What are the treatments for borderline personality disorder?

What are the treatments for borderline personality disorder?

Rhoda Hahn (Psychiatrist) gives expert video advice on: Who is at risk for borderline personality disorder?; What are the treatments for borderline personality disorder? and more...

There have been books and books and books written about the psychotherapy of borderline personality disorder and how you should do it, and everybody has lots of different ideas about how it can be accomplished. I think in general, though, it's trying to develop some insight in these patients that their behaviour is actually responsible for people's reactions to them and the chaos in their lives. Treatment, the individual psychotherapy with a borderline patient, can be very challenging because they will try to recreate the chaos in their external lives and the internal chaos they feel; they'll try to recreate that in the psychotherapy setting. So, if you have a borderline patient in psychotherapy, hold on tight because it's going to be kind of a ride. You've got to be able to tolerate the ups and downs. Oftentimes it appears that the patient is trying to go from crisis to crisis to prevent any meaningful work getting done in therapy, and a lot of what you end up doing is managing those crises. What we end up doing is treating a lot of the symptoms; lots of mood stabilisers and anti-compulsants have been used to address the impulsivity seen in these patients, or even the rage attacks that they're prone to. Since many borderline patients meet the criteria for mood and anxiety disorders it is very common for them to get treated for that as well. Then, they are prone to transient psychoses when they get stressed out, and so it's not uncommon to see them on low-dose antipsychotics.