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Therapy for Borderline Personality Disorder

There are many different orientations to therapy for Borderline Personality Disorder, including medical, psychoanalytic, biological, biosocial and cognitive.

First of all, it is important to know that no form of therapy will assist a person with Borderline Personality Disorder unless that person is properly medicated, reducing many of the symptoms. Paul Markovitz, M.D., Ph. D, states, "Antidepressants do not change the hardwiring. They simply damp down the circuits to a point where many individuals can control their lives. Mood swings, somatic complaints, rage, irritability, binge eating, anxiety, and even black-white thinking are reduced significantly.” 1

Although there is no cure for Borderline Personality Disorder, with the proper treatment, including medication and therapy, the person can get more control over his/her life. Since Borderline Personality Disorder is at least partially also a biochemical disorder (a “broken brain”), it cannot be argued that medication should be the first part of therapy. After all, we give insulin to a diabetic before they can receive any assistance from therapy, don’t we?

Cognitive Behavior Therapy does affect the brain, but not to the extent of recovery from Borderline Personality Disorder. We all have an area in our brain that regulates our emotions, so that when an upsetting event occurs, we emotionally respond to that event. Normally, the level of emotion we feel in response is in proportion to the level of the event that occurred.

However, in people who have Borderline Personality Disorder, this area in the brain "malfunctions," and they have problems with “emotion regulation.” In their case, then, an upsetting event can occur and they might experience a level of emotional reaction that is far beyond what is "appropriate." They can go from feeling “normal” to suicidal very quickly, and for them, sometimes there is no in-between. They need therapy that addresses this need for emotional regulation.

Dialectical Behavior Therapy addresses the person with Borderline Personality Disorder’s need for emotional regulation as part of its therapy. It also addresses learning how to handle stress, skills training, interpersonal effectiveness, and other things that will help the person with Borderline Personality Disorder to make their life better.

Psychodynamic Therapy, according to the 3/02 Harvard Mental Health Letter, is highly recommended along with Dialectical Behavior Therapy for people with Borderline Personality Disorder. This form of therapy brings the unconscious to the conscious level and deals with transference issues. For example, the therapist may point out that the client has misplaced anger. The client may be expressing angry feelings at the therapist and the therapist may suggest that the client is really angry with someone in their past. The client in this form of therapy tells their life story, and the therapist works with them on this.

The best kind of therapy to help someone with Borderline Personality Disorder is the kind that focuses on the "here and now," on self-defeating behavior, on emotion regulation, on improving self-esteem, and that will help them learn to like and love themselves (improve their self-esteem) and to better their lives (their future). The choice of therapy depends upon the person and their level of functioning.

1. http://www.mhsanctuary.com/borderline/therap.html

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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