How DBT Therapists Help with Borderline Personality Disorder

Effective Treatment and Support

Bay Area CBT Center

July 24, 2024

Dialectical Behavior Therapy (DBT) is a specialized form of cognitive-behavioral therapy designed to help individuals with Borderline Personality Disorder (BPD). By focusing on emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness, DBT therapists provide practical tools that address the unique challenges associated with BPD. This article explores how DBT therapists help with borderline personality disorder, covering techniques and real-life success stories that highlight the effectiveness of this therapy.

Key Takeaways

Dialectical Behavior Therapy (DBT) is an evidence-based treatment for Borderline Personality Disorder (BPD) that focuses on four core skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
DBT helps individuals with BPD manage impulsive behaviors and intense emotions by teaching specific techniques such as mindfulness practices and emotion regulation strategies, which reduce harmful coping mechanisms and improve emotional stability.
Both individual and group therapy sessions in DBT provide tailored support and a structured learning environment, which help patients apply skills to real-life situations, build a support network, and significantly improve interpersonal relationships and overall quality of life.

Understanding Borderline Personality Disorder

Illustration of a person in distress representing borderline personality disorder

Borderline Personality Disorder is characterized by extreme mood swings and unstable relationships, along with impulsive behavior. It is a mental health condition that requires proper diagnosis and treatment. To treat borderline personality disorder effectively, it is important to recognize its characteristics, which often manifest as intense fear of abandonment, trouble regulating emotions, and black-and-white thinking in relationships. For those of us living with BPD, these patterns are not just occasional disturbances but chronic issues that deeply affect our daily lives. It is crucial to differentiate between borderline personality disorder and other mental health conditions, such as bipolar disorder, to ensure appropriate treatment and support.

BPD is one of the ‘Cluster B’ personality disorders, characterized by dramatic and erratic behaviors. This group of conditions includes other disorders such as narcissistic personality disorder and histrionic personality disorder. Nearly 75% of individuals diagnosed with BPD are people assigned female at birth, highlighting a significant gender disparity. Although relatively rare, affecting about 1.4% of the adult U.S. population, BPD’s impact on close relationships, jobs, school, social activities, and self-perception can be profound.

Possible links between BPD and environmental factors such as child abuse or neglect have been suggested, though the exact causes remain unclear. Many of us may not even realize we have the disorder or that there is a healthier way to behave and relate to others. Recognizing the symptoms and seeking help from a mental health professional can be a pivotal first step toward recovery for those with mental health issues, including other mental health conditions.

What is Dialectical Behavior Therapy (DBT)?

Illustration of a person learning new skills in therapy

An offshoot of cognitive behavioral therapy (CBT), Dialectical Behavior Therapy (DBT) is specifically tailored for individuals grappling with intense emotions. Developed by American psychologist Marsha Linehan in the 1970s, DBT combines opposite ideas to help individuals accept their reality while learning to change unhelpful behaviors.

Given its emphasis on emotional management and relationship improvement, DBT proves particularly beneficial for individuals battling BPD. Through a structured approach, DBT teaches skills that promote both acceptance and change, the dual pillars essential for treating BPD effectively.

Core Components of DBT

DBT’s strength lies in its four core skills:

Mindfulness
Distress tolerance
Emotion regulation
Interpersonal effectiveness

Each of these skills, recommended by the American Psychiatric Association, addresses a different aspect of the emotional and behavioral challenges we face with BPD.

Mindfulness in DBT is divided into ‘what’ skills and ‘how’ skills. ‘What’ skills focus on recognizing the present moment, while ‘how’ skills teach us to balance rational thoughts with emotions. This practice helps us stay grounded and reduces impulsive actions driven by intense emotions.

Distress tolerance skills are designed to manage crisis situations without relying on harmful coping mechanisms like self-harm or substance use. These skills are crucial for navigating the inevitable storms of intense emotional pain that come with BPD and can also be beneficial for those dealing with post traumatic stress disorder.

Emotion regulation skills help us:

Recognize and manage primary emotional reactions
Prevent secondary distressing emotions such as shame or depression
Learn to think dialectically and balance opposing views
Reduce turbulent feelings
Improve our overall emotional stability.

How DBT Therapists Address Impulsive Behaviors in BPD

Illustration of a person managing impulsive behavior with the help of a therapist

Impulsive behaviors are a hallmark of Borderline Personality Disorder, often manifesting as reckless driving, substance abuse, or even self-harm. These actions are typically a way to distract from underlying emotional issues and an inability to self-soothe.

By imparting skills for effective emotional management and self-soothing, DBT therapists tackle these behaviors. This includes focusing on specific impulsive behaviors like gambling addiction or substance abuse. In some cases, medications might also be necessary to treat symptoms of impulsivity, offering a comprehensive approach to managing these challenging behaviors.

Managing Intense Emotions Through DBT

Illustration of mindfulness practice for managing intense emotions in DBT

DBT provides us with techniques to handle overwhelming, intense negative emotions. It teaches us two core strategies: changing or accepting our emotions. Through mindfulness techniques, we learn to tolerate unpleasant emotions until they pass, reducing the likelihood of impulsive actions.

Emotion regulation skills are another cornerstone of DBT, helping us manage emotional distress without resorting to destructive behaviors. Techniques such as:

‘Act Opposite’
‘Check the Facts’
‘PLEASE’
‘Pay Attention to Positive Events’

These techniques are specifically designed to manage and even transform our emotional experiences, including those related to anxiety disorders.

These skills empower us to handle our emotions more effectively, transforming the way we respond to life’s challenges and significantly improving our quality of life.

Improving Interpersonal Relationships with DBT

Illustration of individuals practicing interpersonal effectiveness skills

Interpersonal relationships often suffer when we have BPD, marked by intense conflicts and misunderstandings. DBT teaches us interpersonal effectiveness skills, which include assertiveness training and maintaining self-respect while navigating social interactions and conflicts.

By practicing these skills in real-life relationships, we learn to communicate our needs clearly and reduce conflicts. Improved communication helps us convey our needs without expecting others to read our minds, fostering healthier and more fulfilling relationships.

The Role of Individual Therapy Sessions in DBT

DBT’s individual therapy sessions offer:

Bespoke support, tailored to our distinct progress and challenges
Customization of DBT skills to address specific issues
A private setting to explore deeper personal issues driving our behaviors

These sessions provide personalized and focused support for your journey.

Reinforcing skills learned in group therapy, individual sessions help us apply DBT techniques to our daily lives more effectively. A strong therapeutic relationship built through these sessions significantly influences our motivation and commitment to the therapy process.

Group Therapy in DBT: Building a Support Network

In the realm of mental health, dbt focuses on group therapy to impart new skills and enable their practice within a supportive setting. These sessions are structured more like a class, with weekly new skills and homework to practice in real life.

Starting with mindfulness practice, group therapy helps us build a network of support, reinforcing our learning and providing a community of individuals facing similar challenges. Completing DBT skills training in group therapy typically takes around 24 weeks, offering a comprehensive and structured approach to skill-building.

Success Stories: Real-Life Impact of DBT on BPD

Real-life success stories highlight the transformative impact of DBT. Holly Marie, diagnosed with BPD, struggled with intense emotions and behaviors such as suicidal ideation and self-harm before discovering DBT. Through consistent application of DBT skills, Holly significantly reduced her self-harm and suicidal ideation, showcasing the therapy’s effectiveness.

These stories illustrate the real-world benefits of DBT, offering hope and inspiration to those of us navigating the challenges of BPD.

Accessing DBT: Finding a Qualified Therapist

Locating a competent DBT therapist could significantly propel one’s journey towards recovery. Insurance coverage for DBT can vary based on plan specifics, including:

the number of sessions allowed
deductible
copay
therapist qualifications

Contacting your insurer directly or using their online portal can provide specific information about DBT coverage.

For those without insurance, sliding scale therapy fees and community-based services can reduce costs. Online talk therapy options like Talkspace offer more affordable and convenient alternatives to traditional in-person therapy.

Common Challenges and Solutions in DBT for BPD

DBT’s application for BPD brings its own difficulties. For clinicians juggling hefty caseloads, the time commitment can be onerous. Merging consultation teams across agencies can help share clinical time and resources, making the process more manageable.

Providing in-service presentations can reduce negative attitudes and increase understanding of BPD and DBT among staff. Clinicians prefer more Q&A sessions and demonstrations during DBT training, which can enhance their ability to implement the therapy effectively.

Summary

In summary, Dialectical Behavior Therapy offers a lifeline to those of us struggling with Borderline Personality Disorder. By teaching essential skills for managing emotions, addressing impulsive behaviors, and improving relationships, DBT provides a comprehensive and effective treatment approach.

Understanding and accessing DBT can transform lives, offering hope and practical solutions for navigating the challenges of BPD. If you or someone you know is dealing with BPD, consider exploring DBT as a path to a healthier, more fulfilling life.

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DBT Therapy

Frequently Asked Questions

What is evidence-based therapy?

Evidence-based therapy involves interventions that are scientifically proven to be effective for particular issues. In this approach, a strong partnership based on trust and collaboration is formed between you and your therapist. Within this supportive and unbiased environment, you can freely express yourself without fear of judgment. Over a series of sessions, you and your therapist will work together to address obstacles and set goals aimed at personal growth and fulfillment. This method ensures that the techniques and strategies used are not only supportive but also empirically validated to help you achieve your therapeutic goals.

Who do we work with?

The Bay Area CBT Center provides therapy services for everyone, from children to adults, and welcomes individuals, couples, and groups. We help with various concerns like anxiety, depression, trauma, relationship issues, and behavior challenges. We value diversity and cultural differences, offering personalized and culturally sensitive care to each client.

Why is it so important to find the right therapist?

Studies show that the bond between you and your therapist, known as the therapeutic alliance, is a key factor in treatment success. This alliance is characterized by the strength of your relationship and how well you both agree on treatment goals. Research indicates that individuals with a solid therapeutic alliance experience better treatment outcomes including greater productivity at work, more satisfying relationships, improved stress management, and decreased engagement in risky behaviors.

What should I expect from the matching appointment?

You can expect a 15-30 minute phone call with our care coordinator, who is extensively trained in ensuring the perfect match for you. During this conversation, our matching expert will collaborate with you to understand your therapy needs, preferences, and scheduling availability. This discussion builds upon the information you provided during sign-up and offers an opportunity for you to address any personal questions or concerns you may have about therapy or our services at The Bay Area CBT Center. Following your conversation, we’ll pair you with the therapist who best aligns with your needs, goals, and preferences.

When will I be matched to a Therapist?

At your matching appointment, we will match you with a therapist specifically chosen for you and schedule your first session. Depending on your availability, you can expect to meet your therapist anywhere from one day to a week after this appointment.

Do you provide in-person or virtual therapy?

Our approach to therapy includes a flexible hybrid model, blending both online and face-to-face sessions. This option is perfect for clients situated close to our clinics in the Bay Area who prefer the flexibility of choosing between virtual consultations or meeting their therapist in person. Our aim with hybrid care is to ensure every client is matched with the ideal therapist and therapy environment, be it from the convenience of your own home or in one of our clinics.

Do you accept insurance?

At the Bay Area CBT Center, we accept PPO insurance plans that allow you to use out-of-network providers. This means if your insurance plan is a PPO and it includes mental health benefits, you could get back some or all of the money you pay for our services, depending on what your insurance company allows. When you see one of our therapists, they’ll give you a superbill. You can send this superbill to your insurance company to ask for reimbursement. If you’re not sure if your insurance covers services from providers not in their network, it’s a good idea to give them a call and check.

You may be eligible to have 60-80% of your costs covered by out-of-network benefits.

Also, if you have an FSA (Flexible Spending Account), you can usually use it to pay for individual counseling sessions. It’s wise to double-check with your FSA provider or talk to your accountant to make sure that counseling sessions are considered an allowed expense.