Therapy Techniques for Borderline Personality
According to the National Institute of Mental Health (NIMH), Borderline Personality Disorder, or BPD, is a serious mental illness which is characterized by “unstable moods, behavior, and relationships.” BPD was first listed as a mental illness in 1980 in the Diagnostic and Statistical Manual for Mental Disorders, Third Edition. Since then, it has been estimated that approximately 1.6% of the U.S. population has been diagnosed with BPD. Interestingly, 75% of diagnosed patients tend to be women, but newer research suggests that there may be just as many men as women who suffer from BPD. Previously, according to the National Alliance on Mental Illness (NAMI), men with BPD may have been misdiagnosed as suffering from PTSD or depression.
Many individuals who suffer from BPD experience difficulty in regulating their emotions or thoughts or may be inclined towards impulsive or reckless behavior. They may also have difficulty maintaining stable relationships with other people because the fluctuate between idealization and devaluation. This behavior is also known as “splitting” since they seem to switch between one emotional extreme and another.
Treating Borderline Personality Disorder with Therapy
Unfortunately, the exact causes of BPD are still under debate, but many scientists agree that genetics and environmental factors play a huge influence. That being said, there are ways to address and treat BPD to make life a little easier for individuals struggling with the disorder. Mindfulness therapy can be a huge help because it can encourage slowing down and grounding oneself to become more self-aware and recognize how certain impulsive urges can potentially be harmful. Describing the sometimes overwhelming nature of BPD, Dr. Blaise Aguirre, assistant professor of psychiatry at Harvard Medical School states: “For people who struggle with impulsivity, the often-dangerous consequence of impulsive behaviors, can, over time can lead to a sense that there is nothing to do, and that it is your destiny to have bad things happen to you. By definition, impulsivity is acting on an urge instead of thinking about the action and consequence.”
Thus, the key to overcoming the potentially dangerous impulsive urges that accompany BPD is through practicing mindfulness. Previously, we’ve addressed how mindfulness therapy can help overcome depression and anxiety, but it is also particularly useful for BPD. Dr. Blaise Aguirre explains the effectiveness of mindfulness therapy on BPD as follows: “The practice of mindfulness in targeting impulsivity is mostly about working with urges rather than reacting. The goal is to avoid acting on strong urges and to become familiar with what happens to your emotions and thoughts in these moments. Then, by knowing your mind, being able to slow down and choosing a different course of action.”
Because mindfulness therapy can be enormously helpful in combating the impulsivity of BPD, let’s look at 3 techniques one can employ help build a resistance to some of the symptoms:
1. Staying Still
For the most part, many of us can identify the impulsive behaviors which get us into trouble. As you develop an awareness of your thoughts and behavior, the realization may arise that in certain situations perhaps the best course of action is none at all. Dr. Aguirre advises that individuals with BPD identify a potentially self-destructive behavior that one is prone to doing when alone and make a commitment that the next time the urge arises to engage in that behavior the individual will instead practice not moving. The challenge here, then, is to essentially commit to resistance. Dr. Aguirre explains: “nothing lasts forever even when things feel like they will. For some people the urge will pass in a short while and for others, it could take quite a bit longer! As you sit or lie down, focus your attention on your breath, and notice the urges, labeling the urge as an urge.” He suggests that over time, intentionally doing nothing will result in reducing overall impulsivity.
2. Learning to Focus
There are times in life when we might be faced with certain situations which may trigger impulsive actions. For example, in situations when we feel emotionally provoked – such as when we receive an upsetting message from someone – might feel more inclined to react impulsively due to our innate emotional response. Acting upon these impulses can lead to instantaneous regret, just as we might regret sending an angry text message or snapping at someone versus telling them how we actually feel. The first step is to identify a situation when an impulsive behavior occurred, then, if and when this situation presents itself again, practice identifying the emotions at play which motivate the urge to act on a behavior which may provide short-term relief but long-term regret. Dr. Aguirre suggests: “ As you notice the intensity of the anger begin to heighten, and the urge to act becomes stronger, shift your attention to your toes.” Why toes? It’s a way of shifting one’s attention from the impulsive urges to something more sensational. While often neglected, feet, toes, and even posture can be a means of redirecting one’s attention from a harmful urge to a far more benign source.
3. Practicing Resistance
As we’ve already explored, an important part of using mindfulness to combat the impulsiveness of BPD is to practice resistance. This can be done in a number of ways, but another useful method of teaching oneself how to resist urges is to sit down and try to resist the urge to swallow. What does this mean? Swallowing saliva can be one of the most basic urges we have, which makes it a prime target for practicing urge resistance. Set a timer for one to two minutes and begin. As we resist this urge, we will begin to notice it intensify. Addressing this, Dr. Aguirre states: “You don’t have to give in to the urge. When the timer rings, swallow! What this practice teaches is that you might have an urge (in this case to swallow) but you don’t have act in the moment of the urge. You have the choice of controlling when, or if, you will act.” This resistance can then be applied to other instances of urges motivated by BPD.
By learning mindfulness and practicing these techniques, individuals struggling with BPD can learn to better take charge of their impulses and be in control of themselves, rather than allowing BPD to do so instead. The key is, as always, to practice, and self-control will follow.