Schema Therapy for Borderline Personality Disorder

December 16, 2018

Those with borderline personality disorder (BPD) experience painful symptoms – an unstable sense of self; a pattern of unstable and intense interpersonal relationships; emotional instability; impulsivity; suicidal tendencies; intense anger; chronic feelings of emptiness; and paranoid thoughts.

BPD has traditionally been seen as one of the most difficult psychiatric disorders to treat through psychotherapy. Schema therapy, which has been evolving as a treatment over the past 30 years, is a very effective approach for the treatment of those suffering with the disorder.

Earlier this year the Australian Psychological Society wrote about the various treatment options for BPD, including schema therapy:

“Young recognised that individuals with borderline personality disorders often experienced rapid emotional changes with simultaneous activations of several schemas, and therefore developed a schema mode model. The mode model describes current states rather than traits and at any one point refers to the interaction between the person’s schemas and their coping style. Researchers have identified six modes relevant in patients that present with BPD. The combination of these six modes differentiate BPD from other personality disorders.”

A blogger (Rosie) diagnosed with BPD, who goes by the pseudonym Talking About BPD, wrote how she experiences a core emotional state through a schema therapy lens in a recent post:

“Many people with a diagnosis of Borderline Personality Disorder have been through all sorts of very difficult experiences in childhood, including abuse, neglect and trauma of all kinds. Many people with this diagnosis didn’t have the understanding or emotional support that they needed during their childhood.

Schema therapy involves understanding what happened to an individual in order for them to develop certain schemas. This therapy understands that different schemas can be activated at at times which can cause an individual to think, feel and behave in a certain way.

..if you were to see me enter abandoned child mode, you would probably see me sobbing on the floor, believing that I have been abandoned by someone I love. I would be in experiencing the sharpest grief, piercing terror and an overwhelming sense of loss. I would believe I was going to abandoned. I might show signs of helplessness and look vulnerable- unable to look after myself and even begging for help.”

A helpful 4 part series was also recently written on how to treat BPD using a schema therapy approach:

“Research has been conducted on the effectiveness of schema therapy for the treatment of borderline personality disorder (BPD); results indicate that this form of treatment is a very effective intervention for people struggling with the disorder. (Giesen-Bloo, et al, 2006).”

Schemas of people with BPD

“According to Jeffrey Young, the core schemas experienced by the person with borderline issues include abandonment, abuse, emotional deprivation, defectiveness, and subjugation. These are defined below (Young, Klosko, Weishaar, 2003):

Abandonment: Involves the sense that significant others will not be able to continue providing emotional support, connection, strength, or protection.

Abuse: The expectations that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage.

Emotional Deprivation: The expectation that one’s desire for a normal degree of emotional support will not be adequately met by others.

Defectiveness: The feeling that one is defective, bad, unwanted, inferior, or invalid; to such a degree that one is unlovable to significant others.

Subjugation: Excessive surrendering to others because one feels coerced – for instance, submitting in order to avoid anger, retaliation, or abandonment.”

How to treat Borderline Personality Disorder: A Schema Therapy Approach:

(Part 1) (Part 2) (Part 3) (Part 4)

We hope you have found these resources to be helpful.

The Secure Nest Team

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