‘Walking the Middle Path’ means replacing ‘either-or’ with a ‘both-and’ stance. Many people make decisions using a black-and-white formula. By changing that perspective, we can better understand what is happening in the moment, and how to make effective decisions.

There’s more than one perspective, or point of view, to each situation. If a person who was bitten by a dog meets a dog in the park, their reaction will be different to that of a person who has never been bitten meeting the same dog.

The heart of DBT is that two things which seem like opposites can both be true. A good example of this in relation to BPD is the issue of self-harm (trigger warning, the next paragraph is related to self-injury).

To the person whose child or partner injures themselves, they see the self-harm as the problem. To the person who injures themselves, self-harm is the solution to the problem of overwhelming distress. The fact is that these opposing views that self-harm can be both a solution or a problem, are both true and co-exist.

A good example of the use of this in recovery, is the practice of recognising multiple points of view. Perhaps you partner came home late from work twice this week and you say ‘you are always home late’, which possibly led to an argument.

In this situation, think of some alternative explanations for what could have happened:

• they are working late to earn extra money, so you can move to a nicer home or pay off some debt
• they are feeling pressured at work to complete projects to deadlines, and are putting in the extra hours to keep their job
• the bus timetables have changed, and he has missed the bus a few times

From a therapy perspective, many people feel that the patient will never change. But remember nothing is constant, except change. We see this every day in the waves of the ocean or the sunset and rise. We see this in the growth of our children from the moment of conception to their adult lives. We see change in things as simple as an ice cube melting.

By accepting that change is constant, patients can push on and continue the therapy. Accepting that things change can be difficult for people with BPD, who cling to routine and safety on a daily basis. But we need to remember that we are changing all the time, even when we don’t know it. So accepting this as a fact of life frees us to keep going.

Think about difficult times in your past, and that you thought things would never change. And yet they did, and you can see that not only did you get through that difficult time, you grew as a person and moved on.