For those that are involved in psychotherapy with clients with borderline personality disorder the April 2006, Journal of Clinical Psychology is a must read. The whole journal is devoted to a series of articles by the best in the field including Marsha Linehan, Jeffrey Young, Otto Kernberg, John Clarkin, Aaron Beck and Peter Fonagy to name but a few. They are a series of highly readable articles with an overall optimistic message. Borderline Personality Disorder is an eminently treatable disorder. While some of the articles are more theory focussed there are also some wonderful outlines and examples of specific technique particularly Levy et al’s article on “The Mechanisms of Change in the Treatment of Borderline Personality Disorder”.
One of the common themes that comes through virtually all of the articles is some type of variation on the need to help the client develop a reflective space where they can actually stop and think about themselves and their lives. While each of the different therapies arrives at this through different techniques all agree on the vital need to develop this in clients with borderline personality disorder.
We, the editors of this special issue, have been fortunate to enlist the participation of some of the leading researchers in the treatment of borderline patients. The various articles in this section stimulate the reader to compare the different approaches to the essential aspects of borderline pathology and the related specific therapeutic interventions. For example, affect dysregulation and related dysfunctional behaviors are conceptualized as the key deficit by Lynch and associates. Fonagy and Bateman place this affect disregulation within the attachment and interpersonal sphere. There seem to be similarities among the concepts of mindfulness (Lynch et al., this issue), mentalization (Fonagy & Bateman, this issue), and reflective functioning (Levy & Clarkin, this issue), all of which are seen as processes the individual can use to modulate affective stimulation.
Here at our own psychology clinic we have an ongoing program for the treatment of clients with Borderline Personality Disorder. Doctoral interns provide a 32 week individual treatment program based on Transference Focused Psychotherapy. As well clients engage in a six month dialectic behaviour based group program run by the Area Health Service. This program has been having remarkable success although we all agree that the 32 weeks of individual treatment is insufficient for many of the clients.