How is a borderline personality disorder treated?

The treatment of personality disorders requires a long breath from everyone involved. Especially for Borderline, however, there are good approaches to meet the specific problems and needs of those affected.

Without motivation no therapy

Motivation and the need to change one's own situation and lifestyle are crucial in order to be able to start therapy at all. This requires a certain amount of insight and the admission to be responsible for life's changes.

At the same time, the tremendous pressure of suffering causes some people to seek help. If the relationship is crumbling or things are not working well again, good advice is expensive.

In the foreground of the therapy of personality disorders are psycho-and socio-therapeutic approaches. Medications are usually used only with appropriate concomitant symptoms, such. a depressive mood or massive states of tension. Here they can help alleviate the symptoms. In addition, they are important if, in addition to the personality disorder, there is another illness. One then speaks of comorbidity. For example, a borderline disorder is often associated with alcohol and addiction disorders that need to be treated separately.

Skills - little helpers in everyday life with the disease

Elemental for the treatment and the handling of the borderline disorder is the learning of strategies in dealing with stress states. While many "borderline" have found (temporarily) effective methods that will do more harm than good for them in the longer term, self-injury is not a solution to reducing internal excitement or emptiness and should be replaced with alternative strategies.

Unfortunately, this is often not easy, since all so-called skills understandably do not have the same stimulus intensity as e.g. achieve a cut through the skin. They usually do not work so strong.

Translated, skills mean skills or abilities. They should help to better deal with the illness in everyday life. There are very concrete skills that involve certain actions; but there are also those on the mental or the level of perception.

The environment in view: Sociotherapy

Sociotherapy aims to strengthen the social environment and improve the psychosocial skills of those affected. This means, for example, to illuminate the family situation and break up old patterns and behaviors if necessary. The job situation and the local environment also play a major role and can both stabilize and unsettle.

Especially for borderline: dialectical behavioral therapy

For the borderline disease, a special form of therapy was developed, the so-called dialectic behavioral therapy. It is based on different strategies and includes cognitive, behavioral as well as psychodynamic approaches.

A cognitive therapy aims at the thinking, the insight and the attitudes of those concerned. An attempt is made to break up deadlocked thinking patterns and to develop new perspectives.

Behavior therapy is work on concrete action and appearance. It is not so much about revealing the background to the behavior, but about behaviors that harm rather than use, reduce and replace them with others.

The psychodynamic school, on the other hand, tries to pinpoint the problems and to investigate the causes. It assumes that personality disorders are due to certain experiences or omissions in the course of development that need to be addressed.

Newer Methods: Schema Therapy

In the further development of psychotherapeutic methods, new approaches of the so-called third wave have proven themselves for the treatment of borderline. This includes in particular the schema therapy, which combines different procedures.

Here it is about recognizing learned patterns and behaviors and "reprogramming" them. It aims to break up old role models and ways of reacting and to learn how to handle people or certain situations differently. The relationship with the therapist is crucial because he is actively involved in the therapy.

Teamwork: patient and therapist

Establishing a sustainable relationship between the patient and the therapist is always essential for successful treatment. A person with a borderline disorder who seeks treatment and wants to work seriously has to divulge and reveal much of himself. For this he must be able to trust his therapist fundamentally.

Unfortunately, the essence of the disease is that building, maintaining, and maintaining relationships is often extremely problematic. The relationship with the therapist is not excluded.Especially when a close relationship has developed, it is at risk to break again someday. But a good therapist knows about these difficulties and can possibly catch them in time.

A stable relationship is also important because therapy is usually a long-standing process in which the therapist becomes a constant companion. After all, treating a borderline disorder is less about eliminating the disease than about finding a way to interact with it and learning to live with it.

Author: Eva Bauer (doctor)