Borderline personality disorder (BPD) is a serious form of mental illness characterized by emotional highs and lows and an inability to bring these emotional extremes under control. A person with BPD has an extreme fear of abandonment and usually sees things in black and white, all or nothing terms. Their difficulty to understand that both good and bad can exist in people at the same time along with their difficulty to regulate emotions are among the characteristics that can set off a crisis of self-harm or suicidal tendencies.
Complex post-traumatic stress disorder (C-PTSD) is a condition that may develop after prolonged or repeated experiences of trauma, usually in situations in which there is no perceived way to escape from the trauma. Symptoms of C-PTSD sometimes overlap with symptoms of BPD. This may lead to a crisis that may include explosive anger or suicidal thoughts or actions.
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Dialectical Behavior Therapy
Dialectical behavior therapy (DBT) is a form of treatment that was developed in the 1980s to help treat people with BPD, particularly those with suicidal tendencies. The goal of this type of therapy is to help people learn new skills and strategies to change patterns of thinking and regulate emotions in order to experience a life worth living.
DBT is an intense form of therapy that requires a time commitment of at least a few hours a week. Besides spending time one-on-one with a psychotherapist, a person undergoing DBT therapy also attends group sessions and is assigned homework in order to practice implementing skills learned in real-world situations.
How DBT Works
The main modules of DBT include:
- Distress tolerance
- Emotional regulation
- Interpersonal effectiveness
The patient and therapist work together to set goals that are important to the patient, such as striving to decrease harmful behaviors and replace these behaviors with better choices. Individual therapy runs concurrently with skills training.
It usually takes six months or longer to work through all the modules of DBT. Skills training is frequently done in groups, which meet each week for about 2.5 hours. Getting through all the skills takes approximately 24 weeks, and the full curriculum may be repeated to make a program that lasts for as long as a year.
Over time, treatment with DBT is very effective, but results are not instant. The extended length of time needed to work through all the different aspects of DBT treatment is part of the reason it is so effective in the treatment of complex mental health issues.
Getting Through a BPD or C-PTSD Crisis
DBT is very effective for helping to improve the symptoms of BPD or C-PTSD, but it may take some time to see a reduction in the intensity of symptoms. When a person is experiencing very intense symptoms, such as self-harm or suicidality, he or she may require treatment in an inpatient facility.
Those who care for someone with BPD or C-PTSD may recognize that their loved one frequently is in crisis. When this happens, caregivers are faced with the challenge of assessing risk and trying to determine how serious each crisis is. While it’s important to allow a person to learn and practice the skills needed to manage a crisis, caregivers may need to consult the individual’s mental health team for help in deciding if inpatient treatment is needed.
As time passes and skills are practiced, an individual with BPD or C-PTSD who is undergoing DBT therapy who experiences a crisis may find that the skills they are learning are helping them to better regulate their emotions and tolerate distress. Depending on where the individual is in the process of DBT therapy, they may find the skills they are learning in DBT make a big difference in getting through a crisis.
Part of DBT therapy is the availability of phone coaching, which means the therapist is available for phone calls between sessions. This allows a person who is undergoing this type of therapy to get help when it’s needed the most to work through volatile emotions.
If you or a loved one are struggling with a mental health crisis, please contact us at (855) 409-0204 or submit the form below and a treatment specialist will contact you.