Borderline Personality Disorder – Therapists and Counselors in Hanover, VA

“I’ve been diagnosed with Borderline Personality Disorder. Now what?”

The first piece of advice for someone diagnosed with Borderline Personality Disorder (BPD) – Don’t believe everything you read! BPD remains a very misunderstood and stigmatized disorder. So, you may read or hear people, even professionals, refer to individuals with BPD as manipulative, liars, dramatic, or untreatable. Not true!

The truth is, Borderline Personality Disorder is not a very good name to describe this set of symptoms that impacts about 3 percent of the population. A better title might be “I’ve been through a lot of crap and now I have trouble coping Disorder.” That wouldn’t look very good to insurance companies or in a book written by tons of doctors. So, we use this term “borderline” that somehow insinuates someone who is unsettled, marginal, or who almost belongs in a certain category but doesn’t quite fit.

To an extent, this is quite true. Many people who meet the diagnostic criteria for BPD previously met criteria for Post-traumatic Stress Disorder; but, they have experienced so much trauma or so much invalidation, the core symptoms of PTSD are no longer present and the symptoms of the “other disorder” are present. Historically, we said people were on the borderline between psychosis and neurosis. What!?

People with Borderline Personality Disorder often experience:

• Fears of being abandoned
• All or nothing thinking
• Difficulty managing emotions
• Impulsivity
• Shame
• Low self worth
• Intense feelings of loneliness or emptiness
• Fall in love quickly and intensely
• Issues with trusting others

What does a journey toward recovery from this disorder look like?

While it is different for everyone, we have learned a lot over the past years about BPD and what effective treatment entails. One of the treatments with the most evidence for recovery is called Dialectical Behavioral Therapy – DBT. This modality was created by a person with her own experience of mental illness that was diagnosed at first as Schizophrenia. Her name is Marsha Linehan and she has talked about how her symptoms likely were BPD and not Schizophrenia.

What is DBT?

Dialectical Behavioral Therapy is a therapeutic approach that involves individual psychotherapy and a skills training component. It has many similarities to traditional Cognitive Behavioral Therapy but incorporates mindfulness and dialectic approaches. Dialectical is essentially the idea that two things that seem opposite can actually exist at the same time. Learning to think this way really helps individuals with BPD who are used to black or white thinking.

What does skills training mean?

In DBT, there are four sets of skills that helps with different aspects of managing BPD. These include:

• Distress Tolerance: how to get through a crisis without making it worse
• Emotion Regulation: how to change emotions you want to change
• Core Mindfulness: how to be fully present in the moment without judging it
• Interpersonal Effectiveness: how to communicate and “be” with other people to get your needs met and maintain the relationship

Skills training is traditionally done in a group setting, but can also be done individually.

What is the prognosis for BPD? I mean, does DBT even work?

Borderline Personality Disorder used to be seen as a lifelong struggle that rarely gets any better. Thankfully, we have learned a lot more about BPD and its treatment. Now, we know people get better. We know treatment works. We know the symptoms of BPD go away for most people who get effective treatment and those symptoms stay in remission for many years.

DBT is considered evidence-based. That means we know, when implemented as it’s designed, it works. Research studies have shown this time and time again.

Are you ready to start your journey toward recovery from Borderline Personality Disorder? Contact us today and let’s get started!