What is Borderline Personality Disorder (BPD)?
Borderline Personality Disorder is often described as a person who feels that they have a sensitive emotional thermostat.
BPD often affects people's relationships because it clouds their ability to see things objectively, or neutrally. It is common for someone with BPD to fear abandonment and feel highly emotional, which can have a negative impact on maintaining healthy relationships with themselves and others.
Other strong characteristics may include dissociating or feeling outside of one's body, feeling very intense loneliness or emptiness, and angry outbursts. At times the internal dialogue, emotions or understanding of a situation can seem disproportionate to what is considered appropriate in a situation, which can lead to further feelings of isolation and sadness and create further breakdown in relationships.
We understand how distressing this can be and will work with you to find balance and different outlooks.
Some common traits of BPD may include:
- fear of abandonment;
- fear of judgment;
- frequent and extreme mood swings;
- self harm;
- suicidal thoughts;
- and impulsivity.
Some of the biggest distressing factors we see with BPD are the inability to self-regulate emotions while managing chronic stressful symptoms of anxiety, fear and anger.
We often see a strong connection between childhood developmental trauma and the development of BPD, but not in all cases, and for some people symptoms start presenting as early as 12 years of age. Some of these early risk factors can include adverse childhood experiences (ACES) where people witness or are subject to abuse, neglect and trauma.
Chronic stress in childhood can cause one’s brain to be on high alert and develop maladaptive coping methods, which may work to shield the child from the reality of what they are witnessing and provide relief, however prove to be more harmful and disruptive to healthy relationships and good mental health later on in life. Our team takes a strengths based approach to supporting individuals with BPD and work to help them find useful, effective and practical solutions and tools to use in daily life to reach their unique goals.
Another factor in BPD is the way one's brain is structured and this can include a family history of mental illness. There is evidence that suggests that activity or abnormalities in areas of the brain that control impulsivity and emotional regulation are contributing factors. It is also more likely for the offspring of someone with BPD to have a higher chance of developing BPD themselves. It's important to note that childhood risk factors and brain chemistry can place someone at a higher risk for BPD but it's also possible for all of the risk factors to be present and the individual not to have BPD, where there are seemingly no risk factors. It is best to take these into consideration and examine the present symptoms.
People are often misdiagnosed or have other mental health diagnoses in tandem with a BPD diagnosis. This can lead to people feeling hopeless, but we are here to help you find the right interventions to gain awareness, build healthy coping skills and tools, as well as work on ways to minimize the overall stress associated with these symptoms.
Approaches to Therapy Treating Borderline Personality Disorder (BPD)
We treat BPD using Cognitive Behavioural Therapy (CBT) to help people gain self awareness and a balanced approach to thinking, Dialectical Behavioural Therapy (DBT) to understand how to cope with intense emotions in the moment, Brainspotting therapy to understand the underlying factors of trauma by bypassing the conscious parts of the brain, and Compassion Focused Therapy (CFT) integrating distress tolerance, coping strategies, and mindfulness skills.
Brainspotting therapy™ (BSP) is a therapeutic process that uses specific points in the client’s visual field to access unprocessed trauma in the subcortical brain. BSP uses relevant eye positions, somatic awareness, focused mindfulness, and the therapist’s attunement to process and release the stored traumas which underlie a wide range of emotional and physical problems. It is a brain-body-based treatment that integrates well with other types of therapies. Often brainspotting is used in conjunction with bilateral sound - music or nature sounds that move back and forth between right and left ears, which balances activation of the right and left brain hemispheres and activates the parasympathetic, or calming, part of the nervous system. Brainspotting therapy was developed in 2003 by Dr. David Grand, an EMDR therapist and relational analyst.
Cognitive behavioural therapy (CBT) is a goal-oriented type of therapy that teaches the client how to first recognize and then change unhealthy ways of thinking and behaving. With the use of in-session practice and homework of skills to work on between sessions, this treatment is tailored to fit the client's goals and is a highly evidence-based collaborative psychotherapy.
Compassion-focused therapy (CFT) is a type of psychotherapy that encourages individuals to be compassionate toward others as well as themselves. This type of therapy is primarily used for clients that struggle with self-criticism and self-contempt. CFT often includes exercises to practice mindfulness and appreciation. Sessions focus on examining the ways we talk to ourselves, where we might have first developed the particular tone and word choices used, and how we can make changes to how we speak to ourselves to increase self-compassion and appreciation.
Dialectical behavioural therapy (DBT) is a type of cognitive therapy that is very structured, where clients are taught skills in the four domains of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. This works to support clients in changing their behaviours, thoughts, and process their feelings in healthier ways. This type of therapy is effective for individuals who want to improve their ability in regulating their emotions and was developed for people with borderline personality disorder and suicidal impulses. DBT requires consistent attendance and adherence to homework that is developed by both the client and therapist working together as a team.
It is the nature of the mind to be made up of subpersonalities or parts. Subpersonalities are aspects of our personality that interact internally, similar to the ways in which people interact. These sub-personalities can consist of wounded parts and painful emotions such as anger and shame. Underlying the parts is a person’s core or true Self. The Self can and should lead the individual's internal system.
Internal Family Systems (IFS) therapy helps individuals achieve balance and harmony within their internal system and subpersonalities/parts.
Using IFS, the clinician will support individuals in developing their Self so it can be an effective leader in their internal system. When the Self is in the lead, the parts will provide input to the Self and help to elevate “wounds” so that individuals can find their natural balance. IFS is suitable for individuals, couples, and families, and it can effectively treat a variety of conditions such as depression, anxiety, panic, phobias, trauma, substance use, physical health conditions, and general well-being.
Psychodynamic psychotherapy is the oldest of the modern therapies and focuses on unconscious processes as they are manifested in the client's present behaviour. The goals of psychodynamic therapy are client self-awareness and understanding of the influence of their past on their present behaviour.
Brief psychodynamic psychotherapy enables the client to examine unresolved conflicts and symptoms that arise from past relationships and manifest themselves in their day to day life as current struggles.
Several different approaches to brief psychodynamic psychotherapy have evolved from psychoanalytic theory and have been used to treat many different mental health presentations.