Dialectical Behavior Therapy To Treat Borderline Personality Disorder

Dialectical behavior therapy (DBT) is an evidence-based treatment for borderline personality disorder (BPD).

Imagine Regina, a woman who constantly battles feelings of self-doubt and worthlessness at work, convinced she is constantly failing to meet expectations. This creates a cycle: Because she feels she doesn’t succeed, she loses motivation to try, and as a result, her performance declines even further.

This pattern of thinking is common in individuals with BPD, where an unstable sense of self can lead to a sense of hopelessness, often accompanied by challenges in regulating emotions.

With DBT, Regina can recognize that the situation isn’t hopeless. Although she may feel dissatisfied with her performance at work, she still has the opportunity to improve.

What Is Borderline Personality Disorder (BPD)?

BPD is a complex condition that can affect both adults and teens and is marked by intense, unstable emotions, relationships, and self-image. The condition usually starts in the teenage years and gradually improves over time.

BPD affects a person’s moods, thinking, behavior, and identity, often leading to impulsive actions and difficulty with self-soothing. People with BPD experience heightened emotional sensitivity, fear of abandonment, and struggle with distress and anger, which can impact relationships.

It’s not unusual for people with BPD to live with other mental health conditions, such as eating disorders, anxiety, depression, and substance use disorder.

The good news is that there is hope for individuals with BPD. Those who seek treatment often find relief from their symptoms and can live more grounded, fulfilling lives.

What Is Dialectical Behavior Therapy?

DBT is a type of psychotherapy or talk therapy. In it, the person diagnosed with BPD works with others in order to reassess their current behaviors and ways of thinking and establish new, healthier patterns.

At its core, DBT combines cognitive-behavioral techniques with mindfulness practices to help individuals manage their emotions and behaviors more effectively. The therapy is called “dialectical” because it aims to balance two seemingly opposing forces: acceptance and change.

The focus on acceptance encourages individuals to understand and validate their emotions without judgment, while the focus on change encourages the development of healthier coping strategies to replace self-destructive behaviors.

3East Adolescent DBT Programs

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McLean’s adolescent dialectical behavior therapy programs, collectively known as 3East, provide specialized care for teens and young adults. Call us today to talk to admission staff.

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617.855.4650
Patient speaking with a therapist on a park bench

How Exactly Does DBT Work for BPD?

While there are different ways to implement DBT, the traditional approach is to break the therapy down into four main elements:

  • Skills training: In this component, individuals learn four main coping strategies for when they’re feeling dysregulated. These include mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
  • Individual therapy: Individual therapy focuses on diving into the reasons a person feels the way they feel and implementing the above skills in real-world situations.
  • Phone consultations: Phone consultations help patients with BPD apply therapy skills in real time, especially during crises, by encouraging healthy help-seeking behavior. Patients who are considering self-harm are asked to contact their therapist before engaging in these behaviors. After any self-harm, a 24-hour no-contact rule is imposed to prevent reinforcement of self-harm and promote earlier intervention.
  • Consultation team: Therapists meet as a team to maintain motivation and commitment when working with BPD patients. It helps therapists manage stress, promote empathy, and focus on accepting the patient rather than forcing change, ultimately reducing self-harming behaviors.

The combination of these approaches helps people with BPD overcome the instability, emotional insecurity, fragility, and impulsivity that characterize this mental health disorder.

Why Does DBT Work So Well for BPD?

The main reason DBT is so effective for treating BPD is that it doesn’t just help individuals cope with everyday issues—it fundamentally changes how they understand and respond to their emotions and how they connect with others in relationships.

This deeper level of transformation allows people to build healthier emotional patterns and improve their interpersonal dynamics, making DBT a powerful tool in long-term recovery.

People with extreme emotional reactions often develop behaviors that may seem irrational or harmful to others. To the individual with BPD, though, these behaviors make sense—they help manage the feelings within.

Because DBT doesn’t punish those feelings but instead shows the individual a better way to accept and deal with them, patients can stop working so hard to shut those feelings down (through negative thoughts and actions) and begin to learn acceptance.

By validating their experiences and providing a supportive environment, DBT empowers individuals to accept themselves while also working towards meaningful change.

Watch Now!

Dr. Anna Precht helps us understand the power of DBT

Living With BPD

Once you leave the therapist’s office equipped with DBT skills, applying those techniques in your daily life is the real test. Consistently using these strategies can truly transform your ability to manage emotions.

It’s important for anyone who has been diagnosed with BPD to understand they are not alone. Many people have BPD and, at times, experience emotional distress from the condition.

However, you don’t have to resort to living a life that’s full of pain and heartbreak. It’s important to take care of yourself, recognize your triggers, and work with your health care team to determine what treatments will work best for you.

By committing to care and learning as much as possible about it, you can make a difference in your quality of life—and the lives of those around you.

Want More Information?

Looking for even more information about dialectical behavior therapy and borderline personality disorder? You may find these resources helpful.

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