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Norman

What Is Substance Abuse?

abusing drugs

Johns Hopkins Medicine asserts, “substance abuse is the medical term used to describe a pattern of using a substance (drug) that causes significant problems or distress.” Every individual is different, and each person will react distinctly when foreign substances are introduced to his or her system. The way an individual processes drugs and/ or alcohol will depend on a variety of factors. These can include, but are not limited to: the type of substance ingested, the personal health history of the individual, the individual’s metabolism, if a mixture of substances is ingested, the presence of any co morbid disorders, and more. Some individuals will innately have an increased tolerance to substances, while others may not (e.g. those known as “light-weights” when it comes to drinking alcohol). When individuals abuse substances in a social setting this can lead to dangerous consequences, as some individuals may be unable to “keep up” with others and could be at increased risk for overdose

What Constitutes Substance Abuse?

There are a variety of ways an individual could abuse substances. Some examples of substance abuse are as follows:

  • Habitually engages in illegal substance use
  • Taking legal medications in a way other than prescribed
    • Snorting pills that were intended to be swallowed
    • Increasing the frequency of ingestion
    • Increasing the amount of pills ingested
    • Taking the medication for a longer duration than prescribed
    • Mixing the medication with other substances (e.g. taking medication while drinking alcohol)
  • Taking medications that were prescribed to another individual
  • Drinking alcohol excessively, which according to the Centers for Disease Control and Prevention (CDC) includes males drinking more than five standard alcoholic drinks within a two-hour period and females drinking more than four standard alcoholic beverages within a two-hour window.
    • One standard drink as provided by National Institute on Alcohol Abuse and Alcoholism to be:
      • 12 ounces of regular beer (5% alcohol content) 
      • 8 – 9 ounces of malt liquor (7% alcohol content)
      • 5 ounces of unfortified wine (12% alcohol content)
      • 1.5 ounces of 80-proof hard liquor (40% alcohol content)

When an individual engages in habitual substance abuse, he or she is at increased risk for developing substance use disorder. Substance use disorder, also known as addiction, is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic brain disorder. It is characterized by compulsively engaging in rewarding stimuli without regard for consequence. Individuals that struggle with addiction will prioritize satisfying drug cravings above all else. This can lead to detrimental consequences affecting all areas of one’s life. 

Most Commonly Abused Substances

There are a variety of both legal and illicit substances that are frequently abused. The substances that are most often abused, according to the National Institute on Drug Abuse (NIH) include the following:

  • Marijuana
  • Alcohol
  • Methamphetamines 
  • Cocaine
  • Hallucinogens
  • Inhalants
  • Opiates 
  • Prescription medicines (e.g. stimulants, anxiety medication, pain pills, etc.)

It is important to note that even individuals with a valid medical prescription for certain controlled substance medications could end up abusing the medication if it is not taken exactly as prescribed. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Marriage Counseling Options In Los Angeles

a couple receiving marriage counseling

Every person is different and each contributes uniqueness to the relationship dynamics that make up a marriage. Much like the roles of each member that make up a family of origin are often firmly established early on, the habits, patterns, and roles in a marriage are often assumed early in the relationship. Few individuals that enter into a marriage fully understand the gravity of the commitment they are making and the personal and combined effort it will take to maintain the sacred bond of marriage, or exit a marriage amicably. As is true with maintaining any authentic relationship, marriage will require active work and dedication. Individuals are evolving people, and as the individuals in a marriage grow and develop, so too must their relationship. As humans age, all will experience shifting desires and changing needs, and the marriage relationship is no exception. A healthy marriage demands the same amount of attention that is reserved for individual evolution. In order for marriage counseling to be truly effective, both members of the relationship must be open to or at the vary least, willing to participate in the therapeutic process. 

Where To Look

Each marriage counselor is different. Not all marriage counselors will resonate with each couple, and when in a situation where the relationship between couple and counselor is less than optimal, it may be best to seek a new marriage-counseling therapist. Los Angeles, California is home to a plethora of qualified couples counseling therapists. Depending on the needs of the couple Los Angeles has many mental health professionals that specialize in marriage counseling, each with differing levels of education, backgrounds, specialties, and experience. When searching for a marriage counselor in Los Angeles, due to the overwhelming number of options, the process could quickly become tedious and for some even anxiety provoking. In effort to alleviate some of the pressure related to the search, consider the following two suggestions:  

  • Ask your network of trusted family and friends for references: even if the recommended therapist is unable to take you on as a client, he or she will likely be able to refer you to someone in his or her professional network.
  • Check out some online sources: many marriage counselors have websites available for potential clients to review and/ or are included in an online compilation of reputable mental health professionals.
  • Ask your primary care provider (PCP): check with your primary care provider to see if they are able to refer you to a marriage counselor that they recommend.
  • Ask us for help: We have years of experience in marriage counseling. And if we are unable to help, we can refer you to someone who can.

The nuanced needs that present in each individual that make up the marriage, respectively, that affect the relationship as a whole will greatly inform the scope and therapeutic strategies used in couples counseling. It is important to bear in mind that not all couples that enter marriage counseling are necessarily in crisis or experiencing relationship fractures. Some may feel that they would simply like to improve certain areas of their relationship, increase communication efficacy, or preemptively learn useful tools to maintain their healthy marriage. Ultimately, the reason behind why a couple enters marriage counseling is entirely personal. There are a variety of benefits that can develop as a result of marriage counseling. Marriage counseling can help individuals learn coping mechanisms, effective communication strategies, and healthy conflict resolution tactics, all of which can be implemented in the couples relationship to enhance the marriage. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Treatment Options for Alcoholism

male alcoholic

Alcoholism, also referred to as alcohol use disorder, is a chronic disease that will affect all areas of one’s life. According to the Mayo Clinic, “it is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptom when you rapidly decrease or stop drinking.” An individual that is addicted to alcohol will prioritize satisfying his or her alcohol cravings above all else. This can invariably lead to physical complications, relationship fractures, financial strain, legal problems, and more. There are a variety of treatment options available for individuals struggling with alcohol use disorder.

Detox

Prior to attending a formal substance abuse and/ or addiction treatment program, an individual that has struggled with alcohol abuse must undergo detox. Detox is the process that rids one’s body of all abused substances. When an individual has habitually abused alcohol, his or her system will become accustomed to functioning with it present. When alcohol is removed from one’s system it will react accordingly and withdrawal symptoms will ensue. Though the withdrawal symptoms that accompany detoxing from alcohol are not inherently life threatening, many can cause severe discomfort, and support throughout the duration of the detox program via a medically supervised detox is recommended. Subsequent to the detox process, an individual that has struggled with alcohol abuse should seek formalized substance abuse and/ or addiction treatment. 

Treatment Options

Every person is different and will require a somewhat customized treatment plan when it comes to recovering from alcoholism. There are two main types of substance abuse and/ or addiction treatment programs, which are inpatient treatment programs and outpatient treatment programs. Inpatient treatment options require an individual to reside at the treatment facility for the duration of the program, whereas outpatient treatment options do not. Though the structure of the programs differs, both have the same primary goal: to help an individual become sober and healthy. Treatment programs can vary in length, typically ranging between twenty-one days long to three months long, in some cases longer. Each inpatient and outpatient substance abuse and/ or addiction treatment program is different. Substance abuse and/ or addiction treatment programs are often comprised of a variety of treatment methods (e.g. individual psychotherapy, group therapy, creative arts therapies, etc.). Both options, inpatient treatment and outpatient treatment, can yield successful results, depending on the needs of the individuals. 

Aftercare

Developing an aftercare plan is an integral component of any type of formalized substance and/ or addiction treatment. An aftercare plan provides general suggestions and personal recommendations for an individual to refer to after he or she has completed the substance abuse and/ or addiction treatment program. An aftercare plan can be an excellent resource as it often includes relapse prevention strategies as well as provides tailored guidance for an individual to maintain continued sobriety.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

The Most Common Causes of Divorce

two broken hearts in divorce case

No two individuals share an identical personality, and the same is true for a relationship: no two relationships are the same. Every individual is different, and each person brings a uniqueness that contributes to the dynamic of a relationship. In the not so distant past, due factors largely remaining unknown, (though many speculate it to be directly related to culturally and/ or socially enforced stigma) divorce was a relatively rare phenomenon in America. Even though the overall divorce rates appear to be declining, still, according to American Psychological Association about 40 to 50 percent of married couples in America end in divorce. 

The National Center for Biotechnology Information (NCBI) conducted a study to better understand the cause for divorce in America. The study included a sample size of fifty-two people (twenty-one men and thirty-one women) who had been involved in a “prevention and relationship enhancement program” (PREP) that focused on teaching couples conflict resolution skills and effective communication strategies. The PREP course occurred before the couples were married, but the study surveyed the fifty-two individuals fourteen years after they had participated in PREP. The findings indicate the top four causes of divorce to be the following: 

  • 75% was due to a lack of commitment: Although marriage is often thought to be the ultimate commitment, an article published in Couples & Family Psychology reports the highest percentage of those of divorced is due to a lack of commitment. 
  • 59.6% was due to infidelity: the study found infidelity and extramarital affairs to be the second largest contributing factor and turning point, instigating the demise of marriages.
  • 57.7% was due to excessive arguing: couples that lacked communication skills and/ or effective conflict resolution strategies were unable to wholly resolve conflicts and arguments, which were in turn left to fester and erode the relationship. As reported in the survey findings, “communication problems increased in frequency and intensity throughout their marriages, which at times seemed to coincide with lost feelings of positive connections and mutual support.”
  • 36.1% was due to financial problems: though many couples did not explicitly identify financial difficulties as the primary reason for divorce, they did allude to the repercussions directly related to financial difficulties (e.g. relationship stress, relationship tension, etc.) to be contributing factors.

Nowadays, not only has divorce become largely normalized in American society but also it had been steadily increasing until 2019. The National survey results compiled from the American Community Survey data from the Census Bureau point to a slight decline in the divorce rates in the United States, asserting that in 2019 for every 1,000 marriages only 14.9 ended in divorce. This is the lowest divorce rate American has seen in the past 50 years, including lower than in 1970 when out of every 1,000 marriages 15 ended in divorce.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

What Are The Causes Of Alcoholism?

denying an alcoholic drink

In the not so distant past, alcoholism carried a strong stigma as individuals struggling with alcoholism were viewed as weak, thoughtless individuals that lacked self-control and often relied on the use of poor judgment. Nowadays, alcoholism, also known as alcohol use disorder, is an addiction to alcohol, which is a chronic mental health disease characterized by uncontrolled drinking and preoccupation with alcohol. The Mayo Clinic more specifically defines alcohol use disorder as “a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.” Individuals that struggle with alcoholism will prioritize satisfying their alcohol cravings above all else, without regard for the inevitable ensuing of negative consequences. This can affect not only one’s physical and emotional wellbeing, but also all areas of one’s life, which often include employment challenges, damaged relationships, legal complications, financial troubles, and more. 

Risk Factors

The precise scientific reason behind why an individual develops alcoholism remains unknown. There are, however, several risk factors that have been reported as potentially playing a role in increasing one’s susceptibility to alcoholism, which include the following:

  • Biological factors: research has found a close link between genetics/ physiology and alcoholism. 
  • Environmental Factors: people exposed to heavy alcohol consumption at a young age may be more likely to develop alcohol use disorder than those who are not. 
  • Social Factors: social situations where alcohol consumption is encouraged and/ or widely acceptable essentially provides an individual with permission to engage in unhealthy drinking.
  • Psychological Factors: individuals who suffer from other mental health conditions are more likely to abuse drugs and/ or alcohol. 

Additional factors such as one’s personal drinking history, the age an individual began drinking, low-self esteem, peer pressure to drink, and experiencing high levels of stress can also influence alcohol abuse and addiction. While it may be true that some individuals are likely predisposed to alcoholism more than others, it is important to note that depending on several factors, including one’s behaviors, anyone has the propensity to go on to develop an addiction to alcohol. 

Treatment

If left untreated, alcoholism can lead to severe short and long-term physical and psychological effects, and in some cases death. There are a variety of treatment options for an individual struggling with alcoholism. An individual that has habitually engaged in excessive alcohol abuse will need to complete detox as the initial stage of his or her treatment process, so as to rid the body of all foreign substances. Often detox from alcohol will include a slew of adverse withdrawal symptoms, some of which could include nausea, vomiting, intense anxiety, hallucinations, seizures, and more. After the completion of detox, subsequent treatment is often recommended. Alcoholism takes time to develop, hence it should be understood treatment is not instantaneous, rather it is often a life-long process. Depending on the needs of the individual there are inpatient substance abuse and addiction treatment program options as well as outpatient options. During any type of substance abuse or addiction treatment program, an individual will develop an aftercare plan. When adhered to, aftercare plans can be useful resources to help with continued sobriety and successful, long-term recovery. 

How To Treat Binge Eating Disorder

woman in dbt session

Binge eating disorder (BED) is a mental health illness that is classified as an eating disorder, and is listed as such in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Binge eating disorder is currently known to be the most common eating disorder in America. The National Eating Disorder Association (NIDA) define binge eating disorder as “severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g. purging) to counter the binge eating.” If left untreated, binge eating disorder and its associated symptoms could result in an individual developing severe short and long-term physiological consequences. 

Signs and Symptoms

There are a variety of signs and symptoms that could manifest in an individual struggling with binge eating disorder. Examples of common signs and symptoms could include any combination of the following, as provided by the Mayo Clinic:

  • Eating until uncomfortably full
  • Eating in secret
  • Eating alone
  • Eating when not hungry
  • Feeling ashamed, depressed, disgusted, and/ or guilty about eating
  • Frequent dieting, possibly without weight loss
  • Feeling out of control with regard to one’s eating behaviors

While most individuals diagnosed with binge eating disorder are overweight or obese, an individual could remain in the normal weight-range and still struggle with BED. 

Treatment

The first step in treating binge eating disorder is to obtain a proper diagnosis from a qualified medical and/ or mental healthcare provider. However, it can be helpful to understand the general diagnostic criteria of BED, which according to the DSM-5 include:

  • Recurrent episodes of binge eating, which is characterized by both:
    • A sense of lack of control over eating during the episode
    • Excessively overeating (an amount that is greater than the norm) in a short period of time (e.g. within a two hour period)
  • Binge eating episodes include three (or more) of the following:
    • Eating large amounts of food when not hungry
    • Eating far more rapidly than normal
    • Eating until feeling uncomfortably full
    • Feeling ashamed, depressed, guilty and/ or disgusted with oneself after eating
    • Eating alone due to embarrassment related to the quantity of food consumed
  • Marked distress regarding binge eating behavior
  • Binge eating episodes occur (on average) at least once a week for three months
  • No engagement of unhealthy compensatory behaviors after binge eating (e.g. purging)

Every individual is different and will be faced with nuanced challenges and unique needs when it comes to treating BED. Hence, it is common practice for binge eating disorder treatment plans to be tailored and include customized combinations of various therapeutic approaches so as to ensure all of the individual’s specific needs a fully accommodated. Treatment plans could comprise of any combination of the following components:

Depending on one’s specific needs it is not uncommon to emphasize establishing healthy daily habits, such as obtaining ample nightly sleep, practicing regular mindfulness techniques (i.e. yoga, meditation, etc.), and engaging in health daily exercise. Recovering from binge eating disorder will be a life-long journey, but with the proper guidance, continued commitment, and support, an individual diagnosed with BED can go on to live a healthy and fulfilling life.

What Causes Borderline Personality Disorder?

woman with hands in face

Borderline personality disorder (BPD) is a serious mental health illness that is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). According to National Institute of Mental Health (NIH), BPD is characterized by “pervasive instability in moods, interpersonal relationships, self-image, and behavior.” This instability interferes with one’s ability to function in his or her daily life, long-term planning, as wells as an individual’s sense of identity. Individuals diagnosed with borderline personality disorder often experience swift mood swings, including intense episodes of depression, anger and/ or anxiety that could last as short as a couple of hours to as long as several days. The symptoms associated with BPD frequently result in highly unstable patterns of social relationships. This chronic condition is also associated with high rates of self-injury and suicidal behavior.

Signs and Symptoms

Every individual is different and will exhibit a somewhat unique set of BPD signs and symptoms. The Mayo Clinic provides several commonly reported signs and symptoms to include the following:

  • Intense fear of abandonment
  • Rapid changes in self-image and self-identity 
  • Impulsive, risky and/ or dangerous behavior (i.e. engaging in unprotected sex, substance abuse, reckless driving, gambling, etc.)
  • Suicidal ideation
  • Wide and extreme mood swings
  • Periods of stress-related paranoia
  • Self-inflicted social isolation
  • Ongoing feelings of emptiness
  • Irrational, inappropriate, and/ or intense bouts of anger

It is important to note that any combination of the above signs and symptoms could manifest as a result of BPD. The severity and length of time they persist will vary, as they will depend on each individual. 

Causes

While there is no singular reason behind why an individual develops borderline personality disorder, there are several contributing factors that have been noted as potentially increasing one’s susceptibility to BPD. These factors can include, but are not limited to the follow, as provided by the National Institute of Mental Health

  • Genetics: people with a family history (i.e. parent, sibling, etc.) with BPD may be at increased risk of developing borderline personality disorder. Psychology Today assert that BPD is approximately five times more common among people with close biological relatives with BPD. 
  • Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk for developing BPD. 
  • Brain factors: some studies have indicated that individuals diagnosed with BPD have structural and/ or functional abnormalities, specifically in the areas of the brain that reign over one’s emotional regulation and impulse control. Furthermore, deviations from typical serotonin (hormone that works to stabilize one’s mood, happiness and feelings of well-being) production could increase one’s susceptibility to BPD. 

Treatment

The nuanced needs of an individual diagnosed with borderline personality disorder will inform his or her individualized treatment plan. Individualized treatment plans could comprise of a variety of therapeutic modalities some of which could include individual psychotherapy, group therapy, and/ or creative arts therapies. Dialectical behavior therapy (DBT), a form of cognitive behavioral therapy (CBT), was specifically designed to help treat individuals diagnosed with borderline personality disorder. Since it was developed in the late 1980s, it is highly common for DBT to be integrated into one’s treatment plan, as it has become the gold standard for treating BPD. Components such as nutritious eating habits, frequent self-care practices, engaging in regular exercise, obtaining ample sleep, and practicing various relaxation techniques (i.e. yoga, meditation, etc.) can also be included in one’s treatment plan. Recovery from BPD will require steadfast commitment, and will be a life-long process. With proper mental health treatment and support, an individual diagnosed with borderline personality disorder can go on to live a healthy and fulfilling life.  

Treatment For Eating Disorders

hope for treatment

A common misconception surrounding eating disorders is that they are a lifestyle choice. However, eating disorders are considered serious mental health illnesses, and when left untreated can result in severe short and long-term consequences. Though there are several different types of eating disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), in a very broad sense, eating disorders are characterized by severe disturbances in people’s eating behaviors and related thoughts and emotions. The different types of eating disorders, according to the Mayo Clinic include: 

    • Anorexia nervosa: is an eating disorder characterized by weight loss and/ or lack of appropriate wait gain in growing children, an inability to maintain an appropriate body weight for one’s age, height, stature, intense fear of gaining weight and a distorted perception of body image (weight and/ or shape). People struggling with anorexia will employ extreme efforts to control their weight and/ or shape, which can significantly interfere with their ability to properly function in their daily life. 
    • Bulimia nervosa: is an eating disorder characterized by a cycle of overeating (bingeing) and compensatory behaviors (purging) in attempts to undo the effects of the binge eating episodes. Purging could include self-induced vomiting, excessively over exercising, and/ or abusing diuretics. 
    • Binge-eating disorder (BED): is an eating disorder characterized by recurrent episodes of compulsively eating abnormally large quantities of food (often quickly) to the point of physical discomfort, without engaging in compensatory behaviors. Often binge episodes are followed with emotions of embarrassment, shame, guilt, and/ or distress. 
    • Rumination disorder: is an eating disorder characterized by repeatedly and unintentionally regurgitating (spitting up) undigested or partially digested food from the stomach, chewing it again and either swallowing it or spitting it out. 
  • Avoidant/ restrictive food intake disorder (ARFID): is an eating disorder characterized by restricting food intake (i.e. eating smaller amounts) and/ or eliminating certain groups to the point of infringing on one’s exposure to and ability to absorb needed nutrients coming from food. 

Each disorder has its own set of signs and symptoms, short and long-term effects, and most effective methods of treatment, respectively. 

Treatment

The treatment for an eating disorder will depend on several contributing factors, some of which include one’s exact diagnosis, how long he or she has been actively engaging in unhealthy eating habits, his or her personal health history, and the presence of any co-morbid disorders. The nuanced needs of a person diagnosed with an eating disorder will greatly inform his or her treatment plan. Most treatment plans for eating disorders will be customized and tailored so as to effectively accommodate all of his or her mental health needs. Depending on the needs of the individual treatment plans could include any combination of the following:

  • Individual psychotherapy
  • Group therapy
  • Family therapy
  • Creative arts therapies
  • Medical care and/ or medical monitoring
  • Medications
  • Nutritional counseling

Additionally, depending on one’s needs, some treatment plans will include practicing and incorporating healthy activities into one’s daily schedule, such as mindfulness techniques (i.e. meditation, yoga, etc.) and/ or encouraging regular and ample sleep habits. Every person is different and will respond distinctly to the various therapeutic options available. Although there is currently no cure for eating disorders, effective treatment will help to provide an individual with healthy coping mechanisms and emotional strategies to enable a person to go on to live a meaningful and fulfilling life. It is, however, important to note, that the recovery process from an eating disorder will require a life-long, steadfast commitment.

DBT vs. CBT: What’s The Difference?

people holding hands

Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two types of psychotherapy (“talk therapy”) that are commonly used in the treatment of a variety of mental health ailments. Through both CBT and DBT an individual will work with a mental health professional to learn how to process, cope with, and integrate challenging experiences as well as teach applicable coping mechanisms, and helpful skills to enable an individual to effectively manage future challenges when they arise. While not the primary focus of either, both CBT and DBT can delve into one’s past to help provide a clearer understanding of how certain situations may have influenced and had an impact on an individual’s current circumstance. Dialectical behavior therapy is actually a specific form of cognitive behavioral therapy that emphasizes the psychosocial aspect of treatment. In order to be able to truly understand how CBT and DBT differ, it is helpful to glean an understanding of each form of therapy, respectfully. 

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is a structured, short-term, goal-oriented therapy that is focused on the present. In CBT, a therapist will encourage his or her client to discuss his or her troubling thoughts and/ or feelings. Cognitive behavioral therapy typically focuses on specific problems and utilizes a goal-oriented approach. The steps of CBT include, as provided by Psychology Today, the following:

  1. Identify troubling situations and/ or conditions in your life (i.e. divorce, a medical condition, anger, grief, etc.). 
  2. Become aware of your emotions, thoughts, and beliefs connected to these troubling situations.
  3. Identify inaccurate and/ or negative thinking that may be contributing to your troubles.
  4. Reshape inaccurate and/ or negative thinking. In order to help facilitate this step, a therapist may encourage you to ask yourself if your view of the situation is based off of an inaccurate perception of the situation or off of facts. 

Cognitive behavioral therapy is based on the notion that thoughts and behaviors influence feelings; therefore shifting the way one thinks and reacts to situations can subsequently improve one’s emotional demeanor. Depending on the needs of the individual, the number of CBT sessions range from five to twenty sessions. 

Dialectical Behavior Therapy

Dialectical behavior therapy was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT employs many of the same components of CBT, but places greater emphasis on the social and emotional aspects. DBT relies heavily on mindfulness skills originating from Zen and Buddhist practices. Dialectical behavior therapy consists of four primary behavioral skill modules, which include: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT includes individual therapy sessions, group skills training sessions, and phone crisis coaching between sessions (if needed). Through DBT clients learn to rely on specific mindfulness techniques that enable them to live with pain in the world and accept the way things are in any given moment instead of having to endure the suffering that comes when trying to change them. 

Primary Difference

The fundamental difference between CBT and DBT is that CBT focuses on how thoughts, feelings and behavior influence one another, while DBT places primary emphasis on mindfulness practices, emotional regulation and learning to accept pain. DBT helps individuals learn to experience and accept the pain that is inevitably experienced in life, without trying to change it. CBT seeks to provide individuals with the ability to identify damaging thoughts, and teaches an individual how to redirect those thoughts.

Your Treatment Options For Borderline Personality Disorder

woman with borderline personality disorder

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a mental disorder. As defined by the National Institute of Mental Health (NIH), borderline personality disorder is an illness characterized by an ongoing pattern of varying moods, behavior, and self-image. The combination of these symptoms often results in difficulty maintaining relationships. It is highly common for an individual diagnosed with borderline personality disorder to have a deep-seated fear of abandonment making it difficult to tolerate being alone. This paired with intense, sometimes irrational, expressions of emotional instability often push others away making it exceeding difficult for an individual with borderline personality disorder to foster and maintain meaningful, lasting relationships. The scientific reason as to why an individual develops borderline personality disorder remains unknown. The onset of BPD typically occurs in early adulthood. The symptoms of borderline personality disorder are usually worse in young adults, and although the condition may gradually improve with age, BPD is a lifelong condition. 

Treatment

The first step in the treatment process is to obtain an accurate diagnosis from a qualified mental healthcare provider. Borderline personality disorder is notoriously known as an illness that is exceedingly difficult to diagnose. However, a thorough psychological evaluation can provide the most detailed diagnosis, which in turn will greatly inform treatment recommendations. The treatment plan for a person diagnosed with BPD will be a unique to the individual. In order to accommodate all the needs of an individual diagnosed with borderline personality disorder, a treatment plan could include and/ or emphasize any combination of the following options: 

  • Individual psychotherapy, also known as “talk therapy,” some of which can include any of the following:
    • Dialectical behavior therapy (DBT): is a form of cognitive behavior therapy (CBT) that focuses on how one’s thoughts and beliefs can lead to actions and behaviors. This skills-based approach teaches how to manage emotions, tolerate distress and improve relationships though group and individual therapy sessions. 
    • Schema-focused therapy: incorporates aspects of CBT and psychoanalytic theories. It helps to identify unmet needs that have led to unhealthy ways of thinking about the world. Conducted in an individual setting or group setting, schema-focused therapy challenges maladaptive beliefs and behaviors and focuses on promoting positive life patterns. 
    • Mentalization-based therapy (MBT): emphasizes thinking before reacting. This is accomplished through helping an individual identify his or her own thoughts and feelings and creating an alternate perspective on the situation.
    • Transference-focused psychotherapy (TFP): helps an individual understand and process his or her emotions and interpersonal difficulties through the developing relationship between the individual and his or her therapist. 
  • Encouraging healthy and frequent self-care practices
    • Eating nutritiously
    • Establishing good sleep habits 
    • Regular exercise
    • Remaining hydrated
    • Practicing calming techniques (i.e. meditation, yoga, journaling, etc.)
  • Medication: The Food and Drug Administration (FDA) has yet to approve a medication specifically designed to treat borderline personality disorder. There are, however, certain medications that can help to alleviate and/ or reduce some of the symptoms arising from BPD or co-occurring disorders (i.e. depression, anxiety, etc.). Common examples of types of medication prescribed as a component of one’s BPD treatment plan include: 
    • Antidepressants
    • Anticonvulsants/ mood stabilizers 
    • Anti-anxiety medications/ anxiolytics
    • Antipsychotics

Customized treatment plans that comprise of a variety of different therapeutic modalities, and are used when treating borderline personality disorder, so as to ensure that the individual’s nuanced needs are appropriately addressed. Every person is different and each will require a distinct combination of the various treatment options when it comes to learning effective coping mechanisms and implementing emotional regulation techniques needed to effectively manage borderline personality disorder, long-term.