The Treatment of Borderline Personality Disorder
Borderline personality disorder (BPD) is characterized by pervasive and often debilitating difficulties in the emotional, behavioral, interpersonal, intrapersonal, and cognitive spheres. This chapter reviews the available psychotherapies for BPD in terms of both research support for the overall therapy and support for the putative mechanism of change that underlies the treatment. Dialectical behavior therapy (DBT) is a multimodal, principle-based therapy developed to enhance emotion regulation by balancing acceptance of the individual's emotional experience with problem-solving to promote behavioral change. BPD is strongly associated with debilitating psychological and functional impairment and is highly comorbid with other psychiatric disorders. In addition, BPD is strongly associated with dysfunctional behaviors such as nonsuicidal self-injury (NSSI) and chronic suicidality. Given the extent of the high-risk behaviors and substantial comorbidities that most patients exhibit, treatment for BPD is a complex endeavor.
