How to Engage in Dialectical Behavioral Therapy

Diagnosing Borderline Personality Disorder is the first step in rebuilding the lives over six million Americans, predominantly women. BPD affects relationships through the manipulative behavior that this disorder causes. Once thought to be caused exclusively by a childhood without sufficient nurturing, researchers have now proven specific physical differences in the brains chemistry that lead to feelings of fear and abandonment and the inability to inhibit impulsive behavior. This gives new hope to individuals seeking treatment and their families. Medications can restore the normal chemistry of the brain and Bialectical Behavioral Therapy or DBT can then be used to restore functional behavior.

Things You'll Need

• The diagnosis of Borderline Personality Disorder
• Psychiatrist to prescribe medications needed
• Psychologist trained in D.B.T,
• Public treatment programs

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Instructions

Treating BPD with Dialectical Behavioral Therapy

• 1

  Find a Board Certified Psychiatrist to confirm the diagnosis of Borderline Personality Disorder after completing a self screening. Be aware that BPD is commonly diagnosed with one or more other conditions such as depression, anxiety, bipolar disorder or substance abuse. Honestly disclosing your symptoms is crucial in securing an accurate diagnosis. It may be helpful to take a support person with you to insure that the symptoms you are describing are taken seriously.

• 2

  Research medication options. Before starting medication for BPD research which drugs are proven most effective. Learn the side effects of each medication option and consult with your primary care physician to make sure there are no contradications in your medical history, Call your insurance company and ask to speak with a Case Manager. This nurse can research medication options for you and provide you with the cost of buying monthly prescriptions. Then call the psychiatrist and discuss the information you've discovered. Medications for Borderline Personality Disorder are usually required for a long time. It's important to know you will be able to take the medications you and your doctor have chosen and that you're able to pay for them, too.

• 3

  Locate a Clinical Psychologist trained in Dialectical Behavioral Therapy. Your insurance company's Case Manager can help you find two or three psychologists to interview. Look for a Clinical Psychologist who is prepared and trained through a program of supervised program in Dialectical Therapy. When interviewing the psychologist ask about their BPD treatment philosophy. Look for a provider who is positive about the opportunity to affect a complete remission from the symptoms of BPD and one who is up to date on the evidence that BPD is a physiological disease and that medication offers the best chance of a complete remission. The personality of an effective DBT therapist should combine a positive, hopeful outlook, kindness and supportiveness, and a non-judgmental spirit.

• 4

  Check with your insurance company to insure the providers you have selected are on their approved list and that DBT is a covered benefit for the diagnosis of BPD. If you are covered by insurance call to ask your provider to appoint a Nurse Case Manger with expertise in behavioral health care to help you manage your treatment. Let the Case Manager know you have been diagnosed with BPD and discuss any other diagnoses as well. The Case Manager can help you research medication options, locate Board Certified Psychologists and she can help you calculate the cost of your treatment. Remember that not treating BPD is far more expensive than medication and DBT. People with untreated BPD have a very low chance of professional success and the relationship damage that accompanies BPD is very expensive too. Legal fees for divorce or child custody, the costs of living alone, impulsive spending and the costs of lost jobs are much higher than finally taking control of your BPD and your life. If you are uninsured or if you don't have the funds to pay your copays and deductibles call the National Institute of Mental Health and ask for a referral to a no cost or a low cost clinic in your area. If your insurance does not cover mental health care talk to your primary care provider about prescribing and call a local University's Department of Clinical Psychology to determine whether DBT is offered there. These are cost-saving measures that can make treatment affordable.

• 5

  Begin taking the medications prescribed in consultation with your psychiatrist or primary care provider.

  Most medications used to treat Borderline Personality Disorder take several weeks to reach an effective level in your blood. Some have side effects that go away with time. Be patient but report side effects to your prescribing health care provider right away.

  Remember BPD is the result of abnormal patterns of neurotransmitters in your brain the medications you are taking are like insulin to a diabetic. They are necessary. It's your right to seek and receive effective treatment for this disease and treatment, including medications is a sign you are ready to become an active particpant, seeking your highest level of wellness and functionality.

• 6

  Attend the private sessions and group sessions of DBT and complete all homework assignments, a process that should take about a year.

  Once you start the treatment process you will progress through four phases. The first phase is a pre-commitment period where you will assess how BPD has affected your life and those of others in your life. During this phase you will be asked to commit to change and the therapist will discuss how that change will be supported. The dialectical nature of DBT is that it recognizes that change is necessary and that change is difficult at the same time. Your goal of this phase is to accept those two truths and to commit to the journey ahead.

  In the first real phase you will be learning new behavioral patterns starting with changing any life-threatening or treatment-threatening behaviors.

  The second phase is designed to increase the your ability to experience a full range of emotions and to reduce post-traumatic stress disorder symptoms. Not everyone with BPD has had traumatic events in their lives but many have and this phase is about resolving the past to free the present.

  The final two phases are the time to rebuild your self esteem based on real accomplishments and dealing with the question of your identity; both factors hurt by BPD.