Our consciousness is nothing more than a delicate balance of chemicals in our brain. Any imbalance in this can lead to mental disorders ranging from mild depression to outright insanity – Borderline Personality Disorder (BPD), a condition in which the patient experiences an ongoing pattern of varying behavior and moods, is a perfect example of this.
Though Borderline Personality Disorder is caused due to chemical causes at the core, it can be treated without chemical intervention, i.e., the use of medication. Dialectical Behavior Therapy (DBT) is one of the most effective non-chemical ways to help reduce or eliminate BPD symptoms.
What is Borderline Personality Disorder?
BPD is an illness characterized by a prolonged pattern of varying moods, behavior, and sense of self-image. The implications of this illness range from impulsive actions to troubled relationships and more.
People suffering from this disorder can exhibit some or all of the following symptoms:
- Episodes of intense depression, anger, and anxiety, which can last between a few hours and several days
- Unstable relationships
- Severe and frequent mood swings
- Rapidly changing interests and values
- Seeing the extremes in every situation, all good or all bad
Out of all psychological treatments that can be used to treat BPD, Dialectical Behavior Therapy is a highly effective option. Let’s see what it is.
What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy was developed by Marsha M. Linehan, a psychology researcher at the University of Washington. DBT combines the standard cognitive-behavioral techniques of emotion regulation and reality-testing with the concepts of acceptance, mindful awareness, and distress tolerance.
The effects of Dialectical Behavior Therapy include reduction of substance abuse, hospitalization due to psychiatric reasons, and suicidal tendencies. DBT also decreases the severity of the general symptoms of BPD.
The basis of DBT is the biosocial theory of mental illness. It is the first therapy that has been experimentally proven to be effective in curing BPD. But before we learn how effective this therapy is, let’s first see the theoretical framework behind it.
Theoretical Background of DBT
Dr. Linehan’s theory states that the actual problem with a person suffering from BPD is emotional dysregulation.
She establishes that emotional dysregulation results from various biological and genetic risk factors coupled with an emotionally unstable childhood. Examples may include parents or guardians with erratic, punishing, or trivializing attitudes towards children.
DBT aims to engage the patient in healthy activities and to teach them useful skills. According to Dr. Linehan’s theory, these skills slowly phase out self-harming and otherwise unhealthy approaches to coping with the problems.
Is DBT an Effective Treatment for BPD?
A recent study on Dialectical Behavior Therapy found it an effective treatment for BPD.
According to the research data gathered and analyzed by StuffThatWorks.health, DBT is currently ranked as the #1 most effective treatment for BDP. StuffThatWorks’ data shows that out of all people who underwent DBT, the therapy worked ‘extremely well’ in 13% of cases and ‘very well’ in 75% of cases.
StuffThatWorks’ data on DBT is not the only study conducted to find the effectiveness of this condition as a cure for BPD. There are several other studies, as well.
Research Support on Effectiveness of DBT
DBT was the first psychotherapy that showed considerable improvement in the condition of patients suffering from BPD. It was established by Linehan, M. M.; Armstrong, H. E.; Suarez, A.; Allmon, D.; Heard, H. L. in their 1991 paper titled, “Cognitive-behavioral treatment of chronically parasuicidal borderline patients.” The results were derived based on controlled clinical trials.
Another recent paper, titled “Effectiveness of dialectic behavioral therapy in routine outpatient care: the Berlin Borderline Study” by Stiglmayr C, Stecher-mohr J, and Wagner T., determined that 77% of the people did not exhibit the symptoms of BPD after receiving DBT group sessions for a year. This research also established DBT as one of the most viable and effective treatments of all options currently available .
Though DBT is not the only therapy effective against BPD, it is one of the best options if you consider the documented success rate. However, the results and effectiveness of this therapy depend a lot on the way it is conducted.
How is DBT Carried Out?
DBT is usually a combination of individual psychotherapy, group skills training, and phone coaching. There can be some exceptions based on each patient.
Patients receiving the therapy are required to monitor and keep a record of their symptoms. The person conducting the therapy also keeps a record of them. The main focus of the therapy is to teach four types of skills to the patients, which form the basis of the treatment.
These skills are as follows:
1. Mindfulness Meditation Skills
Mindfulness meditation skills focus on being entirely in the present. They introduce the concept of living your life one day at a time, as described by Dale Carnegie in his book ‘How to Stop Worrying and Start Living.’
Patients are taught to observe, describe, and participate in everything they experience. This ranges all the way to sensations, thoughts, and emotions that the person feels internally, as well as the things happening around them. The aim is to absorb everything without labeling it as good or bad. It is a core skill that is needed to effectively implement all other skills learned in DBT.
Mindfulness meditation skills gradually enable the patient to consider all factors concerning any situation that they might encounter in real life and react accordingly, eradicating the erratic behavior that results in complications in their relationships.
2. Interpersonal Skills
Interpersonal skills are taught to the patients to help them assert their needs and effectively interact with others. The effects of these skills include dealing better with others, as well as improved relationships.
3. Distress Tolerance Skills
The focus of this skills module is to help the patients to learn ways to tolerate and accept distress.
Patients are trained to handle stress without indulging in things that can make the situation worse in the longer run. The effects of this skills training are seen in the form of the reduced tendency of self-harm and substance abuse.
With enough training and long-term therapy, the patient begins to realize how to handle any given situation in a way that will have no negative implications.
4. Emotion Regulation Skills
This module of DBT teaches the patients to identify and manage their emotional reactions. These skills aim to help patients enhance, reduce, or suppress emotions, according to the need of any given situation, to effectively achieve their individual goals.
After successful sessions, the patients are able to interpret their emotions in a better way. DBT eventually instills in them the ability to manage and express their emotions in a non-destructive way.
That’s exactly what the main aim of this therapy is – to make the patient able to take on emotional strain without buckling.
Dialectical Behavior Therapy is not, strictly speaking, a cure for Borderline Personality Disorder. However, it has been found to be very effective in managing and reducing the symptoms linked with this condition. DBT is currently one of the most successful ways of treating BPD to the maximum degree possible.