Hope in the Treatment of Borderline Personality Disorder

I remember talking with a fellow therapist who did not work for Sunrise, but had worked at an outpatient facility for almost thirty years.  He stated that “you cannot heal someone who is dealing with borderline personality disorder”.  The symptoms of Borderline Personality Disorder include a pattern of intense and stormy relationships, poor self-image, struggles with emotional control with highly changeable moods, impulsive and often dangerous behaviors, self-harming, and suicidal behavior and threats.  All of these behaviors can occur in teens, yet we do not diagnose personality disorders because of their age.  Yet these behaviors still need to be corrected if these young teens want a fulfilling, happy life.

I listened to my therapist friend, and discussed how when we catch the symptoms at a younger age, these girls have a better chance.  He agreed.  What is even more impactful is that the research is saying that we can find healing with the symptoms of Borderline Personality, especially if we catch them at a young age.   The National Institute of Mental Health declares, “ Borderline personality disorder is often viewed as difficult to treat. However, recent research shows that borderline personality disorder can be treated effectively, and that many people with this illness improve over time”.  I have seen this pattern of change over and over again.  So often in residential care, I will have a young lady with a history of cutting, isolating from family, exposing herself to the opposite sex online, having lots of conflict with peers, struggling to build insight into emotion, and even beating herself up with shame infested thoughts, engaging in high risk behaviors that make her family cringe and worst of all harming herself with drugs or even forms of cutting on herself.  These behaviors bring the best of families to a state of destruction.  So when we say that we can heal these behaviors and the research backs our methods up, I feel good.  I feel confident.  And, we can pass this confidence and knowledge to families, which bring healing to every member of the family.

How do we heal symptoms of Borderline Personality Disorder in teens? In part, with DBT therapy, or Dialectical Behavioral Therapy.  DBT therapy is a type of therapy that focuses on the concept of mindfulness, or being aware of, and attentive to the current situation.  DBT teaches skills to control intense emotions, reduces self-destructive behaviors, and improves relationships. This therapy differs from Cognitive Behavioral Therapy, in that it seeks a balance between changing and accepting beliefs and behaviors.  DBT can occur in a group therapy session or in an individual therapy system, but ideally works the best when the whole system such as a residential facility can carry out the precepts collectively.

The research identifies the benefits of Dialectical Behavioral Therapy, as reported by the National Institute of Mental Health.  One study showed that DBT reduced suicide attempts in women by half compared with other types of psychotherapy, or talk therapy. DBT also reduced use of emergency room and inpatient services and retained more participants in therapy, compared to other approaches to treatment.  As a therapist, I like to carry out interventions that are backed by research, and when I carry out those interventions, I like to see results in my own experiences.

I am grateful I don’t have to go my whole career not knowing what works to heal symptoms of Borderline Personality Disorder.  We know the research and we know the techniques that work.  People in the community, need to know the research and what treatment works best as well.

– Steve Child, LCSW, Therapist

  1. Gunderson JG. A BPD Brief: An Introduction to Borderline Personality Disorder: Diagnosis, Origins, Course, and Treatment.(ed)^(eds).http://www.borderlinepersonalitydisorder.com/documents/A%20BPD%20BRIEF%20revised%202006%20WORD%20version%20–%20Jun%2006.pdf . Accessed on July 30, 2007.
  2. Paris J, Zweig-Frank H. A 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry. 2001 Nov–Dec;42(6):482–7.
  3. Zanarini MC, Frankenburg FR, Hennen J, Reich DB, Silk KR. The McLean Study of Adult Development (MSAD): overview and implications of the first six years of prospective follow-up. J Personal Disord. 2005 Oct;19(5):505–23.
  4. Kellogg SH, Young JE. Schema therapy for borderline personality disorder. J Clin Psychol. 2006 Apr;62(4):445–58.