Dialectical Behavior Therapy for BPD

Dialectical Behavior Therapy for BPD
Picture of Medically Reviewed By: Dr. Joshua Yager M.D.

Medically Reviewed By: Dr. Joshua Yager M.D.

Dr. Joshua Yager is an Atlanta native, board-certified family practice physician who is dedicated to the health and wellbeing of his community.

Table of Contents

Living with borderline personality disorder (BPD) presents challenges, notably in emotional management, relationships, self-perception, and coping with suicidal thoughts. Yet, with appropriate treatment and backing, a rewarding and contented life is attainable.

Evidence indicates a favorable prognosis for BPD, particularly for those who engage in targeted therapeutic interventions. Dialectical behavioral therapy (DBT) stands out as the most acclaimed and efficient treatment specifically designed for those with BPD.

If you have been diagnosed with BPD, it’s important to remember that you are not alone. Research shows that while BPD affects 1.6% of the general population, this figure rises to 20% in psychiatric inpatient settings. Despite the challenges, many individuals with BPD have been able to manage their symptoms and improve their quality of life with the help of DBT Therapy.

What is Dialectical Behavior Therapy?

Developed in the 1980s, Dialectical behavior therapy (DBT) was initially crafted for borderline personality disorder (BPD). Its effectiveness has since broadened to address other emotional challenges, including depression. Building on cognitive-behavioral therapy (CBT) foundations, DBT focuses on structured talk therapy sessions guided by mental health experts. Both CBT and DBT aim to provide tools for individuals to face emotional obstacles, reshape behaviors, and enhance coping skills.

DBT especially emphasizes recognizing and understanding damaging thought patterns. This awareness helps individuals confront challenges more resiliently, reducing stress. A core goal of DBT is fostering self-acceptance while processing negative emotions, building resilience to life’s challenges.

While both CBT and DBT believe in modifying thoughts and behaviors to reduce suffering, DBT places unique importance on understanding intense emotions that accompany various mental health challenges. It advocates recognizing these emotions as a crucial part of our journey. Through DBT, individuals learn the importance of validating their experiences while also seeking positive change.

Why Does DBT Work so Well for BPD?

DBT is particularly effective for Borderline Personality Disorder because it takes into account the biological predispositions, early life experiences, and various elements that might lead to BPD symptoms.

The essence of DBT lies in minimizing rash behaviors that can disrupt one’s life and personal relationships. It offers a holistic approach, guiding individuals to identify and prepare for intense emotional surges, such as anger or depression, before they become overwhelming.

What to Expect During DBT Therapy for BPD?

DBT is typically a blend of group skill sessions, one-on-one therapy, and occasional phone coaching. Those undergoing DBT are encouraged to consistently track their symptoms and the application of their newly learned skills, with their progression monitored throughout the therapy.

DBT structures its teachings around four key modules:

  1. Mindfulness Meditation Skills: Concentrating on the present moment, these skills teach participants to observe, describe, and partake in their experiences, be it thoughts, emotions, or external events, without labeling them as “good” or “bad.” For instance, during heightened emotional states, like an argument, someone with BPD might act impulsively. Mindfulness skills train them to recognize, interpret, and regulate these emotions, encouraging thoughtful responses.
  2. Interpersonal Effectiveness Skills: This module gears towards teaching individuals to assert themselves and navigate conflicts in relationships.
  3. Distress Tolerance Skills: These skills aim to teach individuals how to bear distressing moments without exacerbating the situation, like resorting to self-harm. Individuals with strong emotions may occasionally act impulsively to momentarily alleviate their feelings. However, actions like substance or excessive alcohol use can exacerbate the situation in the long run. Distress tolerance skills help individuals develop healthier coping mechanisms.
  4. Emotion Regulation Skills: Here, individuals learn to recognize and manage their emotional responses, enabling them to process and express emotions healthily. For instance, they might learn to accept emotions or find non-aggressive ways to address them.

Each module comes with tailored skills corresponding to its theme. You might explore:

  • Self-comforting techniques
  • Harnessing the ‘wise mind’
  • Practicing radical acceptance
  • Creating enriching experiences

The learning journey in each module integrates group discussions, individual sessions, and practical assignments. For real-time application, your therapist might offer phone guidance.

Dialectical Behavior Therapy for BPD is essentially skills-focused, making it hands-on and practical. Generally, a DBT course spans about a year.

How Does DBT Help Those with BPD?

People with BPD often grapple with extreme, black-or white. This is where the essence of DBT, encapsulated in the term ‘dialectics’, comes into play.

‘Dialectics’ involves embracing two contrasting ideas simultaneously, recognizing the validity of both. In the realm of DBT, this means understanding the need for both acceptance and transformative change to alleviate symptoms, promoting a more balanced mindset and diminishing polarized thinking.

Furthermore, DBT emphasizes mindfulness, helping those with BPD make more thoughtful, aware choices, ultimately reducing impulsive actions and other detrimental behaviors. A key concept introduced during this process is the “wise mind”, which fosters a blend of emotional and rational thinking. This mindset aids in making balanced decisions, whether in moments of crisis or calm.

In essence, DBT not only assists individuals with BPD in managing their daily challenges but also empowers them to thrive in their daily lives.

How Long is DBT for Borderline Personality Disorder?

DBT often offers swift relief for many with borderline personality disorder, helping them manage their emotions and lead more contented lives. But there isn’t a one-size-fits-all timeline for its effectiveness. The duration and impact of DBT can differ for everyone. Several factors, such as one’s commitment, the intensity of symptoms, and the specific therapeutic approach, play a role in determining how long it takes for positive shifts to occur. Like with any treatment addressing mental or physical well-being, outcomes are inherently individual.

What to do if DBT Doesn’t Work

If DBT doesn’t work for you, there are alternative treatments and strategies to explore. Here’s what you can do:

  • Discuss with your treatment team: Talk to your therapist and treatment team about your concerns and explore other options that may be more suitable for you.
  • Consider other evidence-based treatments: Schema Therapy and Mentalization-Based Therapy (MBT) are two alternative treatments that have shown effectiveness for BPD.
  • Explore medication and talk therapy: Medication can help with managing symptoms, and traditional talk therapy with a professional can be beneficial for individuals with BPD.
  • Build a strong support system: Having a healthy and supportive network of friends and family can be life-changing for individuals with BPD.
  • Seek out resources and communities: Online resources, support groups, and communities can provide additional support and insights for managing BPD.

What Research Says About DBT Therapy for BPD

Research has shown that Dialectical Behavior Therapy (DBT) is the most effective form of treatment for individuals with Borderline Personality Disorder (BPD). Some key findings include:

  • DBT is particularly effective in improving suicidal thoughts and behaviors, difficulties with anger management, and overall daily functioning, including socially.
  • A 2012 Cochrane systematic review of psychological treatments for BPD concluded that DBT appeared to be more effective than treatment as usual.
  • DBT has been found to be effective in reducing psychotropic medication use in patients.
  • Several studies have demonstrated the effectiveness and efficacy of DBT for BPD, although the evidence is mostly based on low-to-moderate-quality evidence.

If you feel that DBT isn’t helping you, there are other options you can discuss with your treatment team, including Mentalization-Based Therapy (MBT). Optimizing treatment effectiveness for BPD is highly needed, as a substantial proportion of patients do not respond fully to either DBT or other treatments.

Dialectical Behavior Therapy for BPD in Atlanta, GA

If you’re navigating life with borderline personality disorder and seek tools to lead a more fulfilling journey, consider connecting with a mental health expert skilled in dialectical behavioral therapy. And if you’re curious about how DBT might benefit Post Traumatic Stress Disorder or other conditions, a licensed mental health specialist can provide guidance. Numerous individuals with BPD often discover that embracing this therapy is a transformative choice they wish they’d made earlier. Call us today to begin your journey.

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