Inspiring words from a recovered Borderline
An Open Letter To Everyone with Borderline Personality Disorder
by Ms. A.J. Mahari
Excellent first read for someone freshly diagnosed with BPD.
Emotional Memory Management: Positive Control Over Your Memory
by Joe Carver, PhD.
Choices
by Kerry Dennis
This is a wonderfully inspiring personal article by a woman diagnosed with DID, but very applicable to those with BPD, too.
A Personal Note to People with Anxiety
by Thomas A. Richards, Ph.D, from the Anxiety Network
Self-Soothing and the Borderline
another fabulous article by A.J. Mahari
OK ...so you have a mental illness. What are you going to do about it? Acceptance, Education and Redemption
by Darren Fleeger
Living with Mental Illness: Road to Recovery
from Hopeallianz
Choosing A Therapist for Borderline Personality Disorder
Tips from Dr. Paul Hannig
There may indeed be hope for overcoming the neurologically-based symptoms of BPD
Reclaiming Your Power During Medication Appointments with your Psychiatrist
by Patricia Deegan, Ph.D.
The Three R's for Psychiatric Hospital Patients: Rights, Rules, and Responsibilities
Excellent thoughtful information from Ann Palmer, a woman with Bipolar and Borderline Personality Disorders. She discusses involuntary medication, patient abuse, and general issues of being hospitalized.
Another Sample Crisis Plan for folks with BPD to work on with loved ones
General Discussions of Treatment for BPD
APA Practice Guideline for the Treatment of Patients With Borderline Personality Disorder
There are many treatment options for those suffering from
BPD. In general, current psychiatric research suggests
that the most effective treatment of
Borderline Personality Disorder consists of medication to
contain the more stubborn affective symptoms, combined
with some form of long-term psychotherapeutic
intervention.
This page discusses the many psychotherapeutic ("talk therapy") approaches to BPD treatment. See the page on Medications for BPD to learn more about pharmacotherapy for BPD.
Regardless of the type of therapy selected, the basic goals of a treatment plan for Borderline Personality Disorder should ideally include:
1. Learning pursuit of stable goals
2. Maintaining motivation in pursuit of goals
3. Improving tolerance for frustration
4. Reducing self destructive behavior
5. Developing a productive vocational role
6. Learning to modulate affective intensity
7. Developing stable social ties
8. Developing durable, stable intimate relationships
9. Improving sensitivity and tolerance of needs of others
10. Developing a sense of own strengths and limitations
11. Cultivating ability to be alone
12. Learning to accede control to others
-- Harry L. Mills, Ph.D.
In general, classic psychoanalytic therapy (a la Freud) is not recommended for Borderlines, as this therapy presupposes a level of self-recognition not often found in BPD sufferers. Psychoanalysis' emphasis on the silent receptivity of the analyst to self-exploration guided by the patient can also trigger the Borderline's fears of abandonment and lack of acceptance. However, there are some psychoanalytically-trained therapists who do specialize in treating BPD. Always ask any potential therapist about their experience and successes in treating the personality-disordered.
For similar reasons, self-help workbooks are generally not as effective as one-on-one therapy with a trained counsellor, but there are many workbooks available as adjuncts to clinical treatment or for those who have limited access to BPD-specific treatment. I have a list of them below on this page.
Cognitive Behavioral Therapy (CBT) -- in which more emphasis is placed on re-structuring one's behavioral responses to current life situations than on "uncovering" past trauma -- has shown great efficacy for treating Borderline and other personality disorders, particularly in the beginning of treatment. The immense subjective pain experienced by the Borderline regarding past abuse can be a huge deterrent to advancing in therapy, and CBT can offer an interim approach before these issues are addressed in more detail.
Dialectical Behavioral Therapy (DBT) is a variant of cognitive therapy developed specifically for BPD by Dr. Marsha Linehan of the University of Washington, Seattle. While still in its early years, in clinical studies DBT appears to be at least as helpful in treating BPD as standard cognitive behavioral therapy, and has been very enthusiastically received by the BPD treatment community. Linehan incorporates techniques from Buddhist mindfulness practice into a very effective Western-style therapeutic prgram. Read more specifics on DBT in the section below.
Another variant is Transference-Focused Psychotherapy, developed for personality disorders by Dr. Otto Kernberg and colleagues at the highly-respected Personality Disorders Institute of the New York Presbyterian Hospital. Kernberg incorporates insights from the psychoanalytic tradition into a program for BPD treatment.
In general, standard group therapy is not often recommended for those with BPD, unless it is a highly structured environment such as Dialectical Behavioral Therapy or other groups tailored specifically for Borderline clients. For the Borderline, subjective feelings of worthlessness and the need to compete for caretaker attention can worsen in a group situation; also, some studies have shown that the presence of someone with BPD in a group setting can significantly impact the therapeutic effect for non-BorderlineD participants. A better alternative might be Medication Support Groups.
For couples, in general, individual counselling of each partner is strongly recommended over mutual couples' therapy. Borderlines not yet in advanced recovery tend to respond to such couples sessions with increased needs to prove the partner's "blame", split the therapist 'bad' and exit the process entirely, or engage in behaviors unconsciously designed to validate their perspective by "winning the therapist over." Unfortunately, counsellors with little training in BPD can often fall victim to such manoeuvers, rendering couples' therapy ineffective and frustrating for both partners. One concern often expressed by NonBorderline partners is the fear that a therapist may label them fully at fault for the relationship troubles, or, worse, be unable to see through the myriad accusations and counter-accusations in order to determine the conflicts' source(s). See Who's the Sick One Here? for one therapist's view on this issue.
Family therapy is in general an excellent idea for anyone living with a chronic mental illness such as BPD. Studies of programs such as the Family-To-Family free education series offered by the National Alliance for the Mentally Ill (NAMI) have shown that caretaker education and involvement can vastly improve family dynamics overall. It's also highly recommended that children of Borderline parents (treated or untreated) are allowed the opportunity for therapeutic treatment of their own with a trained childhood psychology expert.
Inpatient treatment appears to be most effective in more serious scenarios where the Borderlines' behaviors are explicitly life-threatening to themselves or others. A tendency of those with BPD to become dependent on the pseudo-nurturing environment of hospitalized care has been noted in several studies, but there are times when it is both appropriate and desirable, particularly among younger Borderlines. On the other hand, a recent study found that inpatient hospital stays were not any more effective at preventing suicide than outpatient day programs. This may be due to the lack of intense psychotherapeutic focus of many inpatient care programs, which instead emphasize medicating the extreme swings of Bipolar manic-depression, the standard historical model of inpatient crisis (which, alas, doesn't apply to the learned behavioral patterns of BPD).
Outpatient treatment, generally consisting of three or more hours per day of treatment sessions in a rigidly-structured clinical environment, has been shown to have great success; it combines the neccessary structured therapy with a subjective sense of control over one's daily life. Often such treatment requires various forms of commitment contracts agreed to by the patient.
Physiologically-based therapies developed specifically for trauma survivors, such as EMDR Therapy, Neuro Feedback Therapy or Neural Linguistic Programming have shown some efficacy in treating BPD, although they appear most effective as a supplement to other sorts of 'talk therapy.' These appear most effective in cases where somatic post-traumatic symptoms are aggravated (sleeplessness, jumpiness, crying jags, etc). See more on these in the section below.
Electro-Convulsive Therapy (ECT, or electric shock treatment), has not been thoroughly evaluated for its use in helping BPD sufferers. One study found that it may be helpful for alleviating comorbid treatment-resistant depression, but not for the behavioral/affective symptomatology of BPD itself.
Medication for BPD generally runs to anti-depressants (usually SSRIs), mood stabilizers (lithium, Depakote, etc), anxiolytics (anti-anxiety drugs such as benzodiazepam, BuSpar), medications to temper addictive impulsivity and self-harm (Revia, etc), prescription sleeping aids, and newer anti-psychotics (Zyprexa, Risperdal) for controlling brief psychotic episodes. For many more details on these and other medications, please see my entire page on Medication for BPD.
This page discusses the many psychotherapeutic ("talk therapy") approaches to BPD treatment. See the page on Medications for BPD to learn more about pharmacotherapy for BPD.
Regardless of the type of therapy selected, the basic goals of a treatment plan for Borderline Personality Disorder should ideally include:
1. Learning pursuit of stable goals
2. Maintaining motivation in pursuit of goals
3. Improving tolerance for frustration
4. Reducing self destructive behavior
5. Developing a productive vocational role
6. Learning to modulate affective intensity
7. Developing stable social ties
8. Developing durable, stable intimate relationships
9. Improving sensitivity and tolerance of needs of others
10. Developing a sense of own strengths and limitations
11. Cultivating ability to be alone
12. Learning to accede control to others
-- Harry L. Mills, Ph.D.
In general, classic psychoanalytic therapy (a la Freud) is not recommended for Borderlines, as this therapy presupposes a level of self-recognition not often found in BPD sufferers. Psychoanalysis' emphasis on the silent receptivity of the analyst to self-exploration guided by the patient can also trigger the Borderline's fears of abandonment and lack of acceptance. However, there are some psychoanalytically-trained therapists who do specialize in treating BPD. Always ask any potential therapist about their experience and successes in treating the personality-disordered.
For similar reasons, self-help workbooks are generally not as effective as one-on-one therapy with a trained counsellor, but there are many workbooks available as adjuncts to clinical treatment or for those who have limited access to BPD-specific treatment. I have a list of them below on this page.
Cognitive Behavioral Therapy (CBT) -- in which more emphasis is placed on re-structuring one's behavioral responses to current life situations than on "uncovering" past trauma -- has shown great efficacy for treating Borderline and other personality disorders, particularly in the beginning of treatment. The immense subjective pain experienced by the Borderline regarding past abuse can be a huge deterrent to advancing in therapy, and CBT can offer an interim approach before these issues are addressed in more detail.
Dialectical Behavioral Therapy (DBT) is a variant of cognitive therapy developed specifically for BPD by Dr. Marsha Linehan of the University of Washington, Seattle. While still in its early years, in clinical studies DBT appears to be at least as helpful in treating BPD as standard cognitive behavioral therapy, and has been very enthusiastically received by the BPD treatment community. Linehan incorporates techniques from Buddhist mindfulness practice into a very effective Western-style therapeutic prgram. Read more specifics on DBT in the section below.
Another variant is Transference-Focused Psychotherapy, developed for personality disorders by Dr. Otto Kernberg and colleagues at the highly-respected Personality Disorders Institute of the New York Presbyterian Hospital. Kernberg incorporates insights from the psychoanalytic tradition into a program for BPD treatment.
In general, standard group therapy is not often recommended for those with BPD, unless it is a highly structured environment such as Dialectical Behavioral Therapy or other groups tailored specifically for Borderline clients. For the Borderline, subjective feelings of worthlessness and the need to compete for caretaker attention can worsen in a group situation; also, some studies have shown that the presence of someone with BPD in a group setting can significantly impact the therapeutic effect for non-BorderlineD participants. A better alternative might be Medication Support Groups.
For couples, in general, individual counselling of each partner is strongly recommended over mutual couples' therapy. Borderlines not yet in advanced recovery tend to respond to such couples sessions with increased needs to prove the partner's "blame", split the therapist 'bad' and exit the process entirely, or engage in behaviors unconsciously designed to validate their perspective by "winning the therapist over." Unfortunately, counsellors with little training in BPD can often fall victim to such manoeuvers, rendering couples' therapy ineffective and frustrating for both partners. One concern often expressed by NonBorderline partners is the fear that a therapist may label them fully at fault for the relationship troubles, or, worse, be unable to see through the myriad accusations and counter-accusations in order to determine the conflicts' source(s). See Who's the Sick One Here? for one therapist's view on this issue.
Family therapy is in general an excellent idea for anyone living with a chronic mental illness such as BPD. Studies of programs such as the Family-To-Family free education series offered by the National Alliance for the Mentally Ill (NAMI) have shown that caretaker education and involvement can vastly improve family dynamics overall. It's also highly recommended that children of Borderline parents (treated or untreated) are allowed the opportunity for therapeutic treatment of their own with a trained childhood psychology expert.
Inpatient treatment appears to be most effective in more serious scenarios where the Borderlines' behaviors are explicitly life-threatening to themselves or others. A tendency of those with BPD to become dependent on the pseudo-nurturing environment of hospitalized care has been noted in several studies, but there are times when it is both appropriate and desirable, particularly among younger Borderlines. On the other hand, a recent study found that inpatient hospital stays were not any more effective at preventing suicide than outpatient day programs. This may be due to the lack of intense psychotherapeutic focus of many inpatient care programs, which instead emphasize medicating the extreme swings of Bipolar manic-depression, the standard historical model of inpatient crisis (which, alas, doesn't apply to the learned behavioral patterns of BPD).
Outpatient treatment, generally consisting of three or more hours per day of treatment sessions in a rigidly-structured clinical environment, has been shown to have great success; it combines the neccessary structured therapy with a subjective sense of control over one's daily life. Often such treatment requires various forms of commitment contracts agreed to by the patient.
Physiologically-based therapies developed specifically for trauma survivors, such as EMDR Therapy, Neuro Feedback Therapy or Neural Linguistic Programming have shown some efficacy in treating BPD, although they appear most effective as a supplement to other sorts of 'talk therapy.' These appear most effective in cases where somatic post-traumatic symptoms are aggravated (sleeplessness, jumpiness, crying jags, etc). See more on these in the section below.
Electro-Convulsive Therapy (ECT, or electric shock treatment), has not been thoroughly evaluated for its use in helping BPD sufferers. One study found that it may be helpful for alleviating comorbid treatment-resistant depression, but not for the behavioral/affective symptomatology of BPD itself.
Medication for BPD generally runs to anti-depressants (usually SSRIs), mood stabilizers (lithium, Depakote, etc), anxiolytics (anti-anxiety drugs such as benzodiazepam, BuSpar), medications to temper addictive impulsivity and self-harm (Revia, etc), prescription sleeping aids, and newer anti-psychotics (Zyprexa, Risperdal) for controlling brief psychotic episodes. For many more details on these and other medications, please see my entire page on Medication for BPD.
Therapists discuss Treatment for BPD -- overviews of various strategies
"Love Me Or Hate Me: Treating the Impulsive, Emotionally Labile Borderline Personality-Disordered Client."
by Cardwell C. Nuckols, Ph.D.
Really fascinating presentation by a psychotherapist.
Understanding And Working With Borderline Personality Disorder
by Luciano Anthony Picchio, M.D.
Another excellent essay from the clinician's standpoint.
Borderline Personality Disorder: Profile and Process of Therapy
by Paul J. Hannig, Ph.D
Great overview from a developmental perspective.
Federal Report: Treatment Improvement Protocol on the Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse
Chapter 7: Personality Disorders/Borderline. Interesting reading; recommendations for therapeutic strategies and treatment from the National Institutes of Health.
Recent Developments in Borderline Personality Disorder
by Anthony P. Winston, June 2000
A good overview of all the recent developments in treatment and their efficacy.
Fairy Tale Princesses and Happier Endings
A good summary of recent treatment strategies by Dr. Richard Moskovitz
Borderline Personality Disorder
by John M. Rathbun, M.D.
Good brief fact sheet on BPD; details the 'modes' of the BP in a therapeutic setting.
3 Levels of BPD Emotion During Treatment
by Dr. John Gunderson, a leading researcher of BPD at MacLean Hospital in Boston.
Researchers Study Causes and Treatment of BPD
By Glen O. Gabbard, M.D., another leading BPD researcher, 1995
BPD: Description/Treatment/Advocacy
by Dr. Joel Paris, McGill University, Montreal; Paris runs a specialized BPD treatment program.
Suicidal Behavior in Borderline Personality Disorder: The Scope of the Problem and Psychotherapeutic Approaches
by Barbara Stanley, Ph.D.
BPD: Recent Advances in Psychotherapeutic Therapies
by Richard Moskovitz, MD, author of the popular Lost in the Mirror.
Clinical guidelines for psychotherapy for patients with borderline personality disorder
by Michael Stone, MD, 2000.
Group Counseling and Borderline Personality Disorder: A psychodynamic approach
by Maria Campo-Redondo
Group Therapy with Psychotic and Borderline Patients: The Difficult Patient in Group
by Howard D. Kibel M. D.
An Interview with Otto Kernberg, M.D.
by Chanda Rankin, 2001
Interesting interview with one of the "fathers" of borderline personality disorder classification.
Listening to High Utilizers of Mental Health Services: Recognizing, responding to and recovering from trauma
Lyn Blackshaw, Ph.D., Andrea Levy, M.A., L.P.C., Janice Perciano, B.S., February 1999
Personality Disorders Among Difficult Patients
by Sean Schafer, MD; David P. Nowlis, PhD, 1998
Interesting full-text study of recognition of the personality disordered based on their interaction with general practitioners.
Group Psychotherapy with Psychotic and Borderline Patients: Medication-Support Groups: are They "Group Therapy"?
by Paul Cox
Ego-State Therapy: An Overview
by Helen H. Watkins
"Ego-state therapy is a psychodynamic approach in which techniques of group and family therapy are employed to resolve conflicts between various "ego states" that constitute a "family of self" within a single individual."
Ego State Therapy and Victimization
by Patricia D. McClendon, MSSW, CSW
Great overview of the specific use of ego-state therapy for dissociative disorders.
Psychoanalytic Treatment of Borderline Personality Disorder
by Anthony W. Bateman, M.A., F.R.C.Psych. Psychiatric Times July 2001
The development of a psychodynamic treatment for patients with borderline personality disorder: a preliminary study of behavioral change
Kernberg et al, Dec. 2001
"This study examines the effectiveness of a modified psychodynamic treatment called Transference Focused Psychotherapy (TFP) designed specifically for patients, with borderline personality disorder (BPD)."
Borderline Personality Disorder: Splitting Countertransference
by Marcia Kraft Goin, M.D.
The Analytic Space: Countertransference and Evocative Knowledge
by Robert M. Young
Classical Adlerian Theory and Practice
Overview of personality development and treatment techniques from this perspective, by by Henry T. Stein, Ph.D. and Martha E. Edwards, Ph.D.
An Object Relations Approach to Projective Identification and the Borderline
by Kathi Stringer
Getting a handle on "projective identification".
Suicidal Behavior in Borderline Personality Disorder: The Scope of the Problem and Psychotherapeutic Approaches
by Barbara Stanley, Ph.D., 1999
Assessing and Treating Comorbid Mood and Substance Use Disorders
by Mark J. Albanese, M.D., Psychiatric Times April 2001
The Family Psychoeductional Approach : Rationale for a Multigenerational Treatment Modality for the Major Affective Disorders
by Demitri F. Papalos
Carl Jung and the MIPS Cognitive Modes Scales
by Theodore Millon, M.D.
Very technical, but this is the guy who developed one of the more often-used assessment tool for Personality Disorders. Millon is probably the best-recognized expert in personality disorder theory in America today.
Self-Management Therapy for Borderline Personality Disorder --- A Therapist-Guided Approach
by Michael H. Langley, Ph.D.
Exploring thriving in the context of clinical trauma theory: constructivist self development theory
(Thriving: Broadening the Paradigm Beyond Illness to Health)
by Karen W. Saakvitne
Abreaction Re-evaluated
Excellent discussion of the notion of abreaction (the remembering and working through of early traumatic memories, a Freudian principle of therapy) by specialists working with MPD (DID). Technical but very good.
Guidelines for the Treatment of Dissociative Identity Disorder
from the International Society for the Study of Dissociation.
Cognitive Behavioral Therapy (CBT)
Basics of Cognitive Behavioral Therapy
Cognitive Therapy Pages
A very nice set of essays outlining and explaining what cognitive therapy is and how it works, by Robert Westermeyer, PhD
Cognitive Therapy for Personality Disorders
by Judith Beck, PhD, 1996
Cognitive Therapy for Borderline Personality Disorder
APA Video with Mary Anne Layden, PhD
Scroll down to read the video's summary for a fabulous detailed write-up of how cognitive therapy was implemented for one BPD patient. ~recommended!
Treating personality fragmentation and dissociation in borderline personality disorder: a pilot study of the impact of cognitive analytic therapy
Abstract of a study by Wildgoose A, Clarke S, Waller G., 2001
"Recent findings suggest that personality fragmentation may be a core component of borderline personality disorder (BPD) and that successful treatment of BPD may depend on the extent to which this is addressed. Cognitive analytic therapy (CAT) can increase integration by strengthening awareness, and hence control, of the dissociative processes maintaining fragmentation. This pilot study aimed to conduct a systematic evaluation of the impact of CAT on BPD severity and personality integration."
Cognitive Therapy and Serious Mental Illness. An Interacting Cognitive Subsystems approach
By Isabel Clarke
Cognitive-Behavioral Treatment for Internet Addiction
by Robert Davis, M.A.
The Effectiveness of Cognitive Therapy in the Treatment of Non-psychotic Morbid Jealousy
Abstract of research Parker G, Barrett E., 1997, demonstrates effective treatment of morbid jealousy symptoms via OCD medication and cognitive therapy.
Cognitive Therapy for Borderline Personality Disorder
Videotape by Dr. Mary Ann Layden
Dialectical Behavioral Therapy
Dr. Marsha Linehan is the creator of Dialectical Behavioral
Therapy, one of the more successful recent treatment
strategies for BPD. It's based on a combination of innovations in Cognitive
Behavioral Therapy and on Eastern spiritual practices of 'mindfulness'. What does "dialectical" mean?
This is a term (used by the German philosopher Georg Friedrich Hegel, among others)
that means 'consisting of opposing forces.'
As anyone involved with BPD is aware, one of the more marked characteristics of this disorder is a heavy reliance on the defense mechanism of "splitting" -- shifting rapidly in one's perceptions from extremes of idealization/devaluation, love/hate, trust/betrayal, etc. The aim of DBT is to challenge these contradictory beliefs and to introduce the ability to achieve a more reality-based, balanced mediation between them. DBT is a mixture of group, individual and private work, and is generally offered by larger clinics or therapy centers. Read all about it below.
As anyone involved with BPD is aware, one of the more marked characteristics of this disorder is a heavy reliance on the defense mechanism of "splitting" -- shifting rapidly in one's perceptions from extremes of idealization/devaluation, love/hate, trust/betrayal, etc. The aim of DBT is to challenge these contradictory beliefs and to introduce the ability to achieve a more reality-based, balanced mediation between them. DBT is a mixture of group, individual and private work, and is generally offered by larger clinics or therapy centers. Read all about it below.
Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder
by Marsha Linehan, Ph.D., 1997
Dialectical behaviour therapy for borderline personality disorder
Excellent, clear full-text article by Robert L. Palmer, an eminent UK clinician in the field.
Purchase or review Linehan's DBT treatment volumes: Cognitive-Behavioral Treatment of Borderline Personality Disorder and Skills Training Manual for Treating Borderline Personality Disorder.
See Linehan's bibliography of publications.
Summary of DBT Research Studies to Date: Abstracts of Published Randomized Controlled Trials
Really excellent up-to-date information with charts from behavioraltech.org. (pdf file will automatically download, requires Adobe Acrobat to read)
The Middle Path
This is the home website of a nonprofit organization run by and for graduates of Dialectical Behavior Therapy who are in recovery from Borderline Personality Disorder. They put out a newletter and offer support resources for those working on DBT skills.
Behavioral Technology Transfer Group
Often updated web site includes many resources on DBT therapy. Click on 'resources: clinical resource directory' to find someone trained in DBT therapy in your area/country.
DBT in a Nutshell
Dialectical Behavioral Therapy: A Review and Call to Research
Great article by Lisa Smith and Patrick Peck.
A Promising Treatment of BPD
Descriptive overview of DBT
by John Gunderson, MD, & Elizabeth Murphy, PhD
Treatment of Borderline Personality Disorder Using Dialectical Behavior Therapy
by Thomas Lynch, Ph.D. and Clive Robins, Ph.D.
Using Dialectical Behavior Therapy to Treat Borderline Personality Disorder: A Broad Overview
by Mikako Osada
Fabulous article (one of the better I've seen) on the practice of DBT.
An Overview of Dialectical Behaviour Therapy in the Treatment of Borderline Personality Disorder
By Barry Kiehn and Michaela Swales, 1995
Very nice clear description of how DBT works in practice.
Not bad reading for a significant other, either.
The Behavioral Treatment of Self-Mutilation Using DBT
by Milton Brown
Great detailed article.
B.F. Skinner Meets Buddha in DBT
by Sally Hansell, LCSW
DBT OPENS THE DOOR TO RECOVERY FOR MANY
by Robin Boyd
Good Description of How DBT works for Borderlines
Adaptation from Linehan's DBT Skills workbook, by an individual with BPD.
Dialectical Behavioral Therapy: What It Is and How It Works, and
Mindfulness by Sarah J. Blake, 29th May 2001
Personal account of the effectiveness of DBT for one individual.
Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial
Bohus M, Haaf B, Simms T, Limberger MF, Schmahl C, Unckel C, Lieb K, Linehan MM., May 2004
DBT Empowers Abusive Men to Regain Self-Control
by Batya Swift Yasgur, March 2001
(You may have to register (it's free) to gain access to this article.)
Physiologically-Based Therapeutic Techniques:
EMDR Therapy (Eye Movement Desensitization and
Reprocessing)
NLP (Neuro-Linguistic Programming)
Neuro-Feedback Therapy
Hypnotic Psychotherapy
NLP (Neuro-Linguistic Programming)
Neuro-Feedback Therapy
Hypnotic Psychotherapy
Posttraumatic Stress Disorder (PTSD) and the Consciousness Restructuring Process
by Iona Miller and Graywolf Swinney, Asklepia Foundation, 2000
I found this to be a very enlightening article; ~recommended as a fabulous introduction to the physiological side of BPD therapy!
EMDR Therapy
What the heck is EMDR?
EMDR in Brief
Read about the book: EMDR: The Breakthrough Therapy For Overcoming Anxiety, Stress, And Trauma
by Dr. Francine Shapiro, inventor of the method.
EMDR Institute
Eye Movement Desensitization and Reprocessing: A Controversial Treatment Technique
A good review of all the arguments pro and contra EMDR as a valid therapeutic movement. Although I am a natural sceptic, for what it's worth I have heard numerous Borderlines (and Non-Borderlines with PTSD) report some success with it as well. Psychosomatic or no, it does seem to help some folks.
Here is a more polemical argument, with numerous links, against EMDR: The Skeptik's Dictionary: EMDR
Treating Complex Posttraumatic Stress Disorder with EMDR and Ego State Therapy
by Carol Forgash, LCSW, BCD, summer 2004.
Fabulous detailed article about the methodology.
Wrestling with the Past
by By Hanno Koppel, EMDR Counsellor.
Very readable article that details an actual EMDR session with a client.
"Worst Case Scenarios": Client Fantasies During and After Traumatic Experiences using EMDR Therapy
by Sylvia Mills, Ph.D., 1998
This write-up of actual experiences in EMDR therapy provides some clearer perspective on exactly how this therapeutic technique works.
EMDR Issue of the Journal of Clinical Psychology
Read these new article abstracts from the Journal of Clinical Psychology, Volume 58, Issue 1, 2002
Find an EMDR Therapist in Your Area
Eye Movement Desensitiztion and Reprocessing Treatment of Internalized Shame
by Dennis Balcom, MSW. , Elizabeth Call, PsyD., Deborah N. Pearlman, Ph.D., 2000
Very interesting write-up!
Controlled Studies of EMDR
Speculations on the Neurobiology of EMDR Therapy
Uri Bergmann, L.C.S.W., B.C.D.
Further Thoughts on the Neurobiology of EMDR: The Role of the Cerebellum in Accelerated Information Processing
by Uri Bergmann, Ph.D 2000
A Narrative Constructivist Perspective Of Treatment Of Post-Traumatic Stress Disorders With Ericksonian Hypnosis And Eye Movement Desensitization And Reprocessing
by Rosemarie Amendolia, Ph.D.
A Single Session EMDR Study With Twenty Traumatized Children And Adolescents
Results appear positive for the treatment of children with EMDR.
A Chaos Model of the Brain Applied to EMDR
A very intellectual and fascinating review by Garry A. Flint, Ph.D., 1996
"Eye movement Desensitization and Reprocessing (EMDR) is a treatment phenomena that has yet to be adequately explained. This is a procedure that usually obtains rapid cognitive and/or perceptual changes of remembered trauma. A chaos model of the process of the olfactory system was extrapolated to a theory for the whole brain process. The interesting results provided an explanation of EMDR and other treatment phenomena. The key elements of the theory are that experience changes behavior, small stimuli evoke massive responses and change takes place in active body experience. Case studies are presented that demonstrate the application of the theory."
Dr. Francine Shapiro, developer of this method, runs a professionals' EMDR Forum for questions
EMDR International Association
The Counting Method for Ameliorating Traumatic Memories
Frank M. Ochberg, M . D.
Another approach with clinical results similar to EMDR.
Neurotherapy and Drug Therapy in Combination for Adult ADHD, Borderline Personality Disorder and Seizure Disorder: A Case Report
by Lisa M. Hansen, B.S., David L. Trudeau, M.D., and Dixie L. Grace Ph.D.
"This is a case report of an adult female patient with ADHD, temporal seizure disorder, and Borderline Personality Disorder treated with 30 weekly sessions of SMR neurofeedback and carbamazepine. Post treatment measures showed improvements in T.O.V.A., self report and QEEG. Both neurofeedback and carbamazepine showed the most effect in early treatment. Progress continued after discontinuance of the drug. "
EEG Spectrum International, Inc.
International center for neurofeedback techniques; read about outcome studies and treatment details on this site.
Institute for the Advanced Study of Health: The NLP World Health Community
International Organization for Neuro-Linguistic Programming; provides information on techniques, support forums and research articles.
Research on Neural-Linguistic Programming
Nice collection of research abstracts on this therapeutic technique.
Body-oriented Hypnotherapy: Releasing Preverbal Trauma
by Linda Edwards, PhD, 2002
"Somatic hypnotherapy, which is based on sound principles about emotions and trauma from the fields of psychology, hypnotherapy and various somatic psychotherapies, can be extremely effective in healing trauma and issues with preverbal roots and working with clients who cannot verbalize their feelings or do not want to tell their stories. This article provides a theoretical understanding of how somatic hypnotherapy works, evidence for its effectiveness, instructions on how it is done, and contraindications for its use."
Click on "download" to download the entire article as a .doc file to your computer (Microsoft Word or similar word-processing software required).
Hypnotizability, Cognitive Processing and Electrocortical Activity in PTSD
by Etzel Cardena, 1998
Hypnotic Psychotherapy in the Identification of Core Emotional Issues
by Constance Spencer, 2000
Discusses the value of hypnotic therapy in treating PTSD and related disorders.
Physiologically-Based Therapeutic Techniques:
ECT (Electro-Convulsive Therapy)
rTMS (repetitive Transcranial Magnetic Stimulation)
rTMS (repetitive Transcranial Magnetic Stimulation)
Is Electroconvulsive Therapy Effective for the Depressed Patient with Comorbid Borderline Personality Disorder?
Abstract of a review by Charles DeBattista, D.M.H., M.D., Kurt Mueller, M.D., Stanford University, 2001
"Among the more common current indications for electroconvulsive therapy (ECT) is treatment-resistant depression. Treatment resistance is correlated with a number of factors, including the presence of comorbid personality disorders, such as borderline personality disorder (BPD). A detailed review of the literature was undertaken and very few reports or studies have dealt specifically with ECT in borderline patients. Thirteen original reports on ECT outcome in personality disordered patients were identified. Depressed patients with a personality disorder, particularly BPD, may have a poorer outcome on some measures. However, the available data suggests that depression in these patients can be effectively treated with ECT. The depressed, borderline patient appears to have two distinct disorders, one which is responsive to ECT and the other which is not."
Stability and predictive value of self-report personality traits pre- and post-electroconvulsive therapy: a preliminary study
Abstract of a study by Blais MA, Matthews J, Schouten R, O'Keefe SM, Summergrad P., 1998
The impact of clinically diagnosed personality disorders on acute and one-year outcomes of electroconvulsive therapy
Abstract of a study by Sareen J, Enns MW, Guertin JE., 2000
"Patients with a clinically diagnosed PD, especially a cluster B PD, had a significantly poorer acute response to ECT than those without a PD. During the first year after treatment, ECT responders with a comorbid PD had a higher rate of relapse of depression."
ECT.org
This site, run by a former patient who experienced ECT, provides a relatively balanced view of the treatment, a message board for friends & family, and other information.
Three and six-month outcome following courses of either ECT or rTMS in a population of severely depressed individuals--preliminary report
by Dannon PN, Dolberg OT, Schreiber S, Grunhaus L., 2002
TMS Treatment for Patients with Persistent Auditory Hallucinations ("Voices")
Workbooks for Those With BPD
Skills Training Manual for Borderline Personality Disorder
Marsha Linehan's groundbreaking volume. It is intended for use in conjunction with professional therapy, but has been reviewed by some folks with BPD as helpful on its own.
Managing Intense Emotions and Overcoming Self-Destructive Habits: A Self-Help Manual
Brand-new title from Lorraine Bell, Nov. 2002
How I Stayed Alive When My Brain Was Trying to Kill Me: One Person's Guide to Suicide Prevention
New title from Susan Rose Blauner, a BPD sufferer, 2002
From the review:
"This personal account of what worked for her offers
excellent practical advice to "teach you how to get through those excruciating
moments when every cell in your brain and body is screaming, `I want to die!' "
Approaching "suicidal thoughts" as an addiction, Blauner clearly explains how some
people's "brain style" responds to environmental stresses or "triggers" with obsessive
suicidal thoughts rather than cravings for alcohol or other drugs. Strongly influenced
by the very successful 12-step model, she fashions a patchwork of strategies for
understanding, preventing and treating suicidal "gestures," which she asserts are not
actually attempts to die but efforts to stop unbearable psychological pain. Childhood
sexual abuse and the death of her mother when she was 14 contributed to Blauner's long
struggle, but she herself had to make the decision and effort to begin therapy at age 19,
before her problem was even recognized or treated. Now Blauner provides others like
herself with "Tricks of the Trade" that can literally save lives. With neither hollow
platitudes nor medical doublespeak, she covers brain function, antidepressants,
finding a good therapist, identifying triggers, creating a "Crisis Plan" for critical
moments and heading off suicidal thoughts by coping with hunger, anger, loneliness and
fatigue. Blauner provides an extremely valuable and much-needed tool for both suicidal
thinkers and their loved ones."
The Angry Heart: Overcoming Borderline and Addictive Disorders: An Interactive Self-Help Guide
by Joseph Santoro, 1997
Santoro's book is one of the few that is also explicitly geared for the male or adult Borderline. It's a progressive self-help program that is tough but very well thought-out. The book is quite dense and should be approached by someone with BPD only when the necessity for treatment has been accepted. Many folks who are working on recovery from BPD have attributed their success in part to the information and exercises in this book. Santoro runs a clinic for BPD in upstate New York.
~It's a super, very enlightening resource for the non-Borderline too.
Laura Paxton's Borderline and Beyond Workbook
The workbook and accompanying flashcards can be purchased here. Paxton is a counsellor previously diagnosed with DID who has done a lot of work in this area. I recommend this workbook for the younger female Borderline, although it's useful for all.
Wellness Recovery Action Plan (WRAP) for dual diagnosis
developed by Mary Ellen Copeland
"Learning self help skills for dealing with physical and emotional symptoms, as well as addictions is a simple process... but it's a much greater challenge using self help methods during the most difficult times -- when they can help the most -- and incorporating them into daily life. This book will help you develop your own list of activities for your every day well being, track triggering events and early warning signs, prepare your personal responses if symptoms increase, and create a plan for your supporters to follow to care for you if necessary."
Check out all of Mary Ellen Copeland's self-help books here.
The Way of the Journal
by Kathleen Adams, M.A.
"In The Way of the Journal, therapist and author Kathleen Adams, M.A. teaches her trademark approach to using reflective writing as a therapeutic process. Adams' ten-step "quick and easy" method was created to provide sexual abuse survivors and dissociative clients with ways to maximize structure, balance, and permission while minimizing overstimulation and overwhelming feeling. Developed while working with dissociative disorders patients at a national treatment center, The Way of the Journal can be used by all survivors, as well as anyone in pain who wishes to gain greater self-understanding."
Workbooks on anxiety, panic & phobias
An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder
by Elke Zuercher-White
The Borderline Personality Disorder Skill Training Manual
by N. Bartels and M. Crotty. Used in the STEPPS group treatment program at the University of Iowa, which recently won a huge grant to study their program of BPD treatment.
The Scarred Soul: Understanding and Ending Self-Inflicted Violence
by Tracy Alderman
One of the best of the self-injury self-help books, in my opinion. Doesn't talk down to the SIer and is great for the friend/family/SO too.
Understanding Self-Injury: A Workbook for Adults
by Kristy Trautmann, Robin Connors
Healing the Hurt Within : Understand and Relieve the Suffering Behind Self-Destructive Behaviour
by Jan Sutton
Came highly recommended by a self-injurer. Also check out Jan's excellent SIARI website.
Bodily Harm
by Karen Conterio, Wendy Lauder
On self-injury. In some ways just an extended advertisement for the SAFE Alternatives treatment program in Chicago, but it has a useful section for families and friends.
Letting Go of Shame
by Patricia and Ronald Potter-Efron, 1996
The Habit Change Workbook
by James Claiborn, Ph.D
Highly recommended by those with OCD-type obsessive-compulsive habits (exercising, skin-picking, nail-biting, etc.)
Reclaim Your Self: An online manual for survivors of sexual victimization
by Bill Davidson
Excellent tips and advice, great place to make a gentle start with the issues.
Addictions and Trauma Recovery: Healing the Body, Mind, and Spirit
by Dusty Miller, Laurie Guidry
Miller is the best-selling author of 'Women Who Hurt Themselves', and this latest is intended as a self-help program in conjunction with a 12-step program or alone.
The Angry Self: A Comprehensive Approach to Anger Management
By Miriam M. Gottlieb, Ph.D.
"This workbook educates readers on the value of anger and how to harness it productively. While anger is often a difficult issue for survivors, learning to access, modulate, and transform it is a crucial part of recovery. The Angry Self presents a sequence of strategies--within a genuinely holistic framework that will help survivors break through years of reflexive anger and redirect it toward creating solutions."
Out of the Nightmare: Recovery from Depression and Suicidal Pain
By David L. Conroy, PhD
Growing Beyond Survival: A Self-Help Toolkit for Managing Traumatic Stress
By Elizabeth Vermilyea
Life After Trauma: A Workbook for Healing
By Dena Rosenbloom and Mary Beth Williams with Barbara E. Watkins
Getting Through the Day: Strategies for Adults Hurt as Children
By Nancy J. Napier, M.A., M.F.C.C.
The Courage to Heal Workbook: For Women and Men Survivors of Sexual Abuse
by Laura Davis. Companion workbook to The Courage to Heal
Desperately Seeking Self : An Inner Guidebook for People With Eating Problems
by Viola Fodor
Overcoming Childhood Trauma : A Self-Help Guide Using Cognitive Behavioral Techniques
By Helen Kennerley
Reclaiming Your Life : A Step-By-Step Guide to Using Regression Therapy to Overcome the Effects of Childhood Abuse
by Jean C. Jenson, Alice Miller
Overcoming Anger and Irritability : A Self-Help Guide Using Cognitive Behavioral Techniques
by William Davies
Cybersex Unhooked: A Workbook for Breaking Free of Compulsive Online Sexual Behavior
Adult Children of Abusive Parents: A Healing Program for Those Who Have Been Physically, Sexually, or Emotionally Abused
by Steven Farmer. Offers a Christian perspective.
The OCD Workbook : Your Guide to Breaking Free from Obsessive-Compulsive Disorder
by Bruce M. Hyman Ph.D., Cherry Pedrick R.N.
Individual Therapists
Therapist Databases
Therapist Databases
Check Their License Here or see Who's Who in Mental Health
How to Evaluate and Choose a Competent Therapist
Patient Rights in Mental Health Care
Behavioral Technology Transfer Group Clinician Locator
Locate a professional trained in DBT (Dialectical Behavioral Therapy) in your area/country.
Individual therapists, state-by-state, who treat BPD, List#1
Secret Shame web site database.
Individual Therapists who treat BPD, List #2
BPDCentral web site database.
Individual Therapists who treat BPD, List #3
Mental Health Today web site database.
List of Therapists/Clinics who Specialize in Self-Injury
Annotated list from the Secret Shame web site on self-injury.
Therapist Databases and Treatment Program Directories
International Listing of Trauma Therapists
Anxiety Disorders Association of America Therapist Listings
Searchable database of listings for specialists in anxiety & panic disorders.
Sidran Traumatic Stress Foundation's Database of Therapists and Treatments
The International Registry Of The American Academy Of Experts In Traumatic Stress®
Addiction Resource Guide: Listings and Reviews of Treatment Facilities
An excellent resource with updated information on intake details, payment plans, international links, etc!
Treatment for Sexual Addiction/Compulsive Sexual Behavior
Overview of options and links to treatment programs.
Personality Disorders Foundation of Connecticut
Regional information and links to clinics and therapists in Connecticut
Dr. Irene's Listing of Therapists who Work with Verbal/Emotional Abuse Issues
The National Organization on Male Sexual Victimization Resource Directory
Therapists who work with male survivors of sexual abuse and their families.
Sexual Offender/Sexual Abuse/Sexual Addiction Therapist List
from Matthew Rosenberg Associates
Substance Abuse Treatment Facility Locator
Huge database from the US Substance Abuse and Mental Health Services Administration
Eating Disorder Clinic Directory, State-by-State (USA)
Many of these also treat personality disorder-related troubles, as well as teens.
Mass. General Mood Disorders Program: Treatment Referral Database
Excellent for those seeking treatment for Bipolar Disorder + BPD.
Amen Clinic's AD(H)D Referral list
Excellent for those seeking treatment for BPD + ADD
Dual Diagnosis Treatment Center Directory
I have no further information on these centers, but it appears to be a decent list.
Comprehensive Listing of Programs/Residential Programs for Troubled Adolescents
Bridge To Understanding's well-maintained listing of facilities, schools, and programs for young people.
Searchable by disorder/problems and region; BPD is included as a criterion.
Check out their other excellent resources for parents of troubled adolescents seeking treatment programs.
Focus Adolescent Services
Another excellent database of residential treatment programs and schools for a variety of young folks' behavioral and mental health issues.
National Eating Disorders Association
Maintains a detailed national list of therapists and programs, DBT specialists included.
Clinics/Programs: Inpatient and Outpatient Treatment
Centers, Referrals
This is by no means an exhaustive list, nor can I
guarantee any of the service providers or their
facilities: the clinics on this list have been specifically recommended
by someone in the Borderline/NonBP community.
If you can't find what you're looking for, I advise contacting a known BPD specialist in your area (see list above) for further references. I am not a licensed mental health professional and cannot provide personal references.
If you would like to recommend (or review) a program or doctor, please contact me at helenbpd@yahoo.com
Advice for family/friends on how to
choose a clinic, prepare your loved one, provide
support, etc.
Creating a Crisis Plan and, equally vital yet so often forgotten, Post-Crisis Planning
If you can't find what you're looking for, I advise contacting a known BPD specialist in your area (see list above) for further references. I am not a licensed mental health professional and cannot provide personal references.
If you would like to recommend (or review) a program or doctor, please contact me at helenbpd@yahoo.com
Creating a Crisis Plan and, equally vital yet so often forgotten, Post-Crisis Planning
USA: Northeast
The Personality Disorders Institute, Cornell Psychotherapy Program at the New York Presbyterian Hospital - Westchester Division
located in Westchester, NY.
Click on all the links to read about the entire treatment program.
Supervised Lifestyles Health Residential Clinic
SLS is located an hour north of NYC in upstate NY: their 'Angry Heart Clinic' is a specialized intensive BPD program. Web site describes the various treatment programs and staff. Has forums (very little traffic) and self-help guides for a variety of problems including BPD.
MacLean Hospital Outpatient Personality Disorder Service
located outside Boston, MA.
Established facility affiliated with MacLean Hospital and the Harvard Medical School. Website describes various treatment programs.
Mt. Sinai BPD Treatment Evaluation and Program
located in uptown New York City.
Center for Anxiety and Related & Comorbid Disorders at Boston University
located in Boston, MA.
Emphasizes cognitive-behavioral techniques. On staff is Dr. Drew Westen, a specialist in adult personality disorders. Also home of the Adolescent and Adult Personality Program, a major site for research on personality disorders & related topics.
Butler Hospital
located in Providence, RI, Butler is the "only private, nonprofit adult, adolescent and child psychiatric and substance abuse hospital in Rhode Island,"
affiliated with the Brown University School of medicine.
Offers outpatient DBT, inpatient and partial hospitalization programs.
The Post-Traumatic and Dissociative Disorders Program
Located in Washington, DC, at the Psychiatric Institute of Washington. Offers a "seven-day-a-week inpatient program, grounded in a safe and supportive environment, features 24-hour nursing care, psychiatric treatment, social work services, and numerous group therapies. Ongoing community education groups and a partial hospitalization option are available for those who do not require 24-hour care."
Personality Disorders Foundation of Connecticut
Regional information and links to clinics and therapists in Connecticut
Mass. General Mood Disorders Program
Excellent for those seeking treatment for Bipolar Disorder + BPD.
Kavod Recovery Program
Excellent program for people with sexual compulsions and addictions,
located in Rochester, NY.
USA: Northwest
Behavioral Research and Therapy Clinics (BRTC) at the University of Washington
located in Seattle, WA.
Offers in- and outpatient DBT treatment as well as being home for a number of research studies on BPD. Home-base for Dr. Marcia Linehan, creator of the DBT method.
Portland Dialectical Behavioral Therapy Program
located in Portland, Oregon.
USA: Midwest
The Menninger Clinic
located in Topeka, Kansas.
Established facility with internationally recognized research and treatment programs specific to BPD. Its Website describes the various treatment programs offered.
Forest View Hospital
located in Grand Rapids, MI.
Treats adult trauma, BPD, and dual-diagnoses (addictions).
Rock Creek Center
"We are a premier psychiatric hospital specializing in the behavioral health needs of adolescents, adults and older adults located in the southwest suburbs of Chicago."
Offers the "NOWCHANGE (SELF MUTILATION/HARM/INJURY) PROGRAM", specialized programs for autism, PTSD, etc.
S.A.F.E. Alternatives Self-Injury Program
located in Chicago, Il.
Not BPD-specific, but a program with a history of success in treating self-injurious and addictive behaviors.
Read about it in the book Bodily Harm by Conterio, et al.
Laurelwood Hopsital and Counseling Centers
Ohio-based programs using DBT. Offers family support sessions.
STEPPS Borderline Personality Disorder Group Treatment Program, University of Iowa
located in Iowa City, IA.
Website describes the treatment program in detail; program uses Bartels/Crotty's book The Borderline Personality Disorder Skill Training Manual, order it on the site.
The STEPPS program is currently recruiting folks with BPD and their families for a clinical trial evaluating their group therapy program.
USA: South/Southwest/Pacific
Timberlawn Mental Health System
located in Dallas, TX.
Offers numerous services for BPD treatment
DBT New Mexico
Northern New Mexico DBT treatment specialist.
Del Amo Hospital
located in Torrance, CA (L.A. South Bay).
Offers in- and outpatient care, sexual addiction, eating disorders, youth and adult services.
The Heartskober Manor
28-day private treatment facility exculsively for the treatment of problem gamblers, located in Southern California.
International
Please see International BPD Resources for more
information.
S.A.F.E. in Canada
Canadian version of the US self-injury treatment program, in London, ON. Workshops held for families/friends.
International Listing of Trauma Therapists
Spiritual and Philosophical Issues in Treatment
Mindfulness in Mental Health
An excellent article on the use of Buddhist Mindfulness in treating mental disorders
by Kedar Nath Dwivedi Feb 2000
The Treatise of Truth. The Mental Health "Carer's" "Soul's Survival" Manual
"A Practical Guide to Understanding the Spiritual Aspect of Subjugation of the Mind & Mental/Emotional Trauma"
Fascinating, lengthy reflections compiled by "Clemencia", Australia.
Spirituality and Mental Illness
by Diana Nielsen, 2001
Very nice reflections on a number of different spiritual traditions and their emphasis on re-connection with community/society as part of recovery. "Without exception, spirituality is inherent in healing."
Against a Wall
A Christian psychiatrist reflects on her spiritual commitment to BPD patients.
Addressing Spiritual and Religious Issues of Clients with a History of Psychological Trauma
by C. J. Graeme, ACSW, PhD, et al Spring 1999
A Christian counselor talks about her take on treating BPD
Pastoral Care for Trauma Survivors
A list of resources from the National Conference of VietNam Veteran Ministers, a group devoted to finding resources for the pastoral care of trauma survivors
A moving essay on spirituality and the experience of "madness" by a woman who has recovered
Resource Guide for Rabbis on Domestic Violence
No Escape from Philosophy in Trauma Treatment and Research
By Jonathan Shay, M.D., Ph.D.
The Borderline Personality : Vision and Healing
by Nathan Schwartz-Salant
From the perspective of a Jungian therapist
How Do I Know it's Abuse? Identifying and Countering Emotional Mistreatment from Friends and Family Members
by David Royse
This book is written specifically for social workers, counselors, psychologists, and psychiatrists to use with their clients and to address the most common questions and concerns of abuse victims.
This Page Last Updated: November 18, 2004
Helen's World of BPD Resources