Trauma Informed Treatment for Borderline Personality Disorder
Dr. Quintin Bailey is a licensed clinical psychologist practicing in Austin, TX. Dr. Bailey specializes in the treatment of personality and dissociative disorders. His approach is psychodynamic and relational, meaning he centers and prioritizes the safety and trust between patient and clinician. Most folks seek care with... more
The diagnosis of Borderline Personality Disorder is too often stigmatized by both the general public and by mental health providers. This stigma ultimately means that the process of finding a therapist and receiving the right treatment means risking the repetition of the same relational trauma that underlies the emergence of Borderline Personality Disorder.
Borderline Personality disorder is characterized by chronic attempts to avoid real or perceived abandonment. When approaching this diagnosis through a trauma informed lens, it becomes clear that for many patients there was chronic misattunement or distress in important attachment relationships. For these patients, throughout childhood relationships are often conditional - you behavior or identify in this particular way, or love and care are withheld. This dynamic can create a sense of never being good enough or worth loving.
Unfortunately, the main approaches to treatment covered by insurance companies repeat this same dynamic. Take for example Dialectic Behavioral Therapy (DBT), which is currently the leading treatment for Borderline Personality Disorder. In this approach to treatment, patients are coded as "resistant," when treatment isn't providing relief and all to often patients report being "fired," from therapy because they are labeled as resistant to treatment. This recreates the exact same relational trauma and abandonment, making healing almost impossible.
Thankfully, psychoanalytic or psychodynamic treatments offer an alternative approach. As an analytic clinician, I approach each patient as a unique individual whose world I must get curious about and enter. This allows treatment to be tailored to individual needs, and re-frames resistance to treatment not as non-compliance on the part of the patient, but as a signal to the clinician that the approach needs to be adjusted.
Unlike treatments such as DBT which risk reinforcing and intensifying the suffering, psychoanalytic or psychodynamic treatments prioritize the connection between patient and clinician, and are flexible enough to hold hope for healing.
