Today’s blog is all about finding alternatives to the Dialectical Behavioral Therapy Model (DBT) of treating Borderline Personality Disorder. I decided to focus on this because I have had a lot of calls recently from clients seeking treatment for BPD. Most of these clients have said something like “I’ve done DBT for a long time and I’m not getting the results I want.” Those results often look or feel like deeper connections to the people around them, having more moments of satisfaction in their experiences and being able to trust their decision-making.
DBT is a fantastic treatment modality and has been the gold standard for BPD treatment since it’s development in the 1980s by Marsha Linehan, a psychologist at the University of Washington. Dialectical Behavioral Therapy is traditionally a structured intensive program that addresses issues of safety such as – mood swings leading to self harm including suicide attempts and harm to others, as well as alcohol & substance abuse. In one study, the use of intensive DBT led to up to 77% of participants no longer meeting the criteria for a DBT diagnosis. While this is super impressive and many people benefit form DBT, it isn’t for everyone.
So what do you do when you feel DBT isn’t working or isn’t enough?
Consider Treating Trauma
One place where the DBT model falls short is the actual processing a trauma that may be present in those with DBT. If you’ve completed a DBT program and still feel there is work to do, finding a trauma-focused therapist may be a helpful second step. Here are some great types of therapy to address trauma.
1. Internal Family Systems Therapy (IFS) – If you are someone that has really learned the skills of DBT and maybe even made great progress but still have trouble trusting others or making decisions, IFS may be a great option. IFS is a type of therapy that is done individually with your clinician (not to be confused with family therapy). IFS is a system of understanding how to work out the many different conflicts we have internally. It is also a great therapy for healing from trauma. Here is a great article by Martha Sweezy from the American Psychological Association on the promising results of Internal Family Systems Therapy on addressing unresolved trauma in people struggling with DBT.
2. DBT Informed Hypnotherapy – While hypnotherapy might not be the first thing you think of as an additional treatment for DBT, finding a hypnotherapist who is DBT informed can be extremely powerful. Hypnotherapy is great for so many things from addictive behaviors to emotional regulation to finding increased satisfaction in our lives. DBT is also great for reducing feelings of panic and overcoming social anxiety. I often recommend this as an addition to DBT (plus its my favorite type of therapy😊
3. Yoga-Therapy – Another no-brainer combo for DBT in my book is yoga=therapy. Yoga-therapy (not to be confused with a yoga class) is an individualized treatment session that uses body awareness, breathwork, philosophy and compassion-building to deepen a client’s relationship with themselves and the world around them. BPD can be super isolating and painful. Yoga-therapy helps to relieve that.
4. Art Therapy – Another common experience of someone with BPD is feeling unheard, misunderstood and generally neglected. Art therapy sessions are generally focused around emotional expression and the ability to understand situations in a new way. Art therapy is also a powerful tool to process trauma.
No matter where your next step in your healing journey, its always good to look for practitioners who are familiar with standard practices in treating BPD. That combined with another type of therapeutic framework can be truly transformational.
Need help deciding which type of therapy might be best for you right now?