After diagnosis, your mental health professional (or GP) will discuss with you a treatment plan. This is likely to include a combination of medication and therapy. There are many types of therapy, and sometimes it can take a while to find the right one for you. The one rule with all therapy is that you get out what you put in – this therapy is there for you to get well, and stay well, and will only work if you are invested in it. Here are some of the common therapies you might be offered.
Many people with BPD, especially those who have suffered trauma, find talk therapy incredibly helpful. Most NHS trusts in the UK have the option to self-refer for a course of talking therapy. There are often long waiting lists, and you will be offered a limited amount of sessions, but having an outlet to discuss your main problems can be very helpful in your recovery.
DBT – Dialectical Behavioural Therapy
DBT is the main therapy that has been proven to help people living with BPD – it was created by Marsha Linehan, who herself lives with BPD. DBT can help you in a number of ways. There are four key skills taught in DBT:
- Mindfulness: the practice of being fully aware and present in this one moment
- Distress Tolerance: how to tolerate pain in difficult situations, not change it
- Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
- Emotion Regulation: how to change emotions that you want to change
Dialectical literally means opposites. So DBT teaches you how to reframe a negative or unhelpful emotion, and gives you the skills to effectively cope with these difficult situations day-to-day. One of the key things DBT does is validate you – helping you accept yourself as you are, without feeling misunderstood or that your feelings aren’t valid. As people with BPD often have extreme emotional sensitivity, working together on validation helps keep a careful balance between acceptance and change. You can find out more about DBT here.
Cognitive Analytical Therapy (CAT)
This type of therapy can help you to understand problems you have in your relationships and can help you to change patterns of unhelpful behaviour. If your BPD causes you to rapidly switch between liking and disliking people in your life, CAT could be useful.
Mentalisation-Based Therapy (MBT)
MBT aims to challenge your thoughts about what other people are feeling or thinking. BPD can cause us to feel abandoned if a loved one wants to go and do something alone, we might think they don’t care about us anymore, that they hate us or even that they will never come back. MBT can help you to better understand other people’s behaviours and your reaction to it, helping you take a more balanced view of what might actually be going on in the minds of others.
Being able to focus solely on the present can be difficult for those living with BPD, as we often are unable to ‘switch off’ the thoughts that go round and round. Mindfulness teaches you to control those thoughts and emotions and focus on the present moment, helping you to manage your emotions.
These are places that you can go to have treatment with groups of people experienceing mental health problems. Community members are able to support each other with understanding of living with a mental health condition. Communities might meet up regularly, or may even be live-in communities.As well as group therapy, communities might also offer activities.