Many will believe that borderline personality disorder does sit “on the border” between other forms of personality disorders. But the fact about borderline personality disorder is that it is a different type of illness wherein a person suffering from it has difficulty in maintaining stable relationships, lacks self-control, cannot avoid impulsive behavior, cannot control outburst of anger, and always feel paranoid on stressful situations. No one knows the cause of borderline personality disorder, but it is affected by certain aspects such as genetic, biological, environmental and social factors.
Dialectical behavioral therapy (DBT) is a comprehensive cognitive-behavioral treatment that is given to those who have a borderline personality disorder. As the name suggests, it operates within a framework of dialectical methods that balances opposites such as acceptance and change. It primarily focuses on acceptance-based strategies and problem-solving. Often, the patients of certified practitioners of dialectical behavioral therapy are described as “difficult to treat.” As Stacey Freedenthal, PhD, LCSW used to explain, “The diagnosis of “borderline personality disorder” carries profound stigma for many people. Even some mental health professionals use the term pejoratively, which is not difficult considering that the diagnosis itself implies that someone’s personality is flawed.”
How Does DBT Work?
Dialectical behavioral therapy was initially intended for those who are suicidal and has extreme emotional issues. Because of these, the therapy happens in stages.
Stage 1. Treats The Most Self-Destructive Behavior: The focus of this stage is to achieve some self-control over intense emotions such as anger. John M. Grohol, Psy.D. says, “An angry person is also a person who is less able to hear and react to others in an empathetic, helpful way. Instead, when we’re angry, we tend to shut down, put our defenses up, and answer back in a way that can be hurtful or uncaring.” People on this stage must learn not to react impulsively or do things that can harm themselves or others. This stage is centered on crisis intervention and safety.
Stage 2. Begins To Address Quality-Of-Life Skills: The goal of this stage is to recognize, label and adjust one’s emotions. It is essential for those who have borderline personality disorder not to bury or hide their emotional pain; instead, bring it to the surface and explore them safely.
Stage 3. Focuses On Improved Relationships And Self-Esteem: During this stage, patients must become more aware of themselves and the people around them, and be attentive to the present moment. They must enhance their quality of life by being happy and stable. Building one’s self-esteem requires the help from other people as they can vouch for and contribute to this process. Self-talk in increasing confidence, however, will not work as much since a person with borderline personality disorder would rely much and believe other’s perceptions more than their own.
Stage 4. Promotes More Joy And Relationship Connection: At this final stage, patients must learn how to interact with others assertively and can navigate conflicts. Their goal is to advance their lives to the next level by maintaining their happiness and success. Clinical Psychologist and relationship expert Molly Gasbarrini, Ph.D. explains, “We should examine the inextricable role that self-love plays in any and all human connection.”
What To Expect In Dialectical Behavioral Therapy?
DBT treatment both consists of skills group and individual therapy sessions. For the individual therapy sessions, the patient will meet a trained therapist as one-on-one meeting. This is to ensure all therapeutic needs are being addressed. Through this, the patient will stay motivated, applied the learned DBT skills into daily life, and solve problems that may surface over the period of treatment.
On the other hand, DBT skills group provides opportunities to learn and practice skills alongside other people who have a borderline personality disorder. Each of them is encouraged to share their life experiences with the group and are expected to provide mutual support to each other. They will be led by their therapist who will oversee leading exercises and teaching new skills. Homework, such as practicing mindfulness exercises are given to all group members. They will meet in six months, every week, and approximately two hours every group session.