Borderline personality disorder (BPD) is characterised by a persistent pattern of instability in interpersonal relationships, self-image and emotional regulation, alongside marked impulsivity. It usually manifests in early adulthood, although many of its features may already be observed during adolescence, and it appears in various contexts throughout a person’s life.
People with BPD are highly sensitive to changes in their environment. The perception of a separation, rejection or loss of external support can trigger intense changes in how they view themselves, in their emotional state, in their thinking and in their behaviour. Intense efforts to avoid abandonment, whether real or imagined, are common.
Borderline Personality Disorder (BPD)
Intervention approach in INTRA-TP
At INTRA-TP, we carry out personalised assessments tailored to each individual’s situation and needs. Clinical experience has shown that working with family members significantly facilitates recovery; therefore, wherever possible, we involve the individual’s support network in the therapeutic process.
In the initial phase, an assessment of the family is carried out to identify available resources, potential difficulties and relevant behavioural patterns. Based on this assessment, the work focuses primarily on psychoeducation, promoting a better understanding of the disorder and the associated relational dynamics.
However, this work with the family is not always possible. In some cases, family members or close friends do not wish to be involved, believing that the problem should be resolved solely by the person affected. In these situations, the intervention is carried out exclusively with the individual. On other occasions, it is the individual themselves who does not wish their family and friends to be involved, a decision that is always respected. This does not prevent us, when necessary, from addressing specific concerns or providing guidance on how to act in certain situations.
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What is BPD?
Some key areas that are typically addressed during treatment include:
Establishing behavioural boundaries that provide a sense of security for the individual and the therapeutic environment.
Promoting independence, whilst avoiding reinforcing dependent behaviours.
Developing coping strategies for new and emotionally intense situations.
Although in many cases symptoms tend to diminish with age, treatment is essential to reduce personal and family distress and promote a more positive outcome.
Key aspects of the therapeutic process
The most common features of BPD include:
Instability in self-image, life goals and personal values
Intense and unstable interpersonal relationships
A predominantly dysphoric mood, with episodes of anger, distress or despair
A chronic sense of emptiness or boredom
Impulsivity in various areas of life
Prolonged periods of emotional well-being are usually rare.
General Therapeutic Approach
The treatment of BPD requires an integrated and personalised approach, tailored to each individual’s characteristics and needs. In many cases, it is beneficial to combine different therapeutic approaches and, where possible, to involve the family.
Treatment may include individual psychotherapy, psychoeducation, work with the family, and coordination with psychiatric services for pharmacological treatment, where indicated. In more complex situations, the involvement of a multidisciplinary team may be necessary.
The individual’s motivation and the existence of a stable therapeutic relationship, capable of withstanding the ups and downs inherent in treatment, are particularly important for progress in the therapeutic process.
Main clinical features
A flexible, inclusive approach
The therapeutic approach may vary depending on the needs of the person seeking help or advice, whilst always maintaining an integrative perspective.
At an individual level, the programme is based on the psychoeducational programme for borderline personality disorder developed by Dolores Mosquera, director of INTRA-TP, published in 2004 under the title ‘Diamantes en Bruto II. Manual psicoeducativo y de tratamiento del trastorno límite de la personalidad. Programa estructurado para profesionales’ (Editorial Pléyades). This programme forms one of the cornerstones of the therapeutic work.
In addition, EMDR is used as a complementary approach, which has shown particularly promising results in this type of condition. With regard to pharmacological treatment, we work in coordination with psychiatric services, both public and private, specialising in different areas.
Important message
Borderline personality disorder does not define a person: it is something one has, not something one is. An accurate diagnosis and specialised treatment, based on understanding, psychoeducation and ongoing support, can lead to significant improvements in the quality of life for both the person affected and those around them.
Psychoeducation and understanding the disorder
Psychoeducation is a central pillar of BPD treatment. It enables individuals to understand what is happening to them, identify patterns of behaviour, and develop greater awareness of their emotions, thoughts and behaviours.
The aim is to provide an understandable and non-stigmatising explanation of the disorder, which facilitates self-observation, emotional regulation and the maintenance of hope for change.