Dialectical behavior therapy (DBT) is a treatment that was originally created by Marsha Linehan and her team to treat individuals with borderline personality disorder (BPD). Folks with BPD have what’s called pervasive emotion dysregulation—in other words, they struggle to identify what they’re feeling, don’t have the skills to effectively manage the emotions that arise, and end up turning to problem behaviors (such as suicide attempts, self-harming behaviors, or substance use), in an attempt to cope.
To the right of me sat Natalie Portman. To the left of me sat the Crown Prince of Dubai. In front of me stood our Nobel laureate professor. And between them, I sat, holding within me the most infamous personality of all, my borderline personality disorder.
The support and understanding of parents if often vital to successful Dialectical Behavioral Therapy (DBT) treatment for adolescents; however, parents (or parental figures) may feel a range of negative emotions surrounding the child and the therapeutic intervention, like shame, guilt, anger, or helplessness. Working with parents to create an open, compassionate environment where their feelings are validated helps ensure that everyone is focused on the recovery of the adolescent—and, by extension, the entire family.
Using mindfulness to treat the suffering that comes with the symptoms of borderline personality disorder is a difficult task because it requires you to attend to what’s going on in your mind. The explicit application of mindfulness used in dialectical behavior therapy provided a way for people with BPD to get unstuck from their judgments and the intense emotions that lead to suffering.
In recent years, developments in neuroscience have offered significant breakthroughs in understanding the brain chemistry that contributes to the behaviors and suffering associated with borderline personality disorder. While mindfulness cannot change your genes, research is beginning to show that it can change the way your genes work (Smalley 2010).
Since 1938, when many of the recognizable features of modern BPD were first described, the criteria for defining BPD have changed. The diagnostic criteria for BPD are outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR (2000), also known as the DSM. For a person to be diagnosed with BPD, the DSM requires that at least five of nine symptoms be present, but there are 256 different possible symptoms that someone with BPD may experience.