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Borderline Personality Disorder and Dialectical Behavior Therapy – Part One

Dialectical Behavior Therapy is a relatively new method of psychotherapy treatment that was developed specifically to treat people who have Borderline Personality Disorder.

According to Marsha Linehan, leading developer of Dialectical Behavior Therapy, patients who show the features of Borderline Personality Disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are notoriously difficult to treat. She states that they are difficult to keep in psychotherapy, that they frequently fail to respond to therapeutic efforts, and that they make considerable demands on the therapist’s emotional resources, particularly when suicidal behaviors are prominent.

Linehan, a psychology professor at the University of Washington in Seattle, hypothesized that the disorder is “a consequence of an emotionally vulnerable individual growing up within a particular set of environmental circumstances,” which she refers to as the “Invalidating Environment.”

In this sense, an “emotionally vulnerable” person is someone whose autonomic nervous system reacts excessively to relatively low levels of stress, taking longer than normal to return to baseline once the stress is removed.

The term “Invalidating Environment” essentially refers to a situation whereby the growing child’s personal experiences and responses are disqualified ("invalidated") by his/her parents. The personal communications of the child are not accepted as an accurate indication of his/her true feelings.

An Invalidating Environment is characterized by the tendency to place a high value on self-reliance and self-control. Any failure on the child’s part to perform to the expected standard is ascribed to lack of motivation or other negative characteristic of his/her character.

Linehan suggests that a child who is emotionally vulnerable can be expected to experience particular problems in an Invalidating Environment. The child will not have the opportunity to accurately label and understand his/her feelings, nor will he/she learn to trust his/her own responses to events. In addition, the child is not helped to cope with situations that he/she might find difficult or stressful, since such problems are not acknowledged by the parents.

It may be expected then that the child will look to other people, rather than the parents, for indications of how he/she should be feeling and to solve problems. However, it is in the nature of an environment such as this that the demands he/she is allowed to make on others will tend to be severely restricted. The child's behavior may then go back and forth between opposite poles of emotion (attempting to gain acceptance), and extreme displays of emotion, in order to have his/her feelings acknowledged.

Erratic response to this pattern of behavior by those in the child’s environment may then create a situation of intermittent reinforcement, resulting in persistence of the child’s negative behavior pattern.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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