About Schema Therapy for Borderline Personality Disorder

Schema therapy expands significantly on the proven principles of cognitive-behavioral treatments. The model draws on strategies from object relations, attachment and self theories, psychodynamic therapy, and emotion-focused therapies. Schema therapy is especially well-suited to treating Borderline Personality Disorder.

Therapists learn how to work with rapidly shifting, intensive affective states ("modes") of BPD patients: the fearful side that frantically avoids real or imagined abandonment; the empty, sad side that desperately tries to fill an emotional void; the angry, impulsive side who is enraged and behaves impulsively; the internalized voice of the critical and punishing parent; and the side that shuts off all emotions, disconnecting them from other people. Schema therapists view BPD patients compassionately, as needy, not greedy. The therapist serves as the "good parent" to the patient's vulnerable side. Through the therapist's "limited reparenting," BPD patients develop a strong, healthy side to calm, soothe, and care for their emotionally intense, labile temperament. With schema therapy, BPD patients are able to:

• calm and soothe intense fear, sadness, and helplessness
• give and receive love, even when terrified of being abandoned
• fight against highly critical, self-punishing thoughts
• express emotions and needs appropriately
• reassure and replace the detached, depersonalized side

Using other types of psychotherapy methods, many therapists may become frustrated in treating BPD. But with schema therapy, therapists use a three stage developmental approach that is flexible, yet direct and structured. This approach provides highly effective strategies to treat even the most difficult symptoms of BPD. Therapists take an active role to help BPD patients foster deep and far-reaching personality changes in their lives.