Alcoholism and Borderline Personality Disorder
Alcoholism and Borderline Personality Disorder
Four Psychotherapies for BPD: Which One Is Right For You?
Twenty years ago, there were no treatments for borderline personality disorder that had been proven to be effective. Today, there are four different kinds of psychotherapy with research support: dialectical behavior therapy, schema focused therapy, mentalization based therapy, and transference focused therapy. All of these therapies have at least one research study demonstrating their effectiveness. Not sure which one is right for you? These articles summarize each approach:
BPD and the Internet
The Internet has become an important source of education and communication for many people with Borderline Personality Disorder (BPD). If you search for "BPD," you will find thousands of websites, articles, blogs and news items devoted to BPD. In some ways, the Internet can be incredibly helpful for people with BPD and their loved ones. In other ways, though, it can make life harder by magnifying some of the symptoms of BPD. Read more about the impact of the Internet on your life with BPD.
Education About BPD Reduces Symptoms
In the past, many people with borderline personality disorder (BPD) were not even informed of their diagnosis-- psychiatrists and psychologists often shied away from disclosing the diagnosis to their patients because of the stigma attached to it. New research, however, suggests that simply being educated about BPD can reduce symptoms.
Dr. Mary Zanarini and her colleagues at McLean Hospital conducted a randomized, controlled study of the effect of "psychoeducation" on BPD symptoms. All participants were informed of their BPD diagnosis, but only half were provided education about BPD (the other half received the education after a 12-week waiting period). Results suggested that receiving education about BPD reduced the impulsivity and relationship instability symptoms of BPD.
Source:
Zanarini MC and Frankenburg FR, "A Preliminary, Randomized Trial of Psychoeducation for Women With Borderline Personality Disorder," Journal of Personality Disorders, 22:284-290, 2008.
On YouTube: An Interview with Alan Fruzzetti, Ph.D.
Watch this excellent interview with Dr. Alan Fruzzetti, posted by andreewitch on YouTube. Dr. Fruzzetti is an Associate Professor of Clinical Psychology at the University of Nevada at Reno and specializes in research on family interactions, emotion regulation, and BPD.
Mindful Monday Exercise: Mindful Driving
Mindfulness is a difficult skill to build up, and it can be hard to remember to practice consistently. In an effort to encourage consistent and repeated mindfulness practice, the "Mindful Monday" blog features a new mindfulness exercise on the first monday of each month. For this edition of Mindful Monday, try this exercise:
On the Radio: A Thoughtful Discussion of BPD
This week I listened to one of the most informative and well-balanced discussions of borderline personality disorder I have ever heard. The segment was originally broadcast on the Leonard Lopate Show on New York Public Radio in 2007, but it can be heard on demand from the WNYC archives.
The segment features Dr. Frank Yeomans, an expert in BPD and clinical associate professor of psychiatry at the Weill Medical College, and Christina Knight and Kiera Van Gelder, two individuals who are recovering from BPD. Incidentally, I discovered the show on the website for a non-profit organization devoted to providing education on BPD, The Middle Path. The organization is directed by Ms. Van Gelder, and the website includes a number of very good BPD resources.
Not All People Who Self-Harm Have BPD
While self-harm is one of the symptoms of borderline personality disorder, not everyone who engages in self-harm has BPD, and not everyone who has BPD engages in self-harm.
Unfortunately, many people equate self-harm with a diagnosis of BPD-- this is simply not the case. Recent research has shown that many people who engage in self-harm not only do not have BPD, they have very low levels of psychiatric symptoms in general. But, whether or not the self-harm is part of the BPD syndrome, it is important to be evaluated, as self-harming behaviors alone can have very serious consequences.
Are People With BPD Better Able To "Read" Others?
In the 1970's and 1980's, a few borderline personality disorder (BPD) researchers proposed that individuals with BPD are unusually sensitive to other people's emotional states, a phenomenon called "borderline empathy." This hypothesis sparked several research studies examining whether people with BPD are better able to "read" others, with mixed results. Some studies demonstrated that people with BPD were more sensitive to others' emotional states, while others did not find evidence for borderline empathy.
However, a recent study adds another twist-- researchers paired people with BPD with non-BPDs, and compared how well each member of the pair could "read" the other's internal state. At first glance, it appeared that the people with BPD were more empathic than their partner. However, further analysis suggested that this effect was probably due to the fact that the person with BPD was more difficult to read, not that they were reading their partner better.
Clearly, more work is needed to fully understand whether "borderline empathy" exists. What do you think? Are people with BPD more sensitive to the internal states of other people?
Source:
Flury JM, Ickes W, Schweinle W. "The Borderline Empathy Effect: Do High BPD Individuals Have Greater Empathic Ability? Or Are They Just More Difficult To 'Read?'." Journal of Research in Personality, 42:312-332, April 2008.
Group Therapy Improves BPD Symptom Reduction
A group therapy program called "Systems Training for Emotional Predictability and Problem Solving," or STEPPS, has been shown to significantly improve treatment outcome for individuals with BPD when added to the traditional treatment regimen (e.g., medications and individual psychotherapy).
STEPPS is a 20-session group therapy based on cognitive behavioral approaches to treatment. In a recent randomized controlled trial, individuals with BPD who received STEPPS in addition to their usual treatment had significantly fewer symptoms of BPD and fewer emergency room visits than individuals with BPD who received only their usual treatment. This study suggests that a relatively brief course of STEPPS can have a very meaningful impact on BPD symptoms.
Source:
Blum N, St. John D, Pfohl B, Stuart S, McCormick B, Allen J, et al. "Systems Training for Emotional Predictability and Problem Solving (STEPPS) for Outpatients With Borderline Personality Disorder: A Randomized Controlled Trial and 1-Year Follow-Up." American Journal of Psychiatry, 165:468-478, 2008.