Therapeutic relationship with borderline personality disorder

The therapeutic alliance in the treatment of personality disorders.

therapeutic relationship with borderline personality disorder

Request PDF on ResearchGate | Therapeutic relationship in the therapy of patients with borderline personality disorder | The therapeutic. The therapeutic alliance in the treatment of personality disorders. In particular, patients with narcissistic, borderline, and paranoid personality traits are likely to. Patients often meet criteria for two or more personality disorders, perhaps Ontogeny of the therapeutic alliance in borderline patients.

As a result, many suffering from BPD have sought treatment only to find themselves not only unable to get proper care, but becoming wary of engaging in treatment.

The therapeutic alliance in the treatment of personality disorders.

BPD and the Possibilities of Therapeutic Alliance In recent years, there have been significant efforts to destigmatize mental health disorders, both within mainstream culture and in the therapeutic community itself. Simultaneously, the therapeutic community has come a long way from the days when BPD was considered essentially untreatable; new research is continuously being produced to help us refine how we support those living with BPD and lend evidence to the possibility of change.

And what that research shows us again and again is that the quality of the therapeutic alliance has a measurable impact on patient experiences and treatment outcomes.

A study published in Psychotherapy examined the effects of the therapeutic alliance on treatment outcomes of women with Borderline Personality Disorder over the course of a year. The researchers found that those women who reported more positive therapeutic alliances had significantly fewer suicide attempts as well as lower rates of self-injury.

While strong therapeutic alliances did not impact rates of depression, the marked effect on self-harming behavior suggests that the therapeutic alliance allows for greater self-regulation and integration of coping skills that act as alternatives to self-harm.

This may come about in part due to the validation and relief that come from a warm, supportive relationship with a therapist in which you are able to fully engage in the course of treatment to gain the insight and skills you need to make meaningful change.

But there is another reason the therapeutic alliance is particularly significant for people with BPD; symptoms of BPD often manifest during the therapeutic experience and within the therapeutic relationship. How these symptoms are handled during treatment can provide unique opportunities to address them in a trusting setting and serve as a model for healthier attitudes toward the self and toward others.

These interactions can provide a blueprint for handling emotional and behavioral disturbances outside of the therapeutic setting, giving you a heightened sense of control and agency in your everyday life. Call for a Free Confidential Assessment.

therapeutic relationship with borderline personality disorder

And sometimes they just go with it. But more becomes much less. There is an escalation of the craziness but nothing useful happens. It's as though the therapist is supposed to meet every need, and of course, they can't and shouldn't. Eventually, if things go well, the feelings do get centered on the therapist, but the therapist must have help with this.

therapeutic relationship with borderline personality disorder

So you have many people bearing bits of the feeling, and the patient begins to feel safe. The potential demand from the patient can seem so unrealistic, even outrageous, that there can be a tendency in both people to write it off as simply craziness, but that is never the real deal.

This kind of trouble challenges both people to try to sit with painful feelings, to try to put them into words. Many patients like this are very appealing. If those feelings can be gotten hold of and sorted out, this person can bring a lot of life.

How a Strong Therapeutic Alliance Improves Treatment Outcomes for Borderline Personality Disorder

In any case, viewing clients so judgmentally rarely leads to a change in their behavior. Searching for a compassionate understanding and conceptualizing according to a cognitive framework why the client is engaging in these behaviors is critical to being able to help change the behavior.

Maybe you have witnessed a typical example. I recently observed a situation in which a customer believed his needs were not being met. Feeling frustrated, he yelled and asked for a manager.

Working with Borderline Personality Disorder | Austen Riggs Center

Then he got what he wanted. Getting what he asked for after he yelled makes it much more likely that the next time he will also yell in a similar situation. The same holds true for clients, and given the highly invalidating and harsh environments in which they live, their learning histories are filled with behavior patterns that are maladaptive, at least some of the time.

If you notice a negative judgment, ask yourself: