Help for BPD and Other Mental Health Conditions

Borderline personality disorder, or BPD, is a serious mental illness well-known for being hard to diagnose and treat. If you have this disorder, you may experience a range of problems that interfere with your ability to function. In addition, you have increased risks for developing substance disorders and certain other mental health issues. For these reasons, effective treatment for BPD is a pressing need.

Psychotherapy is a common treatment option for people affected by borderline personality disorder. One potential psychotherapy option is schema therapy. This therapy was specifically created as a treatment for BPD and other personality disorders. Research shows that schema therapy is effective for people affected by these conditions. It may also help you recover from other forms of serious mental illness.

What Is Schema Therapy

Schema therapy may also be referred to as schema-focused cognitive therapy. It is an integrated form of psychotherapy. This means that it combines ideas and theories from more than one type or school of therapy. The specific root sources of schema therapy are:

  • Cognitive behavioral therapy, or CBT
  • Gestalt therapy
  • Attachment theory
  • Psychodynamic therapy

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The Schema Concept

Schema therapy is based on the concept of something called a schema. This is a term for the ways in which you perceive yourself and the world. Any given schema includes your:

  • Thoughts
  • Emotions
  • Behaviors

It also includes the ways in which you organize and access your experiences and the knowledge you possess. In schema therapy, some schemas are viewed as positive. These ways of perceiving yourself and your world tend to support a sense of well-being. However, other schemas are negative, or maladaptive. This means that they do not support a sense of well-being. Instead, they have the opposite effect.

Some of these negative schemas form at a very early age. As you grow older, they can lead to widespread, damaging changes in your developing personality. In a person with BPD, common examples of harmful schemas include:

  • A sense of abandonment
  • An expectation that other people will hurt or abuse you
  • A belief that your emotional needs cannot be met by others
  • The sense that you are inferior, defective and unlovable
  • A feeling that you are being coerced by others and must surrender to them

If you are affected by BPD, multiple schemas can occur at the same time. This helps explain the rapid mood changes associated with the disorder. Affected people do what they can to try to cope with these complex, fluctuating mental states. This attempt leads to the formation of what schema therapists call modes. These modes are essentially dysfunctional personality manifestations. The four classic BPD modes are known as:

  • The angry/impulsive child
  • The abused/abandoned child
  • The punitive parent
  • The detached protector


Borderline Personality Disorder

Borderline personality disorder is a relatively rare illness. Like all other personality disorders, it triggers harmful changes in your most basic experiences of yourself and your reality. In the case of BPD, these changes include frequent shifts in your:

  • Self-perceived image
  • Emotional state
  • Behaviors

As a result of instability in these core areas, people with BPD may develop a range of symptoms. Potential examples of these symptoms in any given person include:

  • Recurring involvement in reckless, possibly dangerous behavior
  • The urge to avoid abandonment, whether or not that abandonment is real
  • Intense, chaotic relationships that veer between highs and lows
  • Problems trusting others
  • An ongoing sense of emptiness
  • An inability to accurately perceive yourself
  • Involvement in cutting or other non-lethal forms of self-harm
  • Repeated thoughts of threatening suicide or actually committing suicide
  • Bouts of intense anger that have no clear cause

You may first develop telltale signs of BPD as a young child. However, the disorder’s most classic symptoms typically only appear when you are a teen or young adult.


Schema Therapy for BPD

Examples of Schema Therapy at Work

Schema therapists use a number of methods to help people with BPD. One important step is known as psychoeducation. This is a general term for education on the causes, symptoms and treatments of a mental illness. In the case of BPD, psychoeducation includes explaining the basics of the dysfunctional mode concept. It also includes explaining how these shifting modes impact your everyday reality.

Next, your schema therapist will teach you how to respond to each mode in healthy ways. Examples of this kind of schema therapy work include:

Two main methods are used to achieve these goals. The first method is known as imagery rescripting. This technique requires you to start by bringing up memories of a past event or situation. That includes how you thought and felt about your experience. You then recreate that situation while altering it in your mind. The goal of this alteration is to change your perception of what happened in positive ways.

The second method is known as chair work dialog. In this approach, you also recall a past situation or event. However, this time, you interact and “talk” to the important people who were present. Imagery and chair work not only help you meet the needs of your core modes. They also help you improve your ability to feel connected to your emotions.

The Stages of BPD Schema Therapy

Schema therapy for BPD operates in three stages or phases. In the first stage, you work on making a bond with your therapist and improving your emotional control. In the second, you work on changing your dysfunctional schema modes for the better. In the third stage, you work on developing your personal sense of agency or autonomy. Depending on your circumstances, you may undergo schema therapy in a group or individual setting.

The Benefits of Schema Therapy

There are several known benefits of schema therapy. First, the therapy has been shown to help reduce the seriousness of BPD symptoms. The treatment can also help improve your overall quality of life. People who participate in BPD schema therapy report additional benefits such as:

  • Increased understanding of their inner lives
  • A better grasp on their emotional states
  • Higher levels of self-confidence
  • Greater flexibility in their thought patterns
  • A decline in negative attitudes toward themselves

Other Uses for Schema Therapy

Schema therapy is not just an option for people affected by BPD. It was designed to help in the treatment of all personality disorders. In addition to BPD, illnesses in this category include:

  • Narcissistic personality disorder
  • Antisocial personality disorder
  • Histrionic personality disorder
  • Obsessive-compulsive personality disorder
  • Avoidant personality disorder
  • Schizoid personality disorder
  • Paranoid personality disorder
  • Schizotypal personality disorder

There is also evidence that schema therapy may help people affected by:

  • Posttraumatic stress disorder, or PTSD
  • Obsessive-compulsive disorder, or OCD
  • Various kinds of anxiety disorders

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Schema Therapy in Addiction Treatment

Serious drug and alcohol problems are often found in people affected by BPD. The concept of dysfunctional schemas and schema modes may help explain this fact. These kinds of dysfunctional worldviews are common in people affected by addiction. They also have similarly harmful effects. This is true even when BPD itself is not present.

Research shows that schema therapy may be helpful in the treatment of substance abuse and addiction. For example, one study looked at the use of the therapy in people with substance problems who also had PTSD. The results of this study indicate that, in combination with other treatments, schema therapy is effective.

Improve Mental Health Through Schema Therapy at Emerald Isle

Schema therapy is an integrated form of psychotherapy that draws from several sources. This therapy is based on the concept of dysfunctional worldviews called maladaptive or negative schemas. These schemas can shape every major aspect of your perception of yourself and your surroundings. When two or more of them occur together, they can produce what are known as schema modes. These modes are rapidly shifting, harmful expressions of your personality.

The concepts of schema therapy were created to help people with BPD and other personality disorders. The therapy seeks to make healthy changes in your schemas and schema modes. It does so, in part, by educating you about what is happening to you. Schema therapy also relies on two reimaging techniques to help you change your worldview.

While schema therapy was developed as a personality disorder treatment, it has other uses. It may form part of an effective treatment plan for anxiety disorders, PTSD or OCD. The therapy may also play a valuable role in the plans used in drug or alcohol programs.

At Emerald Isle, we offer schema therapy among our extensive slate of options for substance and mental health treatment. If the therapy is right for you, we can incorporate it into your overall recovery plan. As with all of our options, the goal of schema therapy is to improve your mental health and daily function. Our expert staff is dedicated to helping you reach this goal. Even if you have a severe condition, we will support you with workable options for real progress. To learn more about our services, contact us today.