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In spite of what some people intimate, I do endorse non-drug solutions and one of the best adjunct treatments to medications is psychotherapy. Many types of therapy can work for different people, but one current and research-backed therapy is dialectical behavior therapy (DBT).
Now, don’t let the big words scare you – this is not a scary therapy. This is simply a therapy that uses reason to integrate and synthesize opposite points of view. Meaning, the techniques taught are designed to find a balance in emotion, behavior and acceptance.
Dialectical Behavior Therapy and Borderline Personality DisorderDialectical behavior therapy was designed specifically to treat borderline personality disorder; however, it has shown usefulness in mood disorders and research is currently underway to see if DBT techniques are also useful in other disorders. This therapy represents a huge breakthrough as the first indicated treatment of borderline personality disorder.
Dialectical behavior therapy is more about teaching and doing than it is about talking. It is simply not talk-therapy.
Dialectical behavior therapy teaches:
Other techniques such as self-management may also be added to the DBT teachings. It is often done in a group therapy setting.
Now, I admit, I have not had DBT, so I am not speaking from personal experience, but I have talked to local DBT experts who run a four-stage DBT program specifically for borderline personality disorder, and it looks like this:
That depends on who you ask, but the research says yes, it works.
In randomized clinical trials, DBT was more effective than usual treatment in reducing suicidal and self-injurious behaviors, treatment dropout, hospitalizations, and self-reports of anger and anxious ruminations.Increased rates of global adjustment were observed after one year of treatment, and these gains were maintained over the subsequent year.
Because many people with borderline personality disorder have self-injurious behaviors, dialectical behavior therapy has developed specific techniques for handling this behavior. I have been asked about these techniques repeatedly and will go into them next time.
You may not be able to find a therapist who specializes in DBT in your area. This is too bad considering how effective it is. Do not give up; however, as books, workbooks and online resources can walk you through DBT. Here are some DBT book resources:
Note: resources provided by local DBT group and not personally endorsed.
Natasha Tracy is an award-winning writer, speaker, advocate, and consultant from the Pacific Northwest. She has been living with bipolar disorder for 26 years and has written more than 2000 articles on the subject.
Find more of Natasha’s work in her acclaimed book: "Lost Marbles: Insights into My Life with Depression & Bipolar" on Amazon.
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Borderline Personality Disorder is the most difficult to understand and diagnose mental illnesses. As a consequence there is little awareness of its existence in the general public. If there were greater awareness, more resources would be brought to the table to help these people. I believe the biggest problem is its name. “Borderline” means nothing in helping us understand the condition. I have proposed that we change the name to Faultfinding Personality Disorder based on the most important diagnostic criterion – chronic finding of fault with themselves and others due to their black-and-white thinking which leads to disturbed interpersonal relationships. To back this up I wrote the book “Faultfinders: The impact of borderline personality disorder.” I explained the condition using examples of numerous famous people to make the symptoms memorable. I would be interested to hear what others think about a possible name change.
I personally completed all 4 parts of DBT one-on-one with a DBT therapist and it saved my life. I finally have self-compassion which has cut out 90% of my suffering. Cognitive behavioral therapy never worked for me, because it always taught that there was something wrong with my thinking, where as DBT taught me first how to accept my thoughts without judgment. Acceptance and self-compassion is key to change. I primarily fit the criteria for Borderline Personality Disorder 20 years ago, so when I received DBT a few years back, I was just a regular old person with Bipolar II and panic disorders and it worked great for me. I highly recommend it.
I have just started with a DBT therapist in Essex, UK… I am pleased as I have had psychotherapy for years but this seems to offer something very different and specific. I think it involves a lot of hard work and practise… but I don’t mind if it offers some relief. I’ll keep you posted.
Hi Mimyselfannddukie,
That’s great. I know many people have had great success with this therapy where others have failed so yes, please do keep us posted :)
– Natasha Tracy
Great post! Another study was published this month (and e-published last October) providing further evidence for DBT’s effectiveness. In the study, women with borderline personality disorder who received DBT said they had greater “self-affirmation, self-love, self-protection, and less self-attack” during treatment and one year later. Here’s a link to the study: http://www.ncbi.nlm.nih.gov/pubmed/20975829
In 2009 I was in a crisis house for short stay and was introduced to DBT. I didn’t care for it but I think mostly it was because I did not enjoy the woman leading or her style, personally she was ok. Also, I may not of been ready to work it since I had been very suicidal 4 days before.
I would be interested in giving it another try. A woman in my dual iop group counseling is pursuing it so maybe I’ll try it w/ her.
Thanks for having it here for me to read and re-consider. It sounds promising.
Pam
Hi Pam,
I do generally think it’s worth a shot for people. It combines cognitive behavioural therapy (CBT, which I have done) with other therapies. I do think it’s hopeful for many. And hey, no drug-drug interactions or drug side effects with this treatment :)
– Natasha Tracy