Reviews for Cognitive-Behavioral Treatment of Borderline Personality Disorder

The average rating for Cognitive-Behavioral Treatment of Borderline Personality Disorder based on 2 reviews is 4 stars.

Review # 1 was written on 2011-09-17 00:00:00 Marina Maniatis Just started reading this book. However, it's interesting to note that Dr. Marsha Linehan developed this style of therapy because she herself suffered from Borderline Personality Disorder. (BPD) Her style of therapy is both Cognitive and Dialectical. ( CBT and DBT) DBT is based on a model suggesting that both the cause and the maintenance of BPD is rooted in biological disorder combined with environmental disorder. The fundamental biological disorder is in the emotion regulation system and may be due to genetics, intrauterine factors before birth, traumatic events in early development that permanently affect the brain, or some combination of these factors. The environmental disorder is any set of circumstances that pervasively punish, traumatize, or neglect this emotional vulnerability specifically, or the individual's emotional self generally, termed the invalidating environment. The model hypothesizes that BPD results from a transaction over time that can follow several different pathways, with the initial degree of disorder more on the biological side in some cases and more on the environmental side in others. The main point is that the final result, BPD, is due to a transaction where both the individual and the environment co-create each other over time with the individual becoming progressively more emotionally unregulated and the environment becoming progressively more invalidating. Emotional difficulties in BPD individuals consists of two factors, emotional vulnerability plus deficits in skills needed to regulate emotions. The components of emotion vulnerability are sensitivity to emotional stimuli, emotional intensity, and slow return to emotional baseline. "High sensitivity" refers to the tendency to pick up emotional cues, especially negative cues, react quickly, and have a low threshold for emotional reaction. In other words, it does not take much to provoke an emotional reaction. "Emotional intensity" refers to extreme reactions to emotional stimuli, which frequently disrupt cognitive processing and the ability to self soothe. "Slow return to baseline" refers to reactions being long lasting, which in turn leads to narrowing of attention towards mood congruent aspects of the environment, biased memory, and biased interpretations, all of which contribute to maintaining the original mood state and a heightened state of arousal. An important feature of DBT is the assumption that it is the emotional regulation system itself that is disordered, not only specific emotions of fear, anger, or shame. Thus, BPD individuals may also experience intense and unregulated positive emotions such as love and interest. All problematic behaviors of BPD individuals are seen as related to re-regulating out of control emotions or as natural outcomes of unregulated emotions. Dialectical Behavior Therapy: The Treatment Model DBT assumes the problems of BPD individuals are twofold. First, they do not have many very important capabilities, including sufficient interpersonal skills, emotional and self regulation capacities (including the ability to self regulate biological systems) and the ability to tolerate distress. Second, personal and environmental factors block coping skills and interfere with self regulation abilities the individual does have, often reinforce maladaptive behavioral patterns, and punish improved adaptive behaviors. Helping the BPD individual make therapeutic changes is extraordinarily difficult, however, for at least two reasons. First, focusing on patient change, either of motivation or by teaching new behavioral skills, is often experienced as invalidating by traumatized individuals and can precipitate withdrawal, noncompliance, and early drop out from treatment, on the one hand, or anger, aggression, and attack, on the other. Second, ignoring the need for the patient to change (and thereby, not promoting needed change) is also experienced as invalidating. This is the perfect handbook for any therapist who works with BPD or with people who have a difficult time regulating their emotional world.

Review # 2 was written on 2009-04-11 00:00:00 Simon Grech This book is not an easy read, but is well worth the effort. Dr. Linehan understands people with Borderline Personality Disorder, and how they got that way. If more of us understood emotional invalidation, and knew how to validate our children, ourselves, and each other, most mental illnesses as we know them would not exist.