Any alternatives that are as effective or better, in your personal experience? I know CBT is less effective. I'm still in training but I am having difficulty with some of DBT's strategies, for instance, with maintaining the balance between validating and encouraging change. I think it would take a decade to validate some of these folks enough before you can push for meaningful lasting change. Unlike a neurotic who regresses briefly to an earlier stage, a borderline pt has a certain regressed structure in place and it's rock solid; sometimes it feels like even with DBT all I'm doing is throwing tons of construction material that will stick for a minute or two but soon fall through all the cracks, and roll down the misshapen scaffolding.
Alternatives to DBT for BDP
- Thread starter Rooh
- Start date
- Joined
- Feb 8, 2004
- Messages
- 8,026
- Reaction score
- 4,167
There was a recent study in the Green Journal, I believe about 2-3 months ago where DBT given by a non-psychiatrist was compared to psychodynamic psychotherapy with psychotropic medication from a psychiatrist. Both were equally effective.
I didn't like the study. 1) The candidates evaluated where ones that stuck with therapy. 2) The type of medication was open-ended. It could've been anything. Some meds such as benzos, will improve symptoms in borderlines and make them better in the short run but worse in the long run.
I didn't like the study. 1) The candidates evaluated where ones that stuck with therapy. 2) The type of medication was open-ended. It could've been anything. Some meds such as benzos, will improve symptoms in borderlines and make them better in the short run but worse in the long run.
- Joined
- Apr 22, 2007
- Messages
- 2,387
- Reaction score
- 129
Fonagy and Bateman, mentalization therapy.
- Joined
- Oct 16, 2001
- Messages
- 2,871
- Reaction score
- 1,009
- Joined
- Apr 22, 2007
- Messages
- 2,387
- Reaction score
- 129
There are some very good videos of Fonagy demonstrating mentalization-based therapy. My biggest question would be whether it would work if you didn't have a British accent. I worry that many of the things he says would get my southern lilt punched in the face!
- Joined
- Apr 22, 2007
- Messages
- 2,387
- Reaction score
- 129
Also Kernberg's Transference Focused Psychotherapy, a short-term evidence-based psychodynamic treatment. Also unsure if this one would work without a little upper east side flare.
- Joined
- Nov 30, 2009
- Messages
- 4,312
- Reaction score
- 9,865
Peter Fonagy didn't have a British accent the last I heard him talk! The swine! I think he's had us all on! He also managed to become non-executive director of the Anna Freud Centre despite being a faithful Kleinian!
- Joined
- Nov 30, 2009
- Messages
- 4,312
- Reaction score
- 9,865
DBT is a form of CBT - in fact the original paper by Marsha Linehan is called Cognitive Behavioral Treatment of Chronically Parasuicidal Borderline Patients
I quite like the mentalization-based approach, it is not a therapy in itself, more a way of being within a therapeutic context, that encourages the patient to become aware of the mental representations underlying their own emotions, and their responses to that of others. So it is quite easy to apply the principles especially if you work with these patients on a regular basis. Fonagy and Bateman (to his credit, the latter has not been putting on any accents), both analysts themselves, acknowledge that other approaches, such as DBT encourage mentalization. What I particularly like about this approach is that it ties in with what we know about attachment and its role in the development of social cognition.
The other British Based approach is Cognitive Analytic Therapy. I am not all that familiar with it myself, even though I should.
The Australians seem to be keen on schema-focussed cognitive therapy.
I quite like the mentalization-based approach, it is not a therapy in itself, more a way of being within a therapeutic context, that encourages the patient to become aware of the mental representations underlying their own emotions, and their responses to that of others. So it is quite easy to apply the principles especially if you work with these patients on a regular basis. Fonagy and Bateman (to his credit, the latter has not been putting on any accents), both analysts themselves, acknowledge that other approaches, such as DBT encourage mentalization. What I particularly like about this approach is that it ties in with what we know about attachment and its role in the development of social cognition.
The other British Based approach is Cognitive Analytic Therapy. I am not all that familiar with it myself, even though I should.
The Australians seem to be keen on schema-focussed cognitive therapy.
- Joined
- Apr 22, 2007
- Messages
- 2,387
- Reaction score
- 129
Touche', good sir. Here was the video I had seen a while back. My accent-recognizer is off, as is my identify-identifier.
http://www.borderlinepersonalitydisorder.com/Conferences/Yale2011/Yale11-demonstrations.shtml
Twas Bateman, not Fonagy, in the video.
To the OP, I think these videos are great and demonstrate some nice differences between approaches.
Thanks for the suggestions everyone
Wow, who can you trust these days? This kind of makes me angry, almost making me wanna leave my depressive position (though the paranoid position is no picnic either).
Wow, who can you trust these days? This kind of makes me angry, almost making me wanna leave my depressive position (though the paranoid position is no picnic either).
