Hypnotherapy tends to work best for treating symptoms of BPD as an adjunct therapy (i. e. alongside other therapies such as CBT and DBT- see the hypnotherapy section of this site). There are various hypnotherapeutic techniques that may be particularly helpful for treating symptoms of BPD:
The Grounding Technique: A key symptom of BPD is the feeling of dissociation which includes depersonalization and derealization. The grounding technique and imagery can help the client overcome such feelings and can be used after trauma work or at any other time the client is feeling dissociated.
Emotional regulation: The inability to control intense, rapidly fluctuating emotions is a hallmark symptom of BPD and hypnotherapy can employ a wide range of imaging techniques to help the client gain mastery over his/her emotions.
Ego strengthening: This helps with self-worth and anxiety.
Parts Therapy: This is useful for psychological conflicts, ambivalent thinking, and polarized, black and white thinking. Parts therapy helps clients resolve their inner conflicts by the means of the therapist communicating directly with the different parts of the client’s subconscious mind (enhanced by the utilization of hypnosis) that are responsible for creating the conflict. Parts therapy, as the name suggests, is based on the theory that our personalities are made up of various parts. The aim of the therapy is to unite these various, conflicting parts into one unified whole. There exist several therapies that involve working with ‘parts’ including Internal Family Systems (Schwartz), Ego State Work (Watkins and Watkins, 1997), Gestalt Therapy (Peris, 1973), and Structural Dissociation Model (Van der Hart and Steele, 2005).
Safe Place: Those suffering from BPD often feel constantly unsafe and under threat. The ‘safe place’ technique allows clients to retreat mentally to a place of sanctuary at times of acute distress, including the mental pain that trauma work can sometimes entail.
The Rewind Technique: This technique is best utilized later on during therapy once the client feels ready and has developed sufficient self-worth and the ability to self-generate feelings of psychological and emotional safety (see above). It is a simple technique that helps the client to process traumatic memories and involves a degree of exposure to the original traumatic experiences (which is why it is important the client has learned skills that will keep him/her feeling safe during the therapy).
MIND (a major UK charity involved in mental health) describes how people with BPD may feel, based on the symptoms of BPD listed in DSM – 5:
- You may feel terrified of abandonment and rejection and become frantic and desperate when you perceive yourself as having been discarded by others, leading to distraught feelings of fear and anger, erratic, disorganized, and dramatic behaviors in a desperate attempt to avoid such rejection and abandonment.
- You may be extremely emotionally labile switching from one extreme emotion to its opposite in a very short period of time.
- You may only have a weak sense of your own identity and suffer an identity crisis.
- You may find forming and maintaining meaningful relationships highly problematic.
- You may constantly feel a pervasive sense of emptiness.
- You may often feel impulsive leading to self-sabotaging and self-harming behaviors such as drinking binges, drugs, gambling, highly promiscuous (and later regretted) sex, food binges, and suicide attempts.
- Under extreme stress, you may experience waves of uncontrollable rage.
- Under acute stress, you may experience transient feelings of paranoia and dissociation.