1. Preventing Suicide
Since this is a serious illness, one of the first ways to treat borderline personality disorder with psychotherapy is to contract with the individual in order to prevent suicide. A contract is an agreement between the therapist and the patient that they will not try to commit suicide while they are undergoing therapy. Self-injurious behavior like wrist cutting is often associated with borderline personality disorder and it can lead to devastating consequences or death if not addressed at the outset of psychotherapy. This contract may need to be reiterated over time, if the self-destructive behavior continues to exist after the therapy has started. Medications may help control mood swings and make it easier for the therapeutic process to continue.
2. Dialectical Behavior Therapy
The most successful treatment developed to date for borderline personality disorder is dialectical behavior therapy. Research on the treatment indicates that it is able to help individuals focus on the feelings behind the disorder and form better relationships. It addresses many of the core issues underlying borderline personality disorder and is usually conducted in a group setting instead of one-on-one. This type of therapeutic approach concentrates on changing cognitive processes that has shaped a person's personality from childhood and the way that a person perceives the environment around them.
This approach to therapy is comprehensive and expected to be long-term in nature. Since borderline personality disorder is deep-seated and chronic, it should not be expected to resolve within a short period of time. The personality disorder touches every facet of an individual's life including coping skills, relationships, workplace issues and even childhood memories. As such, it is necessary to have stable, structured interventions that can provide lasting results over an extended period of time.
3. Conflict Resolution
While it is not as effective as dialectical behavior therapy, conflict resolution has shown some degree of success in helping persons with borderline personality disorder cope with their illness. It focuses on reducing the issues for conflict within a relationship and helping individuals make better choices. This method has not been as effective in treating the disorder on an ongoing basis, since it does not address the underlying root issues with borderline personality disorder. These feelings of abandonment, extreme emotional distress and impulsivity may not be readily addressed through conflict resolution or social learning approaches to psychotherapy. Conflict resolution may help the individual make better choices in specific types of situations, however, and it should not be completely ruled out as an adjunct therapy.
