The integration of the self-psychological and cognitive-behavioural models in the treatment of borderline personality disorder.
The major focus of the non pharmacological treatment of borderline personality disorders is rapidly shifting from long term, psychodynamically oriented therapies to highly structured and explicitly operationalized cognitive-behavioural treatment models. The goal of these models is changing targeted maladaptive coping behaviour. This paper examines possible limiting factors to Linehan's model of dialectical behaviour therapy, based on the implications of self-definition-seeking behaviour which is commonly observed in these patients. The extent to which borderline patients' self-definition-seeking behaviour is exaggerated and unremitting in a therapeutic context identifies the primacy of these individuals' striving for self-cohesion. If this need is unrecognized and treatment strategies which address it are not incorporated, the success of cognitive-behavioural treatment models can be unnecessarily (and sometimes severely) compromised. A solution to this problem may lie in the integration of therapeutic principles derived from self-psychology. An outline of this theoretical model and its application in brief therapy on increasing self-cohesion are presented.
Patrick
J
J
Department of Psychiatry, McMaster University, Hamilton, Ontario.
D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004532:Ego; D005260:Female; D006801:Humans; D010553:Personality Development; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention