Treatments for PD's

This week I've been spending sometime thinking about treatment for personality disorders. Sometimes working with people who have personality disorders is difficult. Ok, it’s almost always difficult. There is a myth in the field of helping professionals that PD's are untreatable. False. While it can be wildly challenging, it is not impossible to see progress in people diagnosed with PD's. As more research is conducted in order to develop and test treatment interventions for people with PD's, two therapeutic approaches that show real promise: Dialectical behavior therapy (DBT) and Cognitive therapy (CT).  These treatment modalities are mostly directed at treating Borderline Personality Disorder, the most researched of all the PD’s.

 DBT was developed by Marsha M. Linehan, a psychology professor who developed the therapy to help people with BPD learn to control their emotions It is composed of individual and group counseling focusing on distress tolerance, emotional regulation, mindfulness and interpersonal skills. DBT helps people struggling with controlling their emotions learn healthy coping mechanisms in order to refrain from resorting to the use of physical pain (self-harm) and gain control over extreme, overwhelming and confusing feelings. I have gotten some experience with DBT over the past 6 months running therapy groups at my internship at the hospital. I've found it to be especially helpful for teaching patients how to recognize and regulate their emotions.

 The link below is a short video that discusses DBT in a nutshell and what makes it so effective in treating DBT: Treatments for Borderline Personality Disorder (DBT). 

This short video shows Dr. Linehan discusses how she came to develop DBT as well as providing an additional sense of what DBT is all about. Marsha Linehan DBT 

While DBT works to help a client gain emotional regulation, Cognitive therapy is an additional evidence based treatment shown in the literature to be effective in treating BPD. In fact, Judith Beck PhD. Of the Beck Institute for Cognitive therapy applies the constructs of CT as effective in treating all of the personality disorders. CT works to identify and alter faulty core beliefs a person has about themselves, other people, and the world on a global level.  To help restructure these faulty beliefs, CT therapist dig to identify beliefs that often originated in childhood, to help the person reinterpret the early childhood events that formed them.

From, my experiences these two theoretical perspectives are effective when working with people who have BPD. However, I see patients in a very time limited, crisis stabilization environment and, as I've said already, often the majority of the skills of DBT are taught in a group counseling session. This mode of delivery is often highly facilitative for helping people learn emotional regulation skills and learn to identify irrational beliefs that need to be restructured as patients learn to identify with and relate to one another as they describe and discuss their life experiences.

Until Next Time,
Kim