Borderline personality disorder (BPD) is a mental health condition that can cause intense emotions, difficulties in relationships and changes in how you see yourself. Therapy can be an important part of treatment, helping you understand your thoughts, feelings and behaviours while learning new ways to cope.
There is no single therapy that works for everyone. Your choice may depend on your needs, preferences and the support available in your area.
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What therapy is available for BPD?
Several therapies have been developed or adapted for people with BPD. Some are available on the NHS, while others may be offered by private providers or community services.
Dialectical behaviour therapy (DBT)
DBT was created specifically for people with BPD. It focuses on balancing acceptance and change, helping you manage emotions and improve relationships.
It usually includes:
- Weekly one-to-one therapy
- Group skills sessions
- Support between sessions when needed
DBT teaches skills in four main areas:
- Mindfulness
- Distress tolerance
- Emotional regulation
- Interpersonal effectiveness
Cognitive behavioural therapy (CBT)
CBT looks at the links between your thoughts, feelings and behaviour. It helps you spot unhelpful thinking patterns and replace them with more balanced ones.
CBT for BPD may focus on:
- Challenging negative beliefs about yourself
- Reducing behaviours that cause harm
- Developing healthier coping strategies
Mentalisation-based therapy (MBT)
MBT helps you understand your own thoughts and feelings, and those of other people. It can improve how you respond in relationships and reduce impulsive actions.
MBT often includes:
- Weekly individual sessions
- Group therapy
Treatment may last for 12 to 18 months.
Schema-focused therapy (SFT)
SFT combines elements of CBT and other approaches. It focuses on long-term patterns (schemas) formed in early life that can cause distress in adulthood.
Therapy aims to:
- Identify unhelpful schemas
- Challenge and change them
- Develop healthier ways of thinking and acting
Transference-focused therapy (TFP)
TFP uses the relationship between you and your therapist to understand your emotions and behaviour.
It aims to:
- Explore how past relationships influence your current feelings
- Help you integrate different parts of your identity
- Improve stability in relationships
Which therapy is best for you?
There is no single ‘best’ therapy for BPD. The right choice depends on:
- Your personal goals
- What is available locally
- How you prefer to work (individually, in a group, or both)
- Your previous experiences of therapy
Your GP or mental health team can help you explore options and refer you to suitable services.
Are there alternatives to therapy for BPD?
Therapy is often the main treatment for BPD, but other forms of support can help, including:
- Medication for specific symptoms like depression or anxiety (not as a primary treatment for BPD)
- Peer support groups
- Crisis helplines and text services
- Self-help resources such as books and online tools
- Lifestyle changes like regular exercise, balanced diet and good sleep habits
Summary
Therapy can play an important role in managing BPD. Different approaches such as DBT, CBT, MBT, SFT and TFP offer ways to understand yourself better, manage emotions and improve relationships. The best therapy for you will depend on your needs, preferences and what is available in your area.
Other support such as peer groups, crisis lines and lifestyle changes can also help. Working with a health professional can guide you towards the most suitable treatment.ey parts of recovery. If you or someone you know has BPD, professional help can make a real difference.
