Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
Borderline Personality Disorder (BPD) is a psychological disorder affecting
about 1 to 2% of the population. It occurs more frequently in women than in
men. BPD is associated with severe emotional suffering and impulsive behavior.
Research shows that the symptoms of BPD can be improved significantly
BPD is considered a “personality disorder” by the American Psychiatric
Association’s Diagnostic and Statistical Manual, 4th edition (DSM-IV).
Personality disorders typically begin in adolescence or early adulthood and continue
over many years. Personality disorders often cause a great deal of distress
and interfere with a person’s ability to achieve fulfillment in relationships, work,
or school. Although personality disorders are usually not formally diagnosed
until adulthood, there are often early signs in adolescence. In BPD, such signs
could include heightened emotional sensitivity and reactivity, problems maintaining
long-term relationships, and intentional self-injury.
Individuals with BPD often suffer from other psychological problems, including
depression, substance use, post-traumatic stress disorder, bipolar disorder,
and eating disorders. Approximately 75% of individuals with BPD have attempted
suicide, and self-injurious behavior (such as cutting oneself) is quite common.
Such behaviors contribute to the seriousness of the disorder and often
prompt the sufferer - or the individual’s family members - to seek help from a
mental health professional. Many individuals with BPD have been hospitalized
one or more times, often following a suicide attempt or when professionals think
there is a high risk of suicide.
The characteristics of BPD mainly fall into five different problem areas:
Emotion: “Emotion dysregulation” is a core feature of BPD. This is the tendency
to experience frequent and intense emotions, and take a long time to recover
from emotional experiences. Individuals with BPD sometimes feel like they are
on an emotional roller coaster with very quick shifts in mood and emotions.
Many individuals with BPD have frequent experiences of intense anger, fear,
sadness, and shame, often related to the behaviors described below.
Behaviors: BPD is commonly associated with impulsive behaviors that are
potentially self-damaging, including drug and alcohol use, spending sprees,
risky sexual behaviors, and binge eating episodes. Intentional self-injury, including
behaviors such as cutting or burning oneself, head banging, or asphyxiation
(with or without the intent to die) is frequently seen in people with BPD.
Relationships: Individuals with BPD often describe their relationships with
romantic partners, family members, and friends as stormy, intense, and full of
conflict. Relationships tend to have a lot of ups and downs. BPD sufferers often
fear abandonment, worrying frequently that loved ones may leave them. As a
result, individuals with BPD may beg or plead with loved ones to avoid real or
Identity: Individuals with BPD often feel as though they do not have a clear
sense of self. They may have trouble describing who they are. Sometimes this
can be seen in frequent changes in jobs, friends, and life goals. In addition,
BPD sufferers describe chronic feelings of emptiness.
Thoughts: Sometimes, individuals who have BPD can experience intense
feelings of paranoia (feeling like others are out to get them) or dissociation
(feeling spaced out or as though things are unreal; or realizing that they were
not aware of what just happened). These types of changes in thinking tend to
happen when there is a great deal of stress.
A person with BPD may not have problems in each category listed above
and not all the problems may be apparent at any given time.
There is no known single cause of BPD. Similar to other psychological disorders,
BPD is likely caused by a combination of biological, social/environmental,
and psychological factors. Many people with BPD, though not all,
have experienced emotional, physical, or sexual abuse as children. On the
other hand, there are people who were abused as children who do not have
Can Psychotherapy Help?
BPD was once considered a lifelong, untreatable diagnosis. However, recent
studies show that people with BPD often improve significantly over the
course of their lifetime. Often this is achieved through some form of psychotherapy,
although some individuals report improvement without psychotherapy.
Cognitive-behavior therapists who treat BPD often use a particular therapy,
called Dialectical Behavior Therapy (DBT). DBT has been evaluated in
several research trials and shown to be effective for reducing suicidal behavior
and other BPD characteristics over time. DBT has many components and
generally individuals are encouraged to sign on for the full package of treatment
for at least 12 months. The full package of DBT includes one-on-one
therapy with a professional, skills training, phone consultation with the therapist
as-needed, and a weekly consultation team for the therapists. The skills
training portion is aimed at helping individuals learn ways to regulate emotions,
tolerate distress, and interact with others more effectively.
Other therapies that incorporate cognitive-behavioral techniques to treat
BPD include cognitive therapy and schema-focused therapy. Both of these
treatments tend to focus more on changing an individual’s patterns of thinking.
The patterns that are targeted include working to reduce “black and
white” thinking as well as those core beliefs that don’t match reality, like
believing you are a terrible person or unworthy of love. The therapist works
actively with the client to come up with alternative, healthier, and more
adaptive ways of thinking about themselves, others, and the world.
Individuals with BPD also are often treated with psychotropic medications.
Presently, there is no medication that is FDA approved specifically for
BPD, but there are medications that have been shown to reduce particular
symptoms of BPD in clinical trials. For example, mood stabilizing medications
may reduce impulsive behavior and mood changes, antidepressant
medications may reduce sadness and anxiety, and antipsychotics may reduce
paranoid thinking and anger in patients with BPD.
Unfortunately, BPD is associated with three different types of high-risk
behaviors: suicidal, impulsive, and self-injurious behaviors. About 8% of
people with BPD kill themselves. As noted above, self-injury is often seen
among people suffering from BPD and is a particularly serious problem that
sometimes leads to unintentional suicide in people with BPD. If you, or
someone you know, engage in self-injury, it is important to seek appropriate
help as soon as possible.
Resources for Family Members
Family members and partners of individuals with BPD often feel like they
themselves need support in dealing with the person with BPD. Family members
can feel at a loss for how to deal with individuals when they are so emotionally
out of control or when they continue to engage in behavior that
seems so self-damaging. Recently, a number of organizations have come into
being with the explicit purpose of providing education and resources for family
members. These organizations often put on meetings that provide psychoeducation
about the disorder as well as tips for interacting with the person
with BPD. They also often provide referrals for the family members if
they choose to seek therapy for themselves. Here are a few resources that
may be useful for family members:
The mission of NEA-BPD is to “raise public awareness, provide education,
promote research on borderline personality disorder, and enhance the quality
of life of those affected by this serious mental illness.” NEA-BPD frequently
has workshops around the country and family members are encouraged to
attend. You can also listen to a number of presentations on the NEABPD
website by leading experts in the field.
The mission of TARA is to “to foster education and research in the field of
personality disorder, specifically but not exclusively Borderline Personality
Disorder (BPD).” TARA has a number of local chapters throughout the U.S.
for family members to join.
For more information or to find a therapist:
Please feel free to photocopy or reproduce this fact sheet, noting that this fact sheet was writen and produced by ABCT. You may also link directly to our site and/or to the
from which you took this fact sheet