By Kimberly Peters, MSSW, LCSW
DBT Therapist, Sierra Tucson
I still remember my first encounter with someone living with borderline personality disorder; I was in graduate school working as part of an assessment team for a closed psychiatric unit. As we were about to walk in to meet with the patient, my mentor looked at the chart and said, “Oh, she’s borderline.” The interesting thing about this experience is that years later, I don’t remember the assessment or the patient, but what I do remember is my mentor’s dismissive tone of voice and the negative stigma associated with the diagnosis.
For years, borderline personality disorder (BPD) and manipulation were synonymous in the mental health community. With growing research and training, we now understand that people with BPD are simply doing what they know works to get their needs met. When we look at someone with symptoms of BPD, what we often find is someone who was born acutely sensitive to his or her surroundings; perhaps this was a baby that took longer to soothe after becoming activated. If this child is raised in an environment that is validating and helps him or her learn to soothe appropriately, then the child learns how to advocate for him or herself using healthy copying mechanisms. However, if this child is raised in an invalidating environment, often including a trauma, then he or she learns maladaptive coping mechanisms in order to get his or her needs met. As long as these maladaptive coping mechanisms are working, the child will continue this behavior. Moreover, these maladaptive coping mechanisms can, and often do, continue into adulthood.
Dialectical behavioral therapy (DBT) targets maladaptive behaviors on four fronts: mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. DBT skills address identity confusion, feelings of emptiness, cognitive deregulation, interpersonal chaos, fears of abandonment, labile affect, excessive anger, impulsive behaviors, suicidal threats, and parasuicide.
While not every resident that comes to Sierra Tucson is in recovery for borderline personality disorder, many are struggling with how to appropriately manage emotions, foster relationships with others, and cope with life’s stressors in healthy ways. Since Marsha M. Linehan, PhD, ABPP, developed DBT in the late 1980s, not only has it been proven effective for people with BPD, but it has also been effective for individuals that are struggling with depression, bipolar disorder, anxiety, post-traumatic stress disorder (PTSD), addiction, and eating disorders. I personally believe that DBT can be beneficial for anyone regardless of whether or not they have a diagnosis. After all, the goal of DBT is to have a life worth living. Who doesn’t want that?
At Sierra Tucson, DBT skills groups are a part of each individual treatment plan. Our DBT groups are led by trained DBT therapists. Individual DBT appointments may also be added to a resident’s treatment plan per the treatment team or resident’s request. We believe that a life worth living is possible, and we teach our residents how to achieve that.
For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487.