DBT for
Borderline Personality Disorder (BPD)
Approximately 1.4% of US adults struggle with BPD each year.
DBT is an effective approach for treating BPD and related issues such as emotion regulation.
Is DBT effective for this diagnosis?
Dialectical Behavioral Therapy (DBT) is proven to be effective for treating Borderline Personality Disorder (BPD). There is plenty of research supporting this given that DBT was originally created to treat BPD. DBT specifically addresses the emotional dysregulation, interpersonal difficulties, and inability to tolerate the distress that is characteristic of BPD. If Comprehensive DBT is insufficient for your needs, we also offer Informed DBT at Guidepost DBT. Informed DBT integrates other evidence-based, cognitive-behavioral interventions into DBT to create a multidimensional treatment to best address your BPD.
What is Borderline Personality Disorder?
BPD is characterized by an ongoing pattern of instability in self-image, mood, and relationships. Those with BPD often experience intense emotions, avoidance of which can lead to self-destructive behavior. Following this, there is an elevated rate of suicidality among the population with BPD. Despite being classified as a ‘personality disorder,’ BPD is treatable. Before treatment, BPD can be mild or debilitating and harm your quality of life.
How does DBT support this diagnosis?
DBT can help clients learn to concentrate on the present moment, modify ineffective behaviors, and tolerate intense emotions. DBT support for these symptoms extends beyond the therapy session through phone coaching as a crisis intervention tool in addition to individual weekly psychotherapy and skills groups. DBT provides clients with structure and skills to better tolerate distress and guidance on how to apply these skills to the unique situations in their lives.
Do You Have a Borderline Personality Disorder?
Which DBT modules are most relevant for substance abuse?
Learn how to manage substance abuse through the 4 components of DBT: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
Mindfulness: Learn how to be truly present.
Mindfulness skills teach you how to focus on your current situations, stopping rumination on painful past experiences or future uncertainty. Regular mindfulness practice can help keep you grounded in the present moment and increase your mental stability. By being grounded, you are better able to recognize your impulsive behaviors and vacillating emotions and to cope ahead for future stressors.
Emotion Regulation: Learn to manage, change, and accept the different emotions, so that your emotions don’t control you.
Dysregulated emotions and irregular self-care can be exacerbated by substance abuse. DBT teaches Emotion Regulation skills to stop unwanted emotions from starting in the first place, regulate or change such emotions once they start, and learn to accept and become comfortable with unavoidable emotions. Many of the skills meant to regulate emotions also prioritize balanced sleep, eating, exercise, and prescription medication usage, all of which can help reduce urges to use.
Distress Tolerance: Learn to tolerate painful emotions and situations that seem unbearable, and avoid behavior that can make things worse.
Emotions often seem unbearable or intolerable, which can lead you to choose the coping method that provides the fastest relief, no matter the consequences. Distress Tolerance offers tangible skills to use in place of ineffective, impulsive behaviors that can make things worse. These techniques range from guided self-soothing skills, to easy-to-use methods that activate the parasympathetic nervous system, using your own body’s chemistry to reduce distress. Distress Tolerance skills like TIPP and Wise Mind ACCEPTS can help you tolerate the moment instead of resorting to substance use.
Interpersonal Effectiveness: Learn to communicate with others in respectful ways while maintaining healthy boundaries and upholding positive self-respect.
Substance abuse can place strain on relationships. DBT guides you in both being a good friend or partner and getting your needs met. Interpersonal effectiveness skills provide clear instruction on how to maintain relationships with others, ask for what you want, and uphold your self-respect. Interpersonal Effectiveness skills also provide tools to head off problems and better resolve conflicts before they become overwhelming.
References to research that demonstrate the efficacy of the treatment for the diagnosis
1. This study found that ACT and DBT treatments had positive effects on substance use disorders.
Stotts, A. L., Northrup, T. F. The promise of third-wave behavioral therapies in the treatment of substance use disorders. Current Opinion in Psychology 2, 75–81 (2015). https://doi.org/10.1016/j.copsyc.2014.12.028.
2. This article summarizes several clinical trials that found DBT decreased substance abuse in patients with BPD. It also explains the overlap between the two conditions.
Dimeff, L. A., Linehan, M. M. Dialectical behavior therapy for substance abusers. Addiction science & clinical practice 4, 39–47 (2008). https://doi.org/10.1151/ascp084239.
3. This study presents an analysis of how mindfulness can help prevent relapse in substance use disorders.
Breslin, F. C., Zack, M., McMain, S. An Information‐Processing Analysis of Mindfulness: Implications for Relapse Prevention in the Treatment of Substance Abuse. Clinical Psychology: Science and Practice, 9, 275-299 (2006). https://doi.org/10.1093/clipsy.9.3.275.