Borderline Personality Disorder (BPD), which affects about 2 percent of the U.S. population, is a complicated psychiatric disorder. Characterized by emotional instability, self-harmful behavior, and impulsivity, it is the one of the hardest psychiatric disorders to treat.
The causes of Borderline Personality Disorder are just as complex, and are thought to be related to genetic predisposition, environmental factors, and brain chemistry. According to the biosocial theory of BPD, this complex disorder is the result of certain biological predispositions which manifest themselves when met with a dysfunctional or invalidating environment.
For example, temperamental traits such as impulsivity are inherited. If brought up in supportive and empathetic home, an impulsive child will learn to control their behavior and keep tabs on their impulses. However, if the same child faces emotional abuse or neglect, or another invalidating environment, they are more likely to develop BPD later in life.
What Is an Invalidating Environment?
An invalidating environment isn’t necessarily one in which a child is abused or neglected. Even the most well-intentioned families can be invalidating by ignoring, ridiculing, denying, or judging a child’s feelings. Making a child believe their thoughts or feelings are just plain wrong without being understanding of them is invalidating.
People who grow up in an invalidating environment learn to believe that their actions, thoughts, and feelings don’t matter. This can hinder their ability to recognize and label their emotions, and cause them to distrust their emotions. It can also cause them to later turn to substance abuse or self-harm as a way to better cope with and control their emotions.
The biosocial theory of BPD, posited by Marsha Linehan, Ph.D., who developed Dialectical Behavior Therapy (DBT) to treat the disorder, is that BPD is a dysfunction in how bodies regulate emotions. It is a combination of this emotional sensitivity and an invalidating environment that can ultimately trigger BPD.
DBT Based on Biosocial Theory
Dialectical Behavior Therapy has its roots in the biosocial theory, making it an effective BPD treatment. The skills learned in DBT can help someone with Borderline Personality Disorder to change their emotional, thinking, and behavioral problems associated with problems in living while helping them to become more in tune with and express their emotions – and therefore feel more validated.
“Initially, psychoanalytic treatment for individuals [with BPD] focused on developing a supportive relationship with the therapist, creating the space for a safe relationship and teaching individuals to develop better relationships. Cognitive Behavioral Therapy focused on reducing impulsivity and emotional instability,” says Philadelphia-based psychologist Daniel Lee. “The biosocial model did a good job of integrating these two models by focusing on reducing the frequency of borderline behaviors and helping the individual develop adaptive skills for society.”
Through DBT, a person with BPD learns how to recognize and manage their emotional trauma, as well as develops skills on better emotion regulation. People in BPD treatment who are receiving DBT therapy participate in individual and group therapy sessions where they are taught skills in mindfulness techniques, interpersonal effectiveness, emotion regulation, and distress tolerance.
“DBT provides a treatment framework that offers a continuum of support which addresses the primary symptoms of the disorder while also focusing on developing a strong therapeutic relationship, social support, and problem-solving skills,” Lee says.
The skills learned in Dialectical Behavior Therapy can help people with Borderline Personality Disorder to get the validation they were missing growing up and help them more fully live a life worth living.