Schema Therapy for Borderline Personality Disorder

Authors: Arnoud Arntz, Hannie van Genderen

Patients with Borderline Personality Disorder (BPD) experience problems in most aspects of their lives. They struggle with constantly fluctuating moods, difficulties in their relationships with others, issues stemming from an unclear identity, and impulsive behaviors. Outbursts of anger and crises are common among these patients. Despite the fact that many BPD patients are intelligent and creative, they rarely succeed in developing their talents. They often do not complete their education, remain unemployed, or if employed, work in professions far below their capabilities. They are also at imminent risk of self-harm, through cutting themselves and/or substance abuse. Furthermore, the risk of suicide is high among these patients, with approximately 10% dying as a result of suicide attempts (Paris, 1993). In this book, we use the criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), for Borderline Personality Disorder for diagnosis, rather than the psychoanalytic definition of BPD. BPD encompasses a number of personality disorders and Axis I disorders, making these disorders widespread for the treatment of BPD described here. According to the DSM-5, patients must meet at least five of the nine criteria, as shown in Table 1.1, to be diagnosed with BPD. The core general characteristic of the DSM's definition of this disorder is instability, as well as its impact on areas of interpersonal relationships, self-image, emotions, and impulsivity.