Abnormal Psychology

Personality Disorders 607

Similarly, research indicates that cognitive therapy can be effective (Brown et al.,

2004; Davidson et al., 2006; Wenzel et al., 2006).

Targeting Social Factors: Interpersonal Therapy

Interpersonal therapy (IPT) has been adapted to treat borderline personality dis-

order. The goal of IPT for this personality disorder is to help the patient develop

more adaptive interpersonal skills so that he or she feels and functions better. This

therapy tries to help patients integrate their extreme but opposed feelings about an

individual: When they talk about feeling one way about someone (“He’s perfect”),

the therapist tries to discuss opposite feelings as well, underscoring that no individ-

ual is all good or all bad (Markowitz, 2005; Markowitz, Skodol, & Bleiberg, 2006).

A course of IPT for borderline personality disorder typically lasts about 8 months.

Social interactions are also a focus of the group therapy component of DBT.

FEEDBACK LOOPS IN TREATMENT: Borderline Personality Disorder

Successful treatment of borderline personality disorder may target more than one

factor; positive changes in any factor, though, affect other factors via feedback loops

(see Figure 13.9). For example, one goal of DBT is to help patients regulate their

emotions (psychological factor). When the therapy is successful, better emotional

regulation allows patients to calm themselves more effectively when they are anxious

13.9 • Feedback Loops

in Treatment: Borderline

Personality Disorder

Figure 13.9g39

Treatments Targeting

Psychological Factors

DBT: CBT techniques

plus validation,

Buddhist mindfulness,

and dialectical

acceptance

Psychodynamic

therapy

(intensive forms)

CBT

Treatments Targeting

Social Factors

DBT: Group therapy

component

IPT: Focus on current

relationships and

effects of patient’s

actions

Treatments Targeting

Neurological Factors

Medication: SSRIs to

treat symptoms of

mood, anxiety, and

anger; antipsychotics

to treat psychotic

symptoms; mood

stabilizers

Changes neural

activity

Changes thoughts,

feelings, and behaviors

Changes social

interactions

Decreases family conflict

Increases support for

making positive changes

P S

N

P S

N