People with borderline personality disorder (BPD) have interpersonal relationships characterized by irrational behavior and instability. They often have significant trouble in maintaining close attachments with others, even therapists, because they have difficulty separating out their own personal feelings and thoughts from those around them.
BPD is traditionally treated with a combination of a specific type of psychotherapy (called dialectical behavior therapy) and sometimes medications to treat other specific, related concerns (such as depression).
But an alternative psychotherapy treatment approach is also available, called mentalization based therapy (MBT). This psychodynamic approach focuses on helping an individual separate out what thoughts and feelings are theirs, and what thoughts and feelings are others’. While this may seem like an obvious thing to know or how to do, it is theorized that people with borderline personality disorder often have difficulty with just this thing.
New research published today in the American Journal of Psychiatry has found that five years after treatment was completed, people who received mentalization treatment did significantly better than those who didn’t (on measures such as suicidality, diagnosis, medication, global functional and use of additional treatment services).
The mentalization treatment group received 18 months of mentalization based therapy, and they also received another 18 months of maintenance mentalizing group therapy, for a total of 3 years worth of treatment.
Keep in mind that personality disorders like borderline are disorders a person takes a lifetime to learn. Anything that can significantly impact these kinds of disorders in just 3 years’ time is an important treatment approach to note.
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5 Comments to
“An Alternative Treatment for Borderline Personality Disorder”
I’m thrilled to hear of this new treatment method for Borderlines — Mentalization Based Therapy (MBT).
Because that’s exactly the problem Borderlines have !!
They have a thought of their own as to what other people are thinking (”They’re late home from work because they don’t love me anymore”).
That thought causes them to have a feeling (”I feel abandoned”).
That feeling then becomes a fact in their mind (”I ‘am’ going to be abandoned”) — and they then act on that feeling as if it were real.
It’s crazy — and there’s no way another person can even begin to imagine that this is the process going on in the head of a Borderline. So we defend ourselves, try to reason with them, placate them, on and on.
A relationship with a Borderline is like being in the Fun House at a carnival, where the images are all odd, and you can’t see through them to the true picture.
I used to tell my Borderline partner that it seemed like he had “screens over his ears” — what I said was translated into something else when it went into his brain.
I saw the Borderline behavior very clearly. I just didn’t know about the Borderline disorder. I didn’t know the name of my pain.
I forgot to sign my name to my previous post about Borderlines and the “screens over their ears”.
Lynn Melville
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yes. this makes so much sense. and it is welcome for those of us who are just too smart for DBT to work. Nothing like a borderline’s ability to outsmart theraputic methodology even as we seek help. ps thank you to Lynn Melville for the viewpoint of BPDers as “they” and her compassion for her partner. Please note that my comment is BPDers as “we.”
Where can a patient receive this type of treatment?
Hi, I just heard of this type of therapy and am researching it. It sounds interesting to me, although I don’t know enough to have an informed opinion, yet.
I did want to say that I don’t believe anyone is “too smart” for dbt. If ones perceives dbt as stupid, that’s either a borderline thinking issue or a bad group/therapist doing the dbt training.
I am very smart and I love dbt. I think it’s a great technique. What I like most about it is how mulitpronged as approach it is. I don’t get that sense yet with mentalization but, as I said, I don’t have a good grasp on it yet.
Pea
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Last reviewed: By John M. Grohol, Psy.D. on 17 Mar 2008
