How do you “get” BPD?

There has historically been great confusion about the origins of borderline personality disorder, and the theories have changed and developed over time.

According to current research (as summarized by Harvard Medical School), heritable traits contribute about 70% of your chances of being diagnosed with BPD. These traits are often called temperament- those aspects of your personality that you are born with, and result from genetic and biological factors we cannot change. These traits also help determine how people treat you, from birth on. For example, demanding or difficult to soothe babies are more likely to result in parents who sometimes get stressed, angry and withdraw. This affects the care they receive.

This interaction between the personality traits we are born with and the environment we live in produces our whole personality. If something goes awry, this interaction can result in personality related difficulties that we call personality disorders.

Borderline personality disorder is one such personality disorder. According to Marsha Linehan’s biosocial developmental model of borderline personality disorder, BPD results from an interaction between certain biologically determined personality traits (such as heightened reactivity to emotional states) and environmental factors (most commonly, certain parenting styles). Learn more here.

So, how do you “get? BPD? The short answer is you may develop borderline personality disorder if you are born with an emotional sensitivity (70% contribution) and/or grow up in a certain environment that does not nurture your emotional growth.

What is the best treatment for borderline personality disorder?

The best treatment for BPD is dialectical behavior therapy (DBT). According to the American Psychological Association’s Society of Clinical Psychology, DBT is the only treatment for BPD with strong research support.

There are several other types of therapy for BPD with modest or controversial levels of research support. This means they may work for some people, but they may be less likely to work. This does not mean they won’t be effective in treating BPD, and an experienced BPD therapist dedicated to a single form of therapy may become very effective at treating BPD with their chosen method.

What is Dialectical Behavior Therapy?

The best BPD treatment is DBT, so many mental health professionals who call them BPD therapists are DBT therapists. But what exactly is DBT?

Dialectical Behavior Therapy (DBT) is a treatment designed for BPD (and now known to be helpful for other issues as well). It was created because BPD was so difficult to treat, and the treatments we used to have just weren’t every effective.

Basically, people with borderline personality disorder feel things very intensely. Persons with BPD process emotional information differently, and older types of therapy did not effectively take this into account. The result was that people with BPD weren’t getting the help they needed, and they tended to not stay in therapy very long.

DBT was created from the ground up to address the unique issues that arise for people with BPD, and for therapists who specialize in BPD. DBT therapists work differently then other therapists in many ways, and they are experts in BPD. The result is therapy that tends to be highly effective, though demanding on both therapist and client. It requires both parties to work hard, and be dedicated to overcoming BPD.

In DBT, clients attend weekly “skills classes” where they learn new ways of managing their emotions, tolerating distress, building healthy relationships, and becoming more mindful. Clients also attend weekly individual therapy sessions, where they practice applying those skills to the inquire situations of their lives. In addition, clients have access to phone coaching. With DBT phone coaching, clients can reach their therapist in-between sessions for on-the-moment skills coaching.

DBT therapists are also supposed to be part of a DBT consultation team. This is a weekly opportunity for DBT therapists to consult with one other as a team of expert. When you work with a DBT therapist, you have access to the expertise of an entire team of BPD specialists.

How do you find a BPD therapist?

When finding a BPD therapist we suggest looking for a therapist with the following qualities:

• Intensively trained in Dialectical Behavior Therapy (search here), and/or certified by the DBT-Linehan Board of Certification.

• Part of a comprehensive DBT program

• Part of a DBT consultation team

• Dedicated to evidence based treatment

When evaluating a BPD therapist, ask about each of the above. Be wary of therapists using non-evidence based treatments, therapists who seem to specialize in everything, and therapists without training in DBT. There are many different kinds of counseling, and most are not very helpful for BPD.

The best BPD treatment is called Dialectical Behavior Therapy.

Learn more about our DBT program in the Denver Tech Center, lead by our director, a DBT-Linehan Board of Certification, Certified DBT Clinician. Our comprehensive DBT program includes individual therapy, group DBT skills classes, and 24/7 DBT phone coaching. When looking for a BPD clinic near you, look for a program offering comprehensive DBT. DBT therapists are the best equipped therapists to treat BPD.

Most DBT programs are outpatient programs. This mean you see your therapist at their office. Sometimes inpatient programs offer DBT as well, and this can be very helpful if someone with BPD ends up in the hospital after a mental health crises. However, DBT providers usually try to keep their patients with BPD out of the hospital, suggesting hospitalization only as a last result.

Why Is It So Hard to Find a BPD Therapist?

While many therapists are willing to help persons with Borderline personality disorder, for the greatest chance of success you should find a dedicated BPD therapist (who specializes in the disorder, and in the best treatment for BPD, Dialectical Behavior Therapy). BPD is difficult to treat, and it best treated by therapists who spend at least half their professional time working with people who have borderline personality disorder.

Sometimes, persons with BPD are forced to go from therapist to therapist as they search for effective treatment. Often, they give up on the idea of therapy all together.

Other times, therapists who are not prepared for working with those with borderline personality disorder can struggle, make ineffective treatment choices, and suffer burnout. Treating BPD requires special preparation for the therapist, so they are able to work with this difficult condition. 

Finding a borderline personality disorder expert near you may not be easy, but driving a little further will be worth it. Looking for a borderline personality disorder therapist in the Denver area? Our BPD therapists are well trained, specialize in treating BPD, and are located in the Denver Tech Center.

The Client-Therapist Relationship In BPD Treatment

In BPD treatment, the client-therapist relationship is very important. The process of building trust with the client is vital to the success of treatment. You should be very comfortable with your BPD therapist, and feel comfortable being honest with them about your struggles. It can also be a big relief when you realize you have found a therapist that really understands BPD, and the the unique struggles people with BPD face.