bpd Archives - Suzanne Wallach

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) list ten standalone personality disorders and based on similar characteristics, each personality disorder is grouped into one of three categories (cluster A, cluster B, and cluster C). Borderline personality disorder (BPD) belongs to cluster B, which according to the Mayo Clinic are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” More specifically, BPD is defined by the National Institute of Mental Health (NIH), as “an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” The signs and symptoms of borderline personality disorder are highlighted in the diagnostic criteria that is outlined in the DSM-5. Due to the illusive nature of its symptoms paired with the fact that many symptoms overlap with other mental health ailments, BPD is notoriously known as one of the most difficult mental health illnesses to both diagnose and treat.

Tips For Working With Clients With BPD

BPD directly impacts the way individuals interpret information, primarily as it relates to others’ intentions. Thus, it is highly common for people with BPD to feel rejected, abandoned, misunderstood, judged, inferior, and isolated. An individual with BPD experiences profound perceptual shifts and disordered reactions to those perceptions, which causes them to constantly precieve events and personal interactions differently than those around them. This can make treating someone with borderline personality disorder complicated. Nevertheless, there are several key principles that have been established and are important to bear in mind when working with an individual diagnosed with BPD. To guide your treatment protocol, experts suggest considering the following strategies:

• Be compassionate.
• Demonstrate empathy.
• Listen to the person’s current experience.
• Validate the person’s current emotional state.
• Take the person’s experience seriously, noting verbal and non-verbal communications.
• Maintain a non-judgmental approach.
• Remain calm.
• Remain respectful.
• Remain caring.
• Engage in open communication.
• Be open and prepared to acknowledge both the serious and comical side of life, where appropriate.
• Foster trust to allow strong emotions to be freely expressed.
• Be clear, consistent, and reliable.
• Convey encouragement and hope about their capacity for change.

Treatment for BPD aims to help an individual learn strategies, techniques, and tools to reduce the severity of symptoms while simultaneously cultivating an enhanced ability to effectively manage its associated symptoms.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

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 to disregard professional advice or delay seeking treatment.

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health 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.” It is highly common for individuals with BPD to lack the ability to foster and maintain meaningful, lasting relationships. The symptoms that are associated with borderline personality disorder make it difficult to diagnose. In order to secure the most effective treatment an individual must obtain an accurate diagnosis from a qualified mental healthcare provider. The Food and Drug Administration (FDA) has yet to approve a medication explicitly designed to treat borderline personality disorder. While there are other types of therapeutic modalities that can be helpful in treating someone with BPD (e.g., schema-focused therapy, mentalization-based therapy, etc.), the most frequently relied upon type of psychotherapy used to treat BPD is called dialectical behavior therapy (DBT). Treatment for BPD will help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reducing the severity of symptoms experienced and increasing one’s quality of life. 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that places greater emphasis on the psychosocial aspect of therapy. Marsha M. Linehan initially developed it in the 1980s, to help treat chronically suicidal people with borderline personality disorder. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD and has also proven effective in treating individuals with other mental health conditions. DBT utilizes four main strategies for teaching individuals’ skills that help with effectively changing their behaviors. They include the following, as provided by Behavioral Tech: 

1. Core mindfulness: the practice of being completely present and aware in the moment. 
2. Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it.
3. Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions. 
4. Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging.

DBT is comprised of three distinct settings: weekly individual therapy sessions, weekly DBT group skills training sessions, and as-needed phone coaching. The entire DBT program (provided skills modules are not repeated) usually lasts about six months long, as approximately six weeks are allocated to each of the four skills modules. DBT is based on the notion that change can be balanced with self-acceptance. It can help people learn how to regulate emotions and foster change. This gives individuals struggling with BPD the opportunity to build meaningful and stable lives. Although BPD is considered to be a chronic condition, there are a variety of treatment options available to a person diagnosed with borderline personality disorder. 

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. 

Borderline personality disorder is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Each of the ten personality disorders is categorized into one of three clusters (cluster A, cluster B and cluster C). The personality disorders that make up each clusters share similar symptoms and have overlapping characteristics. According to the American Academy of Family Physicians (AAFP) cluster A is characterized as odd or eccentric personalities; cluster B is characterized as dramatic, emotional, or erratic personalities; and cluster C is characterized as anxious or fearful personalities. Borderline personality disorder is classified as a cluster C personality disorder. The National Institute of Mental Health explains, “Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior.” The cause of borderline personality disorder remains unknown. There are, however, certain risk factors (e.g. brain structure and function, genetics, environmental, cultural and social influences, etc.) that have been noted as potentially contributing to its development. Due to the illusive nature of its symptoms paired with the fact that many symptoms overlap with other mental health ailments, BPD is notoriously known as one of the most difficult mental health illnesses to diagnose. 

Signs and Symptoms

The symptoms of borderline personality disorder typically result in overarching interpersonal relationship complications and impulsive actions. The Mayo Clinic provides examples of signs and symptoms that are commonly exhibited in individuals with borderline personality disorder, some of which include, but are not limited to the following:

• Engaging in risky and/ or impulsive behaviors (i.e. reckless driving, excessive gambling, binge eating, substance abuse, unsafe sex…etc.)
• Intense fear of abandonment
• Suicidal ideations
• Self-injury
• Severe mood swings (i.e. elation, irritability, shame, anxiety…etc.)
• Pattern of unstable relationships
• Irrational displays of anger
• Distorted self image
• Feelings of emptiness
• Stress related paranoia

Some individuals may experience numerous symptoms of BPD, while others may only experience a few symptoms. Research has indicated that individuals with borderline personality disorder may experience intense episodes of depression, anxiety and/ or anger that could last from a few hours to several days long. Every individual is different and has the propensity to exhibit a unique combination of signs and symptoms related to borderline personality disorder.

Treatment

Although borderline personality disorder is considered a chronic mental health condition, there are a variety of treatment options available for individuals diagnosed with BPD, which can help individuals, learn to manage their symptoms. The most common method of treatment for borderline personality disorder is dialectical behavior therapy (DBT). Marsha M. Linehan developed DBT in the late 1980s, specifically to better treat chronically suicidal individuals with borderline personality disorder. Dialectical behavior therapy is based on the cognitive behavioral therapy (CBT) approach, and places greater emphasis on the psychosocial aspect of therapy. With proper treatment, an individual diagnosed with borderline personality disorder can learn to effectively navigate his or her symptoms of BPD and go on to lead a happy and fulfilling life. 

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.