BORDERLINE PERSONALITY DISORDER
If you have been told or think you might have Borderline Personality Disorder (BPD) or symptoms of it, you are likely in a great deal of pain. Dr. Marsha Linehan, international expert on BPD, compares this condition to having third-degree emotional burns. Most people with BPD have experienced an extensive history of trauma and/or intensely invalidating environments, usually starting in childhood.
There are many different ways you might experience BPD, but almost all of the symptoms are related to dysregulation, such as:
Emotion dysregulation. You might find that your mood and emotion changes so rapidly, it's hard to predict. One small stressor may lead you to completely shut down for the day. Any criticism feels devastating. Your emotions are more intense than other people's emotions seem to be, and it's hard for you to get a handle on them.
Relationship dysregulation. Your relationships tend to be very "up and down." It's hard for you to know if your feelings about the people in your life will change from day to day (or moment to moment). You may have a lot of conflict in your friendships and romantic relationships. You may find it hard to form stable relationships.
Behavioral dysregulation. It's hard for you to control your impulses. You experience strong urges, and it's harder for you than most people to resist. You may find it hard to control problematic behaviors when you're upset, such as self-harm, suicidal threats, or suicide attempts.
Self dysregulation. It's hard for you to know who you are. You might find yourself constantly changing, trying on new ways of existing in the world. When you look inside, you may feel a sense of emptiness, or a lack of clarity, like looking through a kaleidoscope.
Cognitive dysregulation. When you're upset, your ways of thinking may drastically change. For example, you may believe people are intending you harm who have shown you consistent love.
You may relate to some, but not all of the above forms of dysregulation. You may experience these difficulties but do not relate to a BPD diagnosis, or feel that the concept of complex PTSD captures your difficulties more. The truth is, mental health diagnoses are often flawed, and many people who are diagnosed with BPD are actually reacting sensibly to horrific abuse histories. If you've been diagnosed with BPD, that may or may not be accurate. A trauma specialist can discuss with you what diagnoses seem to apply best to your specific struggles. And what's important is that, if these forms of dysregulation seem to apply to you, treatment can help.
DIALECTICAL BEHAVIOR THERAPY
If you are experiencing difficulties with regulating emotion, you will likely be offered at least some of the skills of Dialectical Behavior Therapy (DBT). DBT skills are, truly, essential life skills for any deeply feeling person. If you are experiencing most of the above forms of dysregulation, DBT may be the primary focus of your treatment. DBT is based on the idea that improving your life requires balance, such as balance between acceptance of yourself exactly as you are, and acknowledgement of the need to change.
DBT involves a great deal of learning of skills for daily living. These skills include mindfulness skills, emotion regulation skills, interpersonal skills, and distress tolerance skills. DBT involves receiving extensive education on how emotions and behavior work and how to help yourself problem-solve ways to build a better life. It's hard work, and can take some time to master. If DBT is the primary focus of your treatment, it may involve a longer treatment course.
Dr. Goodnight does not currently offer a "full model" DBT program. She offers individual DBT, between-session skills coaching, and referrals to local DBT groups. Depending on how severe your symptoms are, you might benefit from services of a more comprehensive DBT program. If you are not sure, feel free to call and consult with her at (678) 298-9707.