Treating Borderline Personality Disorder (BPD) With DBT

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If your loved one has been recently diagnosed with borderline personality disorder (BPD), you may have questions. You likely want to know more about their potential treatment and recovery journey.

Becoming educated about this condition is the first step toward supporting your loved one with BPD. To begin, you can learn how its signs and symptoms often manifest. Further, learning about different treatments available for BPD can serve as motivation for treatment entry and participation. Specifically, dialectical behavior therapy (DBT) has proven to be very effective in treating BPD.

At Pathways Recovery Center, we are well-versed in treating substance use disorder (SUD), mental health disorders, and especially co-occurring disorders. We understand the complex challenges that BPD can pose for treatment and recovery. Moreover, we are confident in our ability to help individuals with BPD achieve lasting symptom management and healing through the wide range of therapeutic services and programs that we offer.

Understanding Borderline Personality Disorder (BPD)

The National Institute of Mental Health (NIMH) explains that BPD “is a mental illness that severely impacts a person’s ability to manage their emotions.”

Such emotional dysregulation tends to encourage high-risk and impulsive behavior, leading to self-destructive tendencies. Commonly, individuals with BPD experience an unstable sense of self. This often interferes with their ability to maintain healthy interpersonal relationships.

Signs and Symptoms of BPD

NIMH explains that individuals with BPD tend to view situations and circumstances in extremes. The feelings that these individuals may have about themselves or others also tend to change quickly. This can trigger frequent relational conflict and emotional pain.

Additional signs and symptoms of BPD include:

  • Efforts to avoid abandonment (either real or perceived)
  • Distorted or unstable sense of self
  • Patterns of intense or frequently unstable relationships
  • Impulsive behavior that puts themselves at risk for further harm (eg. substance abuse)
  • Self-harming behavior
  • Feelings of hopelessness or emptiness
  • Frequent and intense mood swings
  • Issues with anger management
  • Feelings of dissociation
  • Suicidal ideation

Like all mental health disorders, BPD may not manifest in the same way in every case. Its signs and symptoms may vary from person to person in type, intensity, frequency, and duration.

BPD and the Brain

Many BPD symptoms are related to emotions and behavior. However, it is important to remember that all mental illnesses stem from dysregulation within the brain. Even addiction is known to be a brain disorder.

According to the Journal of Psychiatry & Neuroscience, “BPD has been linked to the amygdala and limbic systems of the brain, the centres that control emotion and, particularly, rage, fear and impulsive automatic reactions.” Research shows that for individuals with BPD, these brain systems are smaller in size and yet are also hyperactive.

Both genetic and environmental factors can contribute to an underdeveloped amygdala and limbic system. However, one of the most prominent factors is childhood trauma and adverse childhood experiences. An article by BMC Psychiatry explains:

As a consequence, children exposed to this adverse environment show inability to learn how to understand, label, regulate, or tolerate emotional responses and, conversely, they vacillate between emotional inhibition and extreme emotional lability.

Genetic vulnerabilities, such as having a relative with a mental health disorder such as SUD, can also increase an individual's risk of developing BPD.

Understanding Dialectical Behavior Therapy


Effective treatment for BPD must help individuals develop and restore emotional regulation skills. It should also reduce any self-harming or otherwise self-destructive behaviors. Fortunately, DBT was developed to achieve exactly those goals.

Marsha Linehan, a renowned psychologist, developed DBT by assembling evidence-based, cognitive-behavioral interventions aimed to target multi-problematic, suicidal behavior. DBT specifically was founded on dialectical philosophy, “whereby therapists strive to continually balance and synthesize acceptance and change-oriented strategies,” according to an article in Psychiatry (Edgemont).

Simply put, DBT combines cognitive-behavioral therapy (CBT) with mindfulness approaches to help clients better regulate their emotions. The main goal of DBT is to encourage clients to find a balance between accepting their symptoms, situations, and circumstances and working to change them. A variety of mindfulness skills are taught in DBT sessions. These can help clients focus on their symptoms and sensations in the present moment without judgment.

In addition to emotional regulation and mindfulness skills, distress tolerance and interpersonal effectiveness are the other core strategies used in DBT.

Using DBT to Treat BPD

An article by the Mental Health Clinician explains that DBT helps to address the maladaptive symptoms of BPD. It does this by replacing destructive behaviors with healthier coping skills.

When compared to community-based treatments, DBT is more effective as it:

  • Reduces parasuicidal behaviors
  • Increases treatment adherence
  • Reduces frequency of hospitalizations

The article also states, “Randomized controlled trials have shown the efficacy of DBT not only in BPD but also in other psychiatric disorders, such as substance use disorders, mood disorders, posttraumatic stress disorder, and eating disorders.”

Treatment for BPD at Pathways Recovery

At Pathways Recover Center, we are dedicated to providing client-centered treatment through a wide range of therapeutic approaches and interventions. We strive to use DBT alongside other mindfulness approaches like mindfulness-based stress reduction (MBSR), creative healing, and other holistic modalities to treat BPD and other mental health disorders. Moreover, our facility is passionate about whole-person healing.

Commonly, individuals with BPD often present with a co-occurring SUD or addiction. Fortunately, we have the expertise to help individuals heal from co-occurring conditions in any form. From detox to residential to outpatient treatment and more, we have what individuals need to achieve wellness alongside any mental health diagnosis.

Borderline personality disorder (BPD) is a challenging mental health disorder that often distorts an individual's self-image and understanding of the world around them. Fortunately, dialectical behavior therapy (DBT) was developed to target self-harming and suicidal behavior that often presents with BPD. DBT works to foster emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness strategies to replace maladaptive behaviors. At Pathways Recovery Center, we use DBT alongside several other therapeutic interventions to treat BPD and other mental and behavioral disorders. We offer numerous treatment programs to meet our clients where they are in their healing journey. To learn more about how we can help you, give us a call today at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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