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The Psychotherapy Curriculum

Borderline Personality Disorders


Help is here for therapists struggling to work with and understand their clients with Borderline Personality Disorder.

Program Description

People with Borderline Personality Disorder are probably the most challenging of all the patients most of us see. Many show a profound lack of integration of their personal identity, and some cling to their therapists, refusing to leave when the session is over. Two out of five will quit treatment prematurely. They act out just when things start to be improving, and they’re seen by most clinicians as confusing, upsetting, draining, and notoriously difficult to treat. However, many BPD patients eventually make modest and even splendid recoveries.

Learning Objectives

This program provides clinicians with the opportunity to:

Understand and be able to identify Borderline Personality Disorder from the psychodynamic and attachment theory points of view.

Be able to distinguish three levels of Borderline Personality Disorder.

Learn the importance of the relationship between patient and therapist in treating the person with BPD.

Learn the importance of the relationship between a couple and the therapist in treating the borderline marriage.

Learn the importance of shifting the responsibility of the self-injurer’s treatment from the therapist to the patient.

Understand the impact a person with Borderline Personality Disorder has on the family and people close to him.

Understand the importance of the involvement of significant others and their need for education about BPD.

Develop a basic understanding about dialectical behavior therapy.

Be able to identify four different types of borderline mothers.

Gain a basic understanding of EMDR.

Develop a basic understanding of the neurological bases of BPD and the use of medication.

Interviews

An Object-Relations Approach - Frank Summers, Ph.D. website

Frank Summers, PhD, author of Transcending the Self: An Object Relations Model of Psychoanalytic Therapy, provides case discussions demonstrating how psychoanalytic therapy informed by an object relations model can effect radical personality change.

Attachment Styles in BPD - Karla Clark, Ph.D.

Dr. Karla Clark, an educator and speaker, discusses understanding patients with Borderline Personality Disorder based on their attachment styles.

Borderline Marriages - Charles McCormack

Anyone doing marital therapy knows there are couples, and then, there are couples! The "normal" couple rapidly incorporates the therapist's help with communication and conflict resolution issues. On the other hand, the personality-disordered marriage seems impervious to change and, in fact, seems to get worse in treatment. Charles McCormack is the author of Treating Borderline States in Marriage: Dealing with Ruthless Aggression, Severe Resistance and Oppositionalism. He describes marriage as containing both the dream and the nightmare of the couple's way of being in a relationship. The couple presents a tangle, which all three in the room must work to sort out.

Borderline Mothers - Christine Lawson, Ph.D.

Research is beginning to show the development of BPD depends on an interaction of constitutional biologic vulnerabilities with often adverse environmental circumstances during development. Christine Lawson, PhD is the author of Understanding the Borderline Mother: Helping her Children Transcend the Intense, Unpredictable, and Volatile Relationship. She describes how the neurological functioning of borderline mothers' children is impacted by deficits in early parenting and the projection of massive states of confusion and terror onto the children by these borderline mothers. She also explains how she uses EMDR in her therapeutic work.

Brief Treatment - Sandy Hotchkiss, M.S.W., B.C.D.

Here, Ms. Hotchkiss summarizes three levels of a borderline personality so we can have more nuanced criteria for this disorder. These will help us predict the kinds of treatment and transference issues that may arise in treatment, and thus, may help our decision making about what to offer to the patient.

Development and Film Discussion - Ed Kaufman, MSW

Ed Kaufman, a clinician, educator, and film discussion leader, discusses some of the developmental issues leading to the Borderline Personality, especially as these are portrayed in the film, “You Can Count On Me.”

Dialectical Behavior Therapy - Charles Swenson, MD

Charles Swenson directed one of the first psychoanalytically oriented in-patient programs for BPD, which switched to the use of DBT under his leadership. Here, Dr. Swenson gives an overview of DBT, its basis from a bio-social theory of BPD, its synthesis of principles and strategies from behaviorism, Zen, and dialectical philosophy, and how DBT actually works.

Education and Crisis Intervention with Families of Patients Having BPD - Christine Lawson, Ph.D.

Dialectical Behavior Therapy (DBT) is a comprehensive, cognitive-behavioral treatment for individuals meeting criteria for a borderline personality. Research has shown DBT has reduced suicidal episodes, hospitalizations, and dropout from treatment, while reducing anger and improving social adjustment. Valerie Porr is founder and director of TARA, the only national, nonprofit, educational and advocacy organization for BPD. In this interview, she discusses how she uses DBT in crisis intervention on the telephone and in her educational groups for family and friends of people with BPD.

Impact on Families - Paul Mason, MS

Paul Mason is co-author of the best-selling book, Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder. In this interview, he describes how family and friends can learn what to do to cope with borderline behavior and take care of themselves.

Neuroscience and Medication - Larry Siever, MD

Larry Siever, author of "The New View of Self: How Genes and Neurotransmitters Shape Your Mind, Your Personality, and Your Mental Health," believes knowledge of the biology of Borderline Personality Disorder helps us better understand and treat it. In this interview, he explains a person with BPD is a emotionally vulnerable, has an autonomic nervous system that reacts excessively to relatively low levels of stress, and takes longer than normal to return to baseline once the stress is removed. He also describes how medication can help.

Self-Injurious Behavior - Karen Conterio, Wendy Lader, Ph.D.

A history of self-mutilating behavior is one of the nine indicators of Borderline Personality Disorder. How can things like cutting, gouging, and burning one's body actually make the injurer feel better? That being the case, what possible therapeutic intervention can compete? Karen Conterio and Wendy Lader, co-authors of Bodily Harm, founded the first treatment program in the nation specifically for people who harm themselves. In this interview, they describe a course of treatment based on years of experience and extensive clinical research, as well as compassion, advice, hope, and humor. They use innovative techniques, including cognitive analytic therapy, to look at the underlying dynamics driving the behavior.

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Client Testimonials


“The speakers did a great job. I love the flexibility of listening at my leisure.”


... Christine S.
LCSW


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