Borderline Personality Disorder

Borderline personality disorder (BPD) is characterized by marked instability in many realms of an individuals functioning including affect, relationships, self-image, cognition, and behavior. Individuals with BPD experience emotional pain and are unable to effectively manage their emotions, which may include feelings of emptiness and difficulties with anger. Impulsive behaviors (such as self harm, risky sexual behavior, binge eating, spending) may be viewed as problematic attempts to cope with emotions. People with BPD often have difficulties with relationships. Feelings toward others may shift dramatically and frequently. BPD is a serious and life threatening illness. Approximately 75% have a history of suicide attempts and 10% of individuals with BPD commit suicide.

Approximately 2% of the general population has BPD. The term “borderline” arose in the 1930s to describe individuals who were on the border between neurotic and psychotic. While the meaning of the diagnosis has changed, the name has remained. Today, according to the biosocial theory (Linehan, 1993), BPD is caused by the ongoing reciprocal interaction between an emotionally vulnerable temperament and an invalidating environment. In other words, when a person is biologically highly sensitive to emotions and others respond by punishing or dismissing feelings, a person never learns how to manage or trust one’s internal experience, and difficulties in regulating emotions arise.

Dialectical Behavior Therapy (DBT) is considered the treatment with the most scientific support for individuals with BPD. DBT evolved from standard cognitive behavioral therapy and Zen practice. The goal of DBT is to not only to treat BPD, but to also create a life of meaning. DBT includes a focus on teaching a person skills, including mindfulness, emotion regulation, distress tolerance, and interpersonal effectives.

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Cognitive Therapy of Personality Disorders, Second Edition by Aaron T. Beck, Arthur Freeman, and Denise D. Davis
Cognitive-Behavioral Treatment of Borderline Personality Disorder by Marsha M. Linehan
Dialectical Behavior Therapy in Clinical Practice: Applications across Disorders and Settings Edited by Linda A. Dimeff and Kelly Koerner
Doing Dialectical Behavior Therapy: A Practical Guide. By Kelly Koerner
Handbook of Personality Disorders. Edited by W. John Livesley and Roseann Larstone.
Integrated Treatment for Personality Disorder. Edited by W. John Livesley, Giancarlo Dimaggio, and John F. Clarkin.
Loving Someone with Borderline Personality Disorder: How to Keep Out-of-Control Emotions from Destroying Your Relationship. By Shari Y. Manning
Major Theories of Personality Disorder, Second Edition, Edited by Mark F. Lenzenweger and John F. Clarkin
Practical Management of Personality Disorder by W. John Livesley
Schema Therapy: A Practitioner’s Guide by Jeffrey E. Young, Janet S. Klosko, and Marjorie E. Weishaar
Treating Personality Disorders in Children and Adolescents: A Relational Approach by Efrain Bleiberg
Treatment of Borderline Personality Disorder: A Guide to Evidence-Based Practice by Joel Paris

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Borderline Personality Disorder

Further Reading