Treatment for Borderline Personality Disorder
Psychotherapy is nearly always the treatment of choice for this disorder; while medications may be used to help stabilize mood swings. Controversy surrounds overmedicating people with this disorder, because it is easy to misdiagnose and because it is very tempting to medicate the immediate distress.
Hospitalisation and medication are both essential tools for treating crises, but have potentially little or damaging long-term effects.
While medications can usually help some symptoms of the disorder, they cannot help the patient learn new coping skills, emotion regulation, or any of the other important changes in a person’s life.
An initially important aspect of psychotherapy is usually contracting with the person to ensure that they do not commit suicide. Suicidality should be carefully assessed and monitored throughout the entire course of treatment. If suicidal feelings are severe, medication and hospitalization should be seriously considered.
Borderline Personality Disorder is extremely difficult to treat and historically was called a “rubbish bin diagnosis”; if you got the diagnosis you couldn’t be help and got “thrown away”. This is no longer the case; in fact, in the last 20 years several specialised treatments have developed. These are all more or less well established treatment methods, that have developed specific approaches for BPD. Many have now been used to treat other difficult disorders.
Providing a structured therapeutic setting is important no matter the therapy modality. People with this disorder often “test the limits” of the professional when in treatment. Clear, well-defined boundaries of the therapeutic relationship needs to be carefully outlined at the onset of therapy. This helps the client understand why certain decisions are made when their thinking “shuts down” as emotions rise and helps to clarify some of the complex interpersonal dynamics that can be very confusing to people with BPD.
In the treatment of BPD our primary therapeutic method will be Mentalization Based Therapy (MBT) informed by Schema Focused Therapy (SFT) with a sustainable focus on relational patterns using Attachment Object Relations Theory and System Principles.
Our lead therapist, Kael Cockcroft is a fully trained MBT practitioner with discipline founder, Anthony Bateman as his training supervisor, and have extensive experience in group, family and individual MBT therapy, including developing several treatment programmes. Kael has run groups for BPD and Anti-social PD as well as pioneered using MBT with psychosis, including the training of other clinical staff. This method meets all the established criteria of working with BPD and ongoing research from around the world is providing evidence of its effectiveness.
In our practice we may use some schema tools to enhance the work that related directly to a sufferer’s internal identity struggles. When there is a focus on interpersonal dynamics within the therapy, psychodynamic methods are extremely sophisticated, and when exploring family relationships, a Systemic lens often opens new avenues. MBT was developed as a Meta-Therapy to boost the core therapeutic alliance between therapist and client, it therefore, provides a powerful framework to integrate well established resources from different therapy methods.
What can I expect?
Treatment will be individual session, most usually weekly. We will focus on your current life working on difficulties that you have functioning and in relating to others. There will not be homework tasks in the same way that is often used in symptom focused treatments, but we will be working on you learning new coping and social skills.
There will be a clear contract outlining how we will work with monthly reviews as well as an action plan for difficult periods. We have guidance for making use of resource materials available in the media and online, and our psychiatrist can be involved in any medication and/or admission needs.
Our Borderline Personality Disorder Portal
The following pages are designed to provide additional information and advice on BPD treatment and our approach: