Individuals suffering from psychiatric conditions such as borderline personality disorder (BPD) find there are a vast array of therapies on offer purporting to be able to effectively treat them. The choice can seem overwhelming and confusing.
In the case of BPD, however, although many different therapists may claim that the particular therapy that they offer is beneficial, research shows that there are only a few which result in significant improvement.
Cognitive Behavioural Therapy (CBT) is one example of an effective treatment, but, as I have dealt with that in several of my other posts (just enter ‘CBT’ into this site’s search facility if you are interested in reading any of them) so will not discuss it further here. Instead, in this post I will look at the following 4 evidence-based therapies for individuals suffering from the condition of BPD. These are:
2) MENTALIZATION BASED THERAPY (MBT)
3) TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP)
4) SCHEMA THERAPY
Let’s look at each of these in turn:
DIALECTICAL BEHAVIOUR THERAPY –
this was the first therapy specifically designed to treat BPD. Research into its effectiveness have yielded encouraging result : it reduces the risk of the individual who undergoes it from attempting or commiting suicide, and, further, after a year of being treated with DBT many show a significant improvement in their condition (although, despite this improvement, they may still feel substantial emotional distress; due to this fact, it is clear treatment programs lasting significantly longer than a year need to be implemented and assessed).
What does DBT involve? The therapy uses a combination of psychotherapy and group therapy. The group therapy helps the individual recognise that his/her intense emotions often get out of control, in a destructive way, and teaches techniques related to how these emotions may be regulated (controlled) by the individual who suffers them.
DBT is strongly influenced by Buddhist philosophy, and, drawing from it, encourages the individual to accept his/her distress (see my post entitled ‘Why Fighting Anxiety can Make It Worse’ for more on why such an approach is effective); it also encourages the individual being treated to meditate to calm down the inner emotional storms that may often rage within them.
In conclusion, it is worth saying that although much research suggests that DBT is very effective for treating BPD, because it is complex, and uses techniques from several other therapies, it is difficult for researchers to know exactly which elements of the therapy are the effective ones. More research is necessary to answer that question.
MENTALIZATION BASED THERAPY –
MBT, like DBT, was designed specifically to treat borderline personality disorder. MBT is largely based upon the idea that the core reason why individuals develop BPD is that they EXPERIENCE PROBLEMS EARLY IN LIFE IN CONNECTION WITH HOW THEY BONDED, AND RELATED TO, THEIR PRIMARY CAREGIVERS, which, in turn, leads to them experiencing further DIFFICULTIES WITH FORMING AND MAINTAINING RELATIONSHIPS IN LATER LIFE. MBT seeks to help the individual suffering from BPD empathize with others, ‘put themselves in their shoes’, and develop awareness and understanding in relation to how their volatile emotional outbursts affect others (people with BPD tend to have an impaired ability to do this if they do not seek out trewatment).
So far research into the effectiveness of MBT has been encouraging. It has been found to:
– reduce hospitalizations
– reduce suicidal behaviours
– improve day-to-day functioning
TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP) –
this type of therapy is based upon the theory that individuals who suffer from BPD often have severe difficulties with their perception of interactions with others. Following on from this observation, the theory also assumes that the BPD sufferer will tend, too, to misinterpret his/her relationship with the therapist. In order to try to correct these chronic misperceptions and misinterpretations relating to the individual’s personal interactions, the therapist helps the individual gain awareness of what is going wrong with his/her interpersonal interactions and teach him/her strategies and techniques which help to correct the problem. Research into the effectiveness of TFP continues.
SCHEMA THERAPY –
SCHEMAS are deeply embedded CORE BELIEFS ABOUT ONESELF, OTHERS and THE WORLD IN GENERAL; these deeply held beliefs are LAID DOWN IN CHILDHOOD. The therapy aims to change the BPD sufferer’s NEGATIVE, MALADAPTIVE and UNHELPFUL SCHEMAS into more POSITIVE, ADAPTIVE and HELPFUL ONES.
Early research into the effectiveness of this type of therapy suggests that it can significantly improve quality of life and reduce BPD symptoms. Whilst these findings are encouraging, it is necessary to carry out further research into the therapy’s effectiveness.
David Hosier BSc Hons; MSc; PGDE(FAHE).