The co-occurrence of addiction and borderline personality disorder (BPD) in a patient results in one of the most frustrating clinical challenges for counselors, and leaves the patient highly vulnerable to worsening symptoms in both areas. A 90-minute breakout session that will take place at this year’s National Conference on Addiction Disorders (NCAD) in Orlando, Fla., will instruct professionals about the potential usefulness of dialectical behavior therapy (DBT) in working with these individuals.
Alina Gorgorian, PhD, clinical director of the Clearview Women’s Center for Borderline Personality and Emotional Disorders in California (www.clearviewwomenscenter.com), says she will devote her Oct. 1 talk to an overview of DBT and an introduction to its application within substance use treatment. NCAD (www.ncad12.com), sponsored by the publishers of Addiction Professional and Behavioral Healthcare magazines, will take place Sept. 28-Oct. 2.
Gorgorian says her intent will be for the professionals who attend her session to arrive at “a different understanding of what goes on in the mind of the borderline individual and hopefully find compassion to more of an extent than they have before.” Professionals at addiction treatment conferences generally characterize the BPD patient with a substance abuse history as among the most difficult populations for them to treat.
Gorgorian says she will highlight in her presentation the severe emotional dysregulation that characterizes the co-occurrence of BPD and substance use. DBT, a form of cognitive-behavioral therapy (CBT) developed by psychologist Marsha Linehan in the 1980s, is a strengths-based, collaborative therapy that teaches patients mindfulness, the ability to tolerate crises, and steps needed to regulate emotion.
When DBT is employed in substance use treatment, it is generally acknowledged that relapse should not be interpreted as permanently derailing progress toward recovery goals.
Gorgorian, who like Linehan has a psychology background, recalls her accidental introduction to working with BPD patients about eight years ago, and some of the negative reactions they inspired in other clinicians. “Everyone was afraid of them and didn’t want to work with them,” she says. She hopes that sharing the basics of this form of cognitive therapy with addiction professionals will help to demystify the issues with which this population struggles.