Borderline Personality Disorder
We develop as people as we experience different things and as we mature we become flexible enough to learn from our experiences and change our behaviour to better cope with life. However, people who have a personality disorder find this difficult. Their patterns of thinking, their feelings and behaviour remain fixed and so they will present with a much more limited range of emotions, attitudes and behaviours, thus finding it difficult to cope with everyday events.
As you would imagine, this can lead to distress and a fear that you do not experience life as others do.
BPD has been described as a pattern of instability of interpersonal relationships, self-image and feelings, impulsivity that began possibly in early adulthood as indicated by five or more of the following:
Frantic efforts to avoid real or imagined abandonment A pattern of unstable and intense interpersonal relationships characterised by alternating between extremes of idealisation and devaluation. Impulsivity in at least two areas that is potentially self-damaging. For example spending, sex, substance misuse, reckless driving, binge eating, self harming etc. Identity disturbance, markedly and persistently unstable self-image or sense of self. Recurrent suicidal behaviour, gestures or threats/self harming behaviour Emotional instability due to reactivity of mood. For example, irritability or anxiety which lasts only for a few hours. Chronic feelings of emptiness Inappropriate or intense anger or difficulty controlling anger. Transient, stress related paranoid ideation or dissociative symptoms. Many health professionals are sceptical about the effectiveness of treatment interventions for people with a diagnosis of personality disorder, and as such are often reluctant to accept people with this diagnosis. However, a range of treatment interventions are available for personality disorder, including psychological treatments and drug therapy, and there is growing evidence available on the efficacy of varying treatment approaches. In general, a combination of psychological treatments reinforced by drug therapy at critical times is thought to be the most beneficial treatment available. In order for treatment to be effective it has to: Have structure Be focused Be understandable to both therapist and patient Be long term treatment The types of psychological treatments available are as follows:
Dynamic psychotherapy
Dynamic Psychotherapy is based on a developmental model of personality. The aim is to understand how past events can still have influences on the present. This therapy is usually long term and it is essential that a good relationship is formed between the therapist and the patient as this relationship is used as a way of understanding how the patient interacts with others.
Cognitive Analytical Therapy (CAT Therapy)
CAT Therapy assumes that a set of partially dissociated self states exist and account for the features of BPD. It aims to put these states together to examine them in treatment as well as in life experiences.
Cognitive Therapy (CBT)
CBT is a structured and collaborative therapy that is goal directed and focuses more on identifying and examining underlying beliefs than an initial reduction in symptoms. It is likely that up to 30 treatments would be necessary for BPD with initial treatments identifying basic beliefs about themselves, others and the world around them. CBT involves the patient carrying out homework and being willing to test beliefs which is often difficult. If you would like to know more about CBT please email me at: info@therapysite.org or order my CBT e-book from the site.
Dialectic Behaviour Therapy (DBT)
DBT is an adaptation of CBT. It has been used extensively in the treatment of BPD, especially for patients who self harm. It includes analysis of behaviour, support and skills training. If you would like to know more about DBT please email me at: info@therapysite.org or order my DBT e-book from the site.
Therapeutic Community Treatments
Therapeutic community treatments provide intense therapeutic treatments to the patient. However it is the environment itself that is seen as the driving force for change
Drugs that can be used in the treatment of BPD are as follows:
Antipsychotic Drugs
In trials antipsychotic drugs have had variable results. They are thought to reduce hostility and impulsivity.
Antidepressant Drugs
Tricyclic and SSRI’s have both been recommended in the treatment of BPD. They are especially thought to help such symptoms of impulsivity.
Mood stabilisers
Lithium, Carbamazepine and Sodium Valporate have been useful to treat lability of mood in those with BPD.
CHANGE THE WAY YOU THINK, CHANGE THE WAY YOU FEEL !
Further free information and support can be seen at www.therapysite.org or www.siteknight.co.uk.
Please remember you should always seek the immediate guidance and support of a medical professional.
This self help material is for informational purposes only.
