Managing borderline personality disorder

Being diagnosed with Borderline Personality Disorder (BPD) can often be validating for some. Having difficulties for years and being diagnosed can lead to positive feelings and thoughts similar to "yes, I finally know what has been going wrong, I'm not just going crazy, this is what it is and it can get better". The opposite can also be true for many people.

So you now have a diagnosis - how can therapy help?

Due to the difficulties in regulating emotions and disruptions in relationships (inclusive of friends, partners and families), which is often characteristic of individuals with BPD, many individuals adopt self-harm behaviours or suicidal ideations. It is important to work with alternate self-soothing strategies. In time, this can help people to expand their tolerance of emotions and find more adaptive ways of coping.

Often, people have acquired BPD partly due to adverse experiences or trauma. It is important to learn how trauma effects the mind, brain and body and what can be done to help reverse the effects as much as possible. After a trauma, or adverse experience, a person's baseline level of arousal can be significantly altered, and arousal levels can be jolted more easily. This means that people can be knocked into "fight, flight, or freeze" mode more easily, their relaxed state is often much higher than the baseline of people who have not met BPD criteria, and are more likely to be triggered into anger, rage, anxiety, or depression. Simply put, the nervous system is conditioned to high alert and the aim of therapy is to re-condition the nervous system and process the difficulties in the person's life. 

After these have been worked on, and skills in emotional regulation, self-soothing and grounding (remaining present and connected) have been practiced, processing past experiences and present situations can them be done in a safer manner as the individual is more equipped to manage the extremes of their emotions and can experience past events as completed and not reoccurring. Processing the meanings attached to difficulties is a common task in therapy; plus worldview or outlook is often shaped by adverse experiences. So is processing loss, as there is often some form of loss (the loss of a person, the life I should have had, the person I used to be, the person you should have been for me). Working through self-acceptance is often a crucial task also.

Integrating new knowledge, new skills, new meanings and acceptance into your life are the main tasks of therapy. Once these have been achieved, life can become more manageable. A real sense of control is possible as well as mastery over yourself through the difficulties that life challenges us with. 

It is not an easy task by any means. There is a saying that I heard from people in addiction groups of "life doesn't get better, but we do". I do agree with this mostly, we can get better and life will always be life. However, with successful therapy we will be in a better position to create a better life for ourselves.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Guildford GU2 & Woking GU21
Written by Craig Coventry, MBACP(Accred.), MA, BSC
Guildford GU2 & Woking GU21

I am a counsellor, psychotherapist and trauma therapist based in Guildford and Woking.

A registered member of the BACP.
MA Integrative Counselling and Psychotherapy- University of Roehampton.
BSC Psychology and Counselling- University of Roehampton.
Additional Trauma therapy training through the Wealden Psychology Institute.

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