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If your friend or family member has been diagnosed with borderline personality disorder, here are some tips to help you cope and maintain the relationship. Tip #1: Knowing the symptoms and possible causes of Borderline Personality Disorder (BPD) can help you better understand your loved one. First, learn to spot the symptoms. Those diagnosed with Borderline Personality Disorder (BPD) meet five or more out of nine diagnostic criteria and tend to have problems in five main areas. Emotion regulation Emotion regulation is challenging as individuals vacillate between intense highs and lows, depressed mood, heightened anxiety, and anger. Interpersonal Dysregulation:  Interpersonal relationships may suffer because BPD patients sometimes fear real or imagined abandonment by loved ones and fluctuate between idealizing or devaluing friends and family. Self-Dysregulation: Negative or unstable self-image may lead to reports of identity disturbance or distorted sense of self. Behavioral Dysregulation: Risky behavior such as self-harming and threats

DBT stands for Dialectical Behavior Therapy. What the heck does dialectical mean anyway? Dialectic is a word that describes how both the thesis and the antithesis of a perspective can both be true. Put another way, for every statement or interpretation, there exists an opposite. A dialectical stance holds that both of these opposites can be simultaneously true. In fact, in DBT we often describe dialectics as two opposing truths. For example, you might really want to change parts of your life (thesis) and think that change is impossible (antithesis). In DBT, we try to find the synthesis between these opposing truths. We aren’t looking for some sort of compromise, or “winning” thought, but the integration of the two. So, a dialectical frame of wanting to change would be, “You want to change your life, and you’re not sure how.” You might even find yourself struggling with the dialectical thought,

A quick Google search demonstrates people are divided on whether the social media platform Instagram is harmful. Instagram has been accused of driving an increase in anxiety and depression amongst young people, spreading rampant fear of missing out (FOMO), and contributing to what Dialectical Behavior Therapy (DBT) therapists refer to as “contagious behaviors,” defined as behaviors that, if talked about openly, may create or increase that urge in other people. Some argue the opposite: that Instagram and its users are champions of destigmatizing mental health. My opinion on the matter is also divided. Like with most things, I suspect reality is more of a “both…and” rather than “either…or” (which, in DBT, we call a ‘dialectic’). I certainly find myself changing my mind frequently about whether or not Instagram is something I want to use, for the reasons identified as well as others. These things were in my mind as I

What is validation in DBT? Validation is a key concept in Dialectical Behavior Therapy (DBT). To validate means to acknowledge the validity in what someone else is saying, or feeling. Validation is important for every relationship, including friendships, romantic relationships, and with family members. Parental validation of children is especially important. This is a crucial mechanism by which children learn to trust, and eventually control, their emotions. It is thought that too much parental invalidation can be damaging to children, making it difficult for them to learn to control their emotions and behavior. Parental invalidation (interacting with a biological vulnerability is thought to contribute to the development of borderline personality disorder). That is why validation is an important skill we teach in our comprehensive DBT program. Why is validation important in DBT? It is important to validate for many reasons: It demonstrates we are listening and understand Shows acceptance, care,

As a therapist who specializes in Dialectical Behavior Therapy (DBT), people with Borderline Personality Disorder (BPD) are the focus of my work. Like most therapists I know who also specialize in DBT, I have so much compassion for people who work so hard to improve their lives, achieve their goals and build a life worth living. I am almost daily rendered speechless by my client’s insights, drive and willingness to do whatever it takes to have the life they want. Because of that, any time a client or even potential client tells me that they have been researching “Borderline Personality Disorder,” I have a very mixed emotional response. On the one hand, when someone who has been struggling, sometimes for years, to find a label or an explanation for their struggles finally discovers BPD, that can be very reassuring for some people. Everything seems to click into place and their

As a psychologist who specializes in Dialectical Behavior Therapy (DBT), I am frequently asked by clients and families about how Borderline Personality Disorder (BPD) develops. We think BPD is caused by a combination of factors, so the answer is a bit complicated! The Biosocial Theory reflects our current understanding in how BPD develops. The theory states that BPD is a disorder of emotion dysregulation, and that emotion dysregulation is the result of emotional vulnerability as well as a lack of emotion modulation skills. Moreover, the Biosocial Theory postulates that these difficulties are rooted in biological predispositions that are exacerbated by the environment. Emotional Vulnerability  When we discuss emotional vulnerability, we are specifically referring to three things: sensitivity, reactivity, & slow return to baseline. When an individual is “sensitive,” it means that person has a low threshold for an emotional reaction. What may not be bothersome to most is bothersome to

Most therapy is independent, conducted one-on-one, with the client and therapist working together. When couples are having relationship trouble they may seek couples counseling. Families may seek out family counseling to reduce interpersonal conflict and improve relationships. But, when there is one patient seeking treatment for a specific mental health issue, romantic partner involvement is usually neglected. When someone with borderline personality disorder (BPD) seeks treatment, should romantic partners be included in treatment? BPD greatly impacts the ability to have stable, rewarding relationships. In addition, it can be very stressful for those who love someone diagnosed with BPD. It can be difficult to live with a partner who displays unpredicted shifts in mood, high levels of anger and conflict, self-harm, suicide attempts, and other risky behaviors. There are many ways for those who love someone with BPD to get help. Persons can seek outside support and information. Persons can receive

Borderline personality disorder (BPD) is one of the personality disorders. What is a personality disorder? Personality disorders are generally considered to be the result of early experience and resistant to change. They are thought to be deeply embedded ways of thinking about and responding to the world, and other people. Treating personality disorders is often thought to be very difficult, because the patterns are so ingrained. Some professionals even say you can’t “cure” personality disorders; rather, you treat people who “work around” their ineffective natural tendencies. The truth is much more complicated. Personality development is a very complex process. Genetic and biological factors are important, because they shape our earliest responses. Is a baby fussy, and easily overstimulated? Are they quick to smile and laugh at others? Are they calm and easy to soothe, or do they demand extra attention? These early behaviors in turn shape how other people interact

The 4-miss rule in DBT is quite simple: clients who miss four weeks of individual sessions OR four skills classes in a row must leave the program. This rule is stated upfront, to set up a clear expectation: if you miss four appointments, that is considered a premature dropout. Until you miss four, you’re still in. This information is provided to DBT clients during the early part of treatment, before a commitment to the program is made. By clearly laying out this expectation, clients know the difference between simply missing appointments and dropping out. In many types of therapy, clients are allowed to “drift in and out” of treatment. When some people get relief, or their situation improves, they think they don’t need therapy anymore and they stop coming. Then, when symptoms return or they encounter some obstacle, they return to therapy. This makes lasting progress impossible. The DBT 4-miss