How to help someone with borderline personality disorder (BPD)
This article covers:
– What types of therapies are involved?
– What types of professionals are involved?
– The journey of recovery from borderline personality disorder
What types of therapies are involved?
Psychological therapies are used as the main form of treatment for borderline personality disorder (BPD). Psychological therapies can help the person to learn more helpful ways of coping. Some of these types of therapy will be discussed below.
Dialectical behaviour therapy
Dialectical behaviour therapy (DBT) is a type of talk therapy that focuses on helping people with BPD to manage their emotions and change destructive ways to more useful ways of behaving. This therapy can be provided individually and/or within a group. Research has shown that DBT can be highly effective in treating severe symptoms of BPD in young people.
The idea behind DBT is to help people with BPD by using two concepts, which includes validation and dialectics.
The therapist will work with the person to help them accept their own emotions and acknowledge that these are valid. The person will also learn to develop more openness to other opinions and ways of viewing situations. One of the main goals of DBT is to help the person to see things differently from their “black and white” view.
Mentalisation-based therapy (MBT) is a type of talk therapy that focuses on helping people to understand their own mental states and those of others, and how this relates to behaviour. This therapy can be provided individually and/or within a group. Research indicates that MBT can help to reduce symptoms of BPD in young people.
The idea behind MBT for people with BPD is to help them expand their awareness of mental states and situations, especially when interacting with others.
The therapist might work with the person to recognise their own mental states and to become more aware of other’s mental state through mentalisation. The person will have the opportunity to assess the validity of mental states. This will help them to respond in a more helpful way, as opposed to reacting impulsively in different situations.
Art therapy is a type of therapy that uses creativity to help the person with BPD to express their emotions. This can be especially helpful for the person who finds it difficult to voice how they really feel. Research suggests that art therapy can have many benefits for people with BPD.
Art therapy might involve different forms of art such as painting, sculpting, drama, dance movements and the use of music.
Art therapy courses are provided by trained therapists. They might provide weekly sessions that can last up to two hours. One of the main goals of art therapy is to help the person to express their thoughts and feelings in a way that is productive and informative.
Therapeutic communities (TCs) are environments that are structured and designed to bring together people with complex psychological conditions, such as BPD. Research has shown that TCs can be effective to help people with mental health issues in improving their overall quality of life and social engagement.
The TC might include a residential setting with a specialised programme, where the people involved can take part in different types of therapy and other activities.
Activities might involve chores, meal preparations, games, physical exercises, and community meetings. The aim is to help people with BPD to learn helpful skills and how to be part of a community.
What types of professionals are involved?
There are different professionals that may or may not be involved in the treatment process of BPD. These might include counsellors, psychotherapists, doctors/psychiatrist, mental health nurses, support workers, social workers, and occupational therapists. These terms might be confusing, but the main difference is in the training that each of these professionals have received.
In the UK, there is not much of a distinction made between counsellor or psychotherapist. Both professionals provide therapy. However, there are some slight differences between these two professional terms. These are outlined below.
Counsellors: Compared to psychotherapists, counsellors tend to have had a shorter training and they help people deal with their issues on a more short-term basis. There may be school-based counsellors available that children and young people can approach at their own school. Here at Mindsum, we have counsellors that are available to provide support.
Psychotherapists: Psychotherapy training tends to be longer. Psychotherapists can also give counselling but their approach to talk therapy is more in-depth, exploring the history and causes of certain behaviours and emotional issues. Here at Mindsum, we have psychotherapists that are available to provide support.
Doctors: These are professionals that are trained in medicine. This will likely be the family GP, who might find it necessary to prescribe certain medications that might help the person to cope with other issues, such as health problems.
Psychiatrist: These are professionals that are also trained in medicine. However, they also specialized in the field of psychiatry. Psychiatrists will prescribe certain medications that will help the person to cope with other mental illnesses or to calm the person down during a crisis.
Mental health nurses: Nurses trained in mental health might also be involved. If the person is in a hospital setting or is seen by a crisis team due to self-harm or suicide, a mental health nurse might help to give treatment by administering medication.
Support workers: Workers trained in helping vulnerable people to live better lives might also be involved with the person. This might be within a community setting or a crisis situation. Their role is to provide emotional and practical support (e.g. helping parents to cope, helping with paperwork, making child-care arrangements).
Social workers: Workers trained in protecting vulnerable individuals might also be involved. This might be within a community setting or a crisis situation. Social workers will problem-solve and organise the right support for the person to ensure their protection.
The journey of recovery from borderline personality disorder
Therapy for BPD can vary in length depending on the person’s needs and how they live their life. Usually, a complete course of therapy for BPD can last up to one year or longer. The treatment for BPD can look different for each person. But there are some things that are expected when going through therapy for this disorder.
This is an important phase, where the therapist and/or other mental health experts will get a feel of what is going on. The therapist might need to diagnose whether the person has BPD. This process can be quite complex, and it can take some time before a diagnosis can be confirmed. At this stage, the therapist will need to ask many questions. This will help to create a full picture of what is going on and to know what type of treatment will be most helpful.
Therapy sessions will take place individually and/or within a group setting. An important aspect of therapy sessions is the relationship that the therapist will build with the person. This will create a safe space that will encourage them to explore their difficulties. The sessions will equip the person to manage their emotions by developing more productive ways of reacting to themselves, certain situations, and other people.
Progress and setbacks
When having treatment for BPD, there will be progress and setbacks. It is important not to feel discouraged when this happens, as this is normal when dealing with a complex mental illness, such as BPD. These situations provide opportunities to discover new ways to move forward together with the mental health experts involved in the treatment.
The therapist will eventually prepare the person for the end of therapy. The end of therapy will take place once the person has made a lot of progress and has reached their treatment goals. This phase might not be easy for a person with BPD, as they might easily feel rejected or abandoned. However, a skilled therapist will help the person to develop as much resilience as possible, so that they can feel more confident to cope without the therapist.
There might be an agreement with the therapist to have a follow-up meeting once therapy is over. This is to check how the person is coping. If they are doing well, there will be no need for more support. But if they continue to have challenges, this will be an opportunity to have extra support.
List of useful resources
Borderline personality disorder
To read our information on BPD, you can click here to access the link.
Treatment for borderline personality disorder
Mental health UK offers some helpful information on what treatment for BPD can involve on their website. You can click here to access the link.
Introduction to counselling and psychotherapy
The British Association for the Counselling Professions (BACP) have a useful document on different aspects of therapy. To read more, you can click here to access the link.