Is CBT or DBT Better for Treating Borderline Personality Disorder?

Borderline personality disorder (BPD) affects the way you think and feel about both yourself and others, which can cause problems in your everyday life. BPD is characterized by a pattern of instability in relationships, an intense fear of abandonment, wide mood swings, impulsive behavior, feelings of emptiness and frequent suicidal thoughts or actions.

While the intensity and unpredictability of the symptoms of BPD are sometimes challenging to treat, that doesn’t mean that BPD isn’t treatable. Symptoms can improve over time with treatment. The main treatment of BPD is psychotherapy, also known as talk therapy. Two of the forms of psychotherapy that are often used in treating BPD are cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT).
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Cognitive Behavioral Therapy (CBT)

CBT is one of the most frequently practiced forms of psychotherapy. This form of therapy strives to help you learn how your thoughts affect your feelings and behaviors. CBT uses reasoning and critical thinking to help you see your problems in a logical way.

By using this approach, you’ll work with your therapist on recognizing and reducing self-defeating thoughts and behaviors. This can help you to respond to day-to-day challenges in healthier ways and with less reactivity. This type of therapy works to change behaviors, which can help to change mood and thoughts.

Dialectical Behavior Therapy (DBT)

DBT was designed specifically to treat people with BPD. It’s a form of CBT that focuses on skills like tolerating distress, regulating your emotions, living in the present and managing your interactions with others. It aims to help you change your behavior patterns rather than trying to think or talk through issues that are causing problems in your life.

If you’re being treated with DBT, you’ll participate in different settings, including individual therapy, learning new skills in a classroom environment and phone coaching. Therapists meet with a consultation team to work on finding solutions for complex issues. DBT includes four main strategies:

• Mindfulness – This is skill that helps you to stay focused on the present moment, which can help you to reduce rumination and alter your ability to process and solve problems.
• Distress tolerance – You’ll learn skills to help you accept your current situation and tolerate uncomfortable feelings while you work toward resolving problems.
• Emotional regulation – This is a method of recognizing and coping with negative emotions to help reduce or prevent potentially destructive or harmful behaviors.
• Interpersonal effectiveness – You’ll learn how to express and assert your needs without being aggressive.

Differences Between CBT and DBT

CBT and DBT share some common characteristics. Both acknowledge that thoughts influence feelings, which in turn affect behavior. Both require a good relationship between patient and therapist for it to be effective.

DBT recognizes that those with BPD sometimes don’t feel validated or that their emotions seem to be minimized. If this happens, patients end up quitting therapy. DBT adds acceptance and validation to help you accept your feelings as real and valid. When your therapist also accepts your feelings as valid, it helps to build trust in the relationship, so you can work toward a balance between acceptance and change. DBT has been found to be very effective for people who are suicidal or self-harm, because it offers coping skills that work in many different situations.

Choosing the Best Form of Psychotherapy to Treat BPD

Different people respond differently to each type of therapy, so a psychotherapist trained in treating BPD will consider your personality and the nature of the problems being treated when choosing a form of therapy that is likely to be most helpful to you. Both CBT and DBT have been found to be helpful for people who are struggling with BPD.

DBT is a modified form of CBT that uses many of the same cognitive-behavioral skills that are used in traditional CBT.  If you have BPD and have found that CBT isn’t as effective as you and your therapist have hoped it will be, the skills learned in DBT can be very effective in teaching ways to cope. Learning to manage your emotions and behaviors using either CBT or DBT can be done but takes time, and is most effective when you obtain treatment from a therapist who has training and experience in treating BPD.

If you or a loved one are struggling with Borderline Personality Disorder or another mental health disorder, please contact us at (855) 409-0204 or submit the form below and a treatment specialist will contact you.