Borderline Personality Disorder

People with borderline personality disorder have difficulty with dysregulation in several different areas: emotions, cognitions, behavior, sense of self, and in relationships.

Traits involving emotions:
Quite frequently people with BPD have a very hard time controlling their emotions. They may feel ruled by them. Marsha Linehan)said, "People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement."
1. Shifts in mood lasting only a few hours.
2. Anger that is inappropriate, intense or uncontrollable, and may become raging.

Traits involving behavior:
3. Self-destructive acts, such as self-mutilation or suicidal threats and gestures that happen more than once
4. Two potentially self-damaging impulsive behaviors. These could include alcohol and other drug abuse, compulsive spending, gambling, eating disorders, shoplifting, reckless driving, compulsive sexual behavior.

Traits involving identity
5. Marked, persistent identity disturbance shown by uncertainty in at least two areas. These areas can include self-image, sexual orientation, career choice or other long-term goals, friendships, values. People with BPD may not feel like they know who they are, or what they think, or what their opinions are, or what religion they should be. Instead, they may try to be what they think other people want them to be. Someone with BPD said, "I have a hard time figuring out my personality. I tend to be whomever I'm with."
6. Chronic feelings of emptiness or boredom. Many patients with BPD describe feeling empty inside and trying desperately to fill the emptiness. Being alone makes the emptiness more apparent and it is often difficult for people with BPD to be alone.

Traits involving relationships
7. Unstable, chaotic intense relationships
8. Frantic efforts to avoid real or imagined abandonment Alternating clinging and distancing behaviors (I Hate You, Don't Leave Me). Sometimes you want to be close to someone. But when you get close it feels TOO close and you feel like you have to get some space. This happens often.

Traits involving cognitions
9. Transient, stress-related paranoid ideation or severe dissociative symptoms
10. Black and white thinking, tendency to overidealize or vilify others and situations.

Miscellaneous attributes of people with BPD
People with BPD are often bright, witty, funny, life of the party.
They may have problems with object constancy. When a person leaves (even temporarily), they may have a problem recreating or remembering feelings of love that were present between themselves and the other. Often, BPD patients want to keep something belonging to the loved one around during separations.
They frequently have difficulty tolerating aloneness, even for short periods of time.
Their lives may be a chaotic landscape of job losses, interrupted educational pursuits, broken engagements, hospitalizations.
Many have a background of childhood physical, sexual, or emotional abuse or physical/emotional neglect.


Eating Disorders

Our program for eating disorders includes cognitive behavior therapy combined with dialectical behavior therapy. Dialectical Behavior Therapy provides skills training for learning constructive ways to manage emotions including the anxiety about food and eating. Cognitive behavior therapy addresses directly the distorted cognitions evident in eating disorders. Both address the issue of behavior change needed to recover. In addition to outpatient individual and group sessions, we offer an intensive outpatient program (9 hours per week).

Borderline Personality Disorder and Chronic Mood Disorders

For the treatment of borderline personality disorder (BPD) and chronic and treatment resistant mood disorders we offer a full DBT program. We have multiple outpatient skills groups as well as individual therapy. We also have an intensive outpatient program (IOP) that is 9 hours a week: 2 individual sessions and 7 hours of skills training.