CBT and Borderline Personality Disorder

Page content

Overview of Borderline Personality Disorder

Borderline personality disorder is usually only diagnosed in people over the age of 18, and is most often found in women. Characteristics of the borderline patient include extreme thinking (also known as black and white thinking), a love/hate relationship with others, impulsive decision making, inability to cope with being alone, fear of abandonment, loss of control over her emotions, feelings of emptiness, a lack of identity and self-injurious behaviors.

The borderline person often has chaotic relationships with others, either pushing them away or pulling them close. They feel out of control in regards to their emotions. They are unstable. BPD can come from abandonment as a child, abuse, poor communication as a child, or growing up in a dysfunctional family. Many people with BPD feel powerless over their condition.

Overview of Cognitive Behavior Therapy

CBT has various components that can teach a person how to better manage their emotions. These components include Rational Behavior Therapy, Rational Living Therapy, Rational Emotive Behavior Therapy, Cognitive Therapy and Dialectical Behavior Therapy.

CBT teaches the person to actually change their thoughts, so that their emotions can follow. This form of therapy is direct, structured and hands-on; the person is given written homework that helps them look at how their thinking is creating chaos in their life. The more aware the person is of their own thought patterns, the more in control they become of what they do with those thoughts.

For example, if a person is stuck in traffic their mind will probably start thinking about how awful it is that they are going to be late. There are now two options: the person can give into those thoughts and get upset and angry, or they can accept the situation as it is, knowing that nothing can be done to change it, and move their mind elsewhere.

If the person gets angry, it will most likely affect the outcome of their day; if they accept what they are thinking without allowing it to determine what they are feeling, they remain in control. This way there are numerous benefits of CBT for borderline personality disorder.

How Cognitive Behavior Therapy Can Help Borderline Personality Disorder

CBT emphasizes the importance of emotions, particularly emotional management in leading a happy and fulfilling life. For the person with borderline personality disorder this seems like an impossible feat at first.

CBT lasts for sixteen weeks, and throughout that time, the patient works one-on-one with a trained CBT therapist who tries to help the patient learn to reframe their thinking and take control of their emotions. CBT teaches that thoughts control emotions and emotions control behaviors. Since people with borderline can be aggressive and violent when their emotions are strong, being able to control the thought will enable them to change the way they behave in the event of a particular emotion.

Written assignments give the borderline an opportunity to chart their distorted thinking so that they can deconstruct it with their therapist and see where their thinking is skewed. Some assignments teach them to look at their black and white thinking, and try to find a gray area while they are in the midst of the particular situation.

CBT teaches that practice and repetition can lead to routine and habit. If the patient continually tries to challenge distorted thinking, it will eventually become second-nature. Borderline personality disorder is one of the few personality disorders that is not chronic. People can and do recover from BPD and the benefits of CBT for borderline personality disorder are evident. Cognitive behavior therapy is a successful way to help people get on the path to recovery and a more stable life.


Borderline Central Accessed October 13, 2010

NIMH: Borderline Personality Disorder Accessed October 13, 2010