Which Therapy Is Helpful For BPD?

The American Psychiatric Association (APA) defines personality disorders as conditions in which “one's way of thinking, feeling, and behaving deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time”. Borderline personality disorder (BPD) falls into this category. It is important to be aware of BPD, especially if you know someone with the condition.

Symptoms Of Borderline Personality Disorder

They tend to be frightened of being alone, often causing them to react in extreme ways—which can paradoxically push people in their lives away even more. Common BPD symptoms include:

• Paranoia
• A lack of connection with reality, sometimes to the extent of requiring an inpatient stay at a psychiatric hospital
• Impulsive behavior or self-destructive behavior, including self-harm
• Mood swings
• Inappropriate behaviors or anger
• Suicidal threats
• Unstable relationships with family, friends, and romantic partners

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.

Note that the above isn't an exhaustive list of symptoms and that they may present in any number of combinations and levels of severity. Each person can experience the disorder differently.

What Causes Borderline Personality Disorder?

There are a variety of theories about where exactly this disorder comes from and why someone may develop it. It’s likely due to a combination of factors. In general, most experts assume that the following components may play a role in a person’s development of a personality disorder like BPD:

• Heredity/genetics
• Differences in brain development
• Stress or trauma in childhood

Can BPD Be Cured With Therapy?

According to a study published by the National Library of Medicine, a borderline personality disorder is seen as a “lifelong, highly disabling disorder”. So while it’s not typically thought of as “curable”, various types of therapeutic treatments have demonstrated effectiveness in helping treat borderline personality disorder. 

What Is The Best Type Of Therapy For Borderline Personality Disorder?

It’s important to note that someone with BPD can still live a healthy life when they seek and engage in treatment. When it comes to seeking treatment for BPD, both medication and therapy are often used to manage symptoms. There are several therapy modalities that may help with the disorder. Speaking with a mental health professional to determine a treatment plan is usually helpful in choosing the best therapy for BPD. Consuming a healthy diet rich in Omega-3 fatty acids may also improve BPD symptoms.

Dialectical Behavior Therapy (DBT)

Dialectical Behavioral Therapy (DBT) is a type of cognitive behavioral individual therapy (also often referred to as systems training) to treat BPD and other mental health conditions. It can help people learn to tolerate and control intense emotions. It typically focuses on helping the individual learn skills so that they can react more effectively when they’re in a difficult situation and/or feel strong emotions arising, so they can better manage distress. This type of therapy also emphasizes improving interpersonal skills to help with conflict management in personal relationships, as well as cultivating a sense of mindfulness to aid in the patient’s ability to tolerate distress and foster emotional predictability. 

Schema-Focused Therapy

This type of therapy focuses on the way that an individual’s unhealthy upbringing can lead to an unhealthy development of ideas and attitudes about themselves and the world around them. One of the goals of schema therapy is to shift some of these negative beliefs present in a patient’s own thoughts in a more positive direction. It seeks to change the flawed and/or damaging perspectives a child may have internalized from a difficult environment growing up and transform them into healthier, more positive views that can help address symptoms, improve interpersonal relationships, and create a better self-image. Group schema therapy, in conjunction with weekly individual therapy, has been shown to be especially effective.

Mentalization-Based Therapy

In mentalization-based therapy (MBT) is a well-studied type of psychodynamic psychotherapy that can effectively treat BPD. MBT is also referred to as transference-focused therapy or transference-focused psychotherapy) emphasizes how the thoughts, feelings, and behaviors of the individual may affect those of others. It’s a socially focused therapy that helps the person tune into the impacts of the choices they make. Since symptoms of BPD often have the potential to negatively impact others, this type of treatment can help a person learn to better manage their behaviors. Mentalization-based therapy is an excellent method for assisting persons with BPD in understanding themselves and becoming sensitive to the feelings of others.

Therapy For Emotional Predictability

Systems Training For Emotional Predictability And Problem-Solving, known as STEPPS, is an adjunct therapy option that combines cognitive behavioral therapy, skills training, and elements from systems therapy. It is typically offered as a 20-week group outpatient program, and can effectively improve symptoms of borderline personality disorder as well as improve depression related to BPD.

Medication For Borderline Personality Disorder

Certain medications may be an important component of treatment for someone with borderline personality disorder. It may help them manage symptoms, prevent symptoms from worsening, and treat co-occurring disorders such as depression, anxiety, post-traumatic stress disorder, or eating disorders. Their effects may also help a person adhere to their psychotherapy treatment, which can be integral for long-term success. The most common types of medications prescribed for BPD include antidepressants, antipsychotics, anxiolytics, and/or mood stabilizers. A psychiatrist can evaluate a person’s specific situation and make recommendations accordingly for good psychiatric management of medications. 

Online Therapy For Borderline Personality Disorder

In-person therapy sessions have traditionally been the norm for treating a variety of mental health disorders. However, online therapy is becoming an increasingly popular option for those who prefer it. It’s a more available format for people who can’t travel to a provider’s office regularly or who have trouble locating a provider in their area. It’s also typically more cost-effective since virtual providers have fewer overhead costs. 

Research from 2022 suggests that online therapy can be an effective treatment for personality disorders. Other studies have suggested that it can be as effective as in-person sessions for a variety of mental health conditions such as depression and anxiety, which can coexist with borderline personality disorder. If you’re interested in pursuing online therapy, you might consider a platform like BetterHelp. You’ll be asked to fill out a brief questionnaire about your needs and preferences and will then be matched with a licensed provider accordingly. You can speak with them via phone or video call and exchange in-app messages between sessions as needed. They can evaluate you and your situation and help you address the challenges you may be facing. See below for client reviews of BetterHelp counselors.

Counselor Reviews

“Loretta has undoubtedly changed my life. In my late attempt to deal with trauma, she has shown me the light at the end of the tunnel. Through various strategies and methods she has provided me, I have become less paranoid, guilt-ridden, and anxious. I am so glad I decided to start using BetterHelp and was paired with Loretta.”

“I can't speak highly enough about David. I came to BetterHelp about 3 months ago with severe PTSD that was ruining my life and my relationships. In a short time, I began to learn better and healthier coping mechanisms, tools to stop and change thought patterns and find a new sense of peace and confidence. What a difference. I would recommend David to anyone who may be seeking help from trauma and anxiety, he is very good.”