist are frequently provoked by Borderline Personality Disorder patients who fear abandonment but engage is rejection baiting behaviors to manage their fears. Not keeping appointments, late night emergency calls, and angry or seductive behavior are common. The best type of treatment is one that we use a BlueSky: Dialectical Behavior Therapy (DBT). DBT is a form of cognitive-behavior therapy designed by Marsha Linehan, Ph.D., specifically for Borderline Personality Disorder treatment. DBT is a skills training therapy that teaches BPD patients how to manage their volatile emotions through self-soothing techniques. Borderline Personality Disorder treatment requires an extended period of at least several months and the cooperation of the patient. Since trust is fragile in BPD clients building rapport is tedious and slow.
One way that BlueSky helps in this rapport building process is by using the self-help techniques described in the book The Angry Heart, by Dr. Joseph Santoro and Dr. Ronald Cohen. This book takes our patients through a step-by-step process of self-exploration and skills training to help them begin the journey of recovery. It addresses the co-occurring features of Borderline Personality Disorder such as addiction and self-injury. It teaches the patient to use positive affirmations and recovery exercises to deepen their understanding of themselves, thus facilitating their motivation to learn new self-regulation skills.
It also features the first-person recollections of a BPD sufferer who wrote in its first chapter: “It’s so hard to sit down and try to write down my past. The past is such a dark place to me. Every time I think about the past, it changes. Waves of piercing emotions overwhelm me, as though I am still there. ‘There’ was not a happy place for me. Anger and distrust seemed to be a way of life for everyone around me, but as a young child I wasn’t quite sure why.”
Many people with Borderline Personality Disorder experience significant psychological trauma as children which likely played a role in the development of this disorder.
While there are no medications that have been specifically developed for Borderline Personality Disorder treatment there are medication therapies focused on symptom patterns. Anti-depressants, mood stabilizers, and anti-psychotic medications can be used to reduce symptoms that are most debilitating and which interfere with therapy.
BPD patients in treatment frequently need hospitalization if self-injurious behavior or suicidal thoughts are present. Residential treatment is often very helpful if the program includes DBT and a structured living environment. In-residence clinical treatment of the type provided by BlueSky Behavioral Health’s Enhanced Treatment Program can be very valuable. Our intensive daily therapies are combined with a safe living environment and the assistance of a life coach. These three components work together to help our clients in Borderline Personality Disorder treatment reach their recovery goals.
With an extended period of treatment that includes abstinence from drugs and alcohol and a healthy support system people with Borderline Personality Disorder can exit the borderline zone and enter into a more stable and satisfying pattern of living.