Counselling or psychotherapy is nearly always the treatment of choice for BPD. Medication is typically only provided to help stabilise mood swings. Therapy can be a long process but it can help sufferers to get a better understanding of their thoughts and feelings. A therapist will provide support and guidance; encouraging clients to discuss sensitive issues and suggesting ways to resolve problems. The aim of therapy for BPD is to shape healthier thoughts and feelings and help sufferers to take control of their symptoms.
The two most common therapies used in borderline personality disorder treatment are:
Dialetical behaviour therapy (DBT)
Dialetical behaviour therapy is specially designed to treat BPD sufferers. This approach addresses two important factors that can contribute to the development of the condition: emotional vulnerability and a person’s environment. The goal of DBT is to help clients believe that their emotions are acceptable, valid and real. It also teaches them to be open about their opinions and ideas, rather than thinking in a solely black and white mindset. These concepts are used to promote positive behavioural changes and help sufferers of BPD to perceive the world in a way that is not rigid or limiting.
DBT is recommended by NICE as a leading borderline personality disorder treatment option. It can be provided in group or individual sessions.
Mentalisation-based therapy (MBT)
This is an additional long-term form of borderline personality disorder treatment. It’s based on the idea that people with the condition are unable to effectively examine their own thoughts and beliefs, or assess whether they are realistic. For example some people with BPD may have an urge to self-harm and will do so without questioning their behaviour. They lack the ability to take a step back and consider their actions.
Another aspect of this inability to ‘mentalise’ is failure to understand and recognise that other people have their own thoughts, feelings and needs. BPD also means sufferers will not see how their actions impact on other people’s emotional states. This can further complicate their relationships. The goal of MBT is to address these issues and help clients to see themselves and others in a more realistic and healthier light.