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Borderline Personality Disorder and Dialectical Behavior Therapy – Part Two

Dialectical Behavior Therapy is a type of psychotherapy treatment developed specifically to treat people who have Borderline Personality Disorder by Marsha Linehan, a psychology professor at the University of Washington in Seattle. In Part One of this series, we discussed the background of her theories. In this article, we will continue the discussion on Borderline Personality Disorder and Dialectical Behavior Therapy.

In Dialectical Behavior Therapy, the term “Invalidating Environment” refers to an environment in which the growing child’s personal responses and experiences are "invalidated" (disqualified) by his/her parents. In other words, the child’s personal communications aren’t accepted as a real indication of his/her true feelings.

Linehan suggests that a child in an Invalidating Environment won’t have the chance to accurately label (nor understand) his/her feelings, nor to trust his/her own responses to events. Neither will the child be helped to cope with stressful or difficult situations, since these problems will not be acknowledged by his/her parents.

Because of growing up in an Invalidating Environment, it can be expected that the child will then look to other people for indications of how he/she should be feeling and for help in solving his/her problems. However, an erratic emotional (negative) pattern of behavior will persist as the child begins to grow, and this will lead to problems in interpersonal relationships, which is characteristic of Borderline Personality Disorder.

Linehan believes that one particular consequence of this behavioral pattern will be a failure to understand and control emotions – a failure to learn the required skills for what she calls “emotion modulation.” Given the emotional vulnerability of people with Borderline Personality Disorder, this will result in a state of what Linehan terms “emotional dysregulation,” which describes the erratic display of extreme emotional displays also characteristic of Borderline Personality Disorder.

According to the National Institute of Mental Health (NIMH), mostly young women are affected by Borderline Personality Disorder. In fact, women are diagnosed with the disorder approximately two to four times more often than men, most likely because of sexual abuse in childhood, which occurs ten times more often in women than in men. Linehan calls childhood sexual abuse a particularly extreme form of invalidation.

In Dialectical Behavior Therapy, Linehan groups the features of Borderline Personality Disorder in a particular way, describing the patients as showing dysregulation in the sphere of emotions, behavior, relationships, cognition, and sense of self. She suggests that, as a consequence of the situations that have been described, the person shows typical patterns of behavior (the term “behavior” referring to cognitive, emotional, and autonomic activity, as well as external behavior in the narrow sense).

In Part Three of this series, we will go over these typical patterns of behavior in detail.

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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