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A Relational Approach to Psychotherapy and Counselling for Borderline Personality Disorder

26/2/2015

2 Comments

 
This is the second in a series of posts about relational therapeutic approaches to mental health issues. You may find it helpful to get background to this by reading the last post, on a relational approach to depression.

Borderline personality disorder, like depression, has in the past often been medicalised, objectified, or managed. I’ll attempt to give a brief no-jargon sense of a different, more relational way of working with people whose symptoms fit this diagnosis.

People with this diagnosis are known for having intense, chaotic, and often destructive relationships. Relational therapy with people with this diagnosis is an attempt by both client and therapist to build what may be the client’s first experience of a stable, healthy, and boundaried relationship. This involves both therapist and client acknowledging and working through the inevitable challenges of staying in relationship with each other. These challenges include the disappointments, the injuries, the wounds, and the traumas both large and small that are often the reflections of the hurts and inadequacies of earlier relationships. This is big work - connecting with someone consistently over the long term in a real and honest way. Once we've developed the capacity to do this with a therapist, then we're much more likely to be able to do this in our other relationships, and we probably will no longer fit the diagnostic criteria for borderline personality disorder.

Realistically, enough attending to relationships has to happen in any successful therapy with people with this diagnosis. My experience is that the more openly and consciously relationship issues (including the therapist and clients, as real fallible humans) are addressed, the better. This doesn’t exclude other approaches, such as practising DBT distress tolerance skills to get through crisis.

Please let me know in e-mail or comments what you think about this. Check in again soon for the next post in this series: a relational approach to anxiety.

2 Comments
Anxiety Treatment Centers Los Angeles link
14/1/2025 09:44:07 pm

Los Angeles-based centers specializing in therapies and programs to help individuals manage and overcome anxiety disorders.

Reply
zeolis link
23/4/2025 11:08:09 am

Thank you for this compassionate and insightful piece. The relational approach makes so much sense—especially the emphasis on co-creating a secure, authentic connection over time. As someone based in Auckland exploring therapy options for a loved one, I wonder: how do you approach building this kind of trust in an online therapy setting? Do you find the same depth of connection can be fostered remotely? I’d love to hear your thoughts on adapting relational work to digital formats.

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    Michael Apathy and Selina Clare are practitioners of psychotherapy at Lucid who are excited about fresh, innovative, and effective therapy for individual and environmental change.

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Lucid Psychotherapy and Counselling provides affordable and effective individual psychotherapy, counselling, Intensive Short Term Dynamic Psychotherapy (ISTDP), ecotherapy, treatment for depression, stress, panic and anxiety disorders, and mindfulness mentoring, servicing the area of Ōtautahi Christchurch, Hokitika, Māwhera Greymouth, West Coast, Aotearoa New Zealand. We also offer online therapy sessions. © 2015-2025 Lucid Psychotherapy & Counselling. All rights reserved.
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  • Home
  • About
    • James Weaver
    • Di Robertson
    • Michael Apathy
    • Selina Clare
    • Fees
  • Contact
  • Get Help With
    • Addictions
    • Dealing with Anger
    • Borderline Personality Disorder
    • Depression and despair
    • Eating Disorders
    • Relationship Difficulties
    • Sex and Sexuality
    • Spirituality >
      • Tibetan Buddhism
      • Theravadin Buddhism / Vispassana
      • Zen Buddhism
    • Stress & Anxiety
    • Trauma and Abuse
    • Social / Climate Justice
  • ISTDP