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DIALECTICAL BEHAVIORAL THERAPY (DBT)

As would be expected, in the course of learning all that I could about Borderline Personality Disorder (BPD), one of the most pressing questions was "How can people with Borderline Personality Disorder or related tendencies be helped to improve their lives and relationships?" It is a daunting question, as the identity and misperception issues involved in the Borderline pattern are fundamental and run deep.

However, there was one treatment method that was mentioned repeatedly as relatively effective by the various sources that I consulted for understanding.

Dialectical Behavioral Therapy (DBT) is a model developed by Marsha Linehan at the University of Washington specifically for use with clients struggling with Borderline Personality Disorder, and since adapted for use with a wider variety of clients. The treatment involves a heavy focus on assisting the client in the development of crucial basic psychological, communication and relationship skills in four main areas:
  1. Mindfulness Skills
  2. Emotional Regulation Skills
  3. Interpersonal Effectiveness Skills
  4. Distress Tolerance Skills
The reason for the use of the word "dialectical" is that the treatment aims to assist the client in transcending the dichotomy between their rational and emotional sides.

I really appreciate this model because it blends a systems-oriented approach, seeking key leverage points for change, with an affirmative, skill-building mindset reminiscent of positive psychology and appreciative inquiry, all without suppressing the difficult and unpleasant emotions and experiences that are a necessary part of growth. It sees recovery from Borderline Personality Disorder not so much as curing an illness as a process of developing new strengths and skills in fundamental areas of psychological and relationship functioning.

I also greatly appreciate the dialectical aspect of the treatment, as transcending dichotomies and seeking win-win and third-hand solutions are fundamental principles of my mindset.

As effective as DBT may be in treating BPD, lately it has come to my attention that another systems-related mindset, Schema Therapy, may be proving even more effective. Hopefully, even more models will be developed that continue to assist us in addressing the widespread challenges posed to our society by Borderline patterns.


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