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From Chaos to Calm: How Dialectical Behavior Therapy Transforms Life with Borderline Personality Disorder

  • Writer: Julie Barris | Crisis Counselor | Therapist-in-Training
    Julie Barris | Crisis Counselor | Therapist-in-Training
  • Dec 5, 2024

Dialectical Behavior Therapy (DBT) transforms life by teaching individuals how to manage overwhelming emotions, reduce impulsive behaviors, and build healthier relationships. Through its structured approach, DBT empowers those with Borderline Personality Disorder to find stability and emotional resilience, leading to a more balanced and fulfilling life.

From Chaos to Calm: How Dialectical Behavior Therapy Transforms Life with Borderline Personality Disorder

Borderline Personality Disorder (BPD) is often viewed through the lens of chaos—emotional instability, intense mood swings, impulsive behavior, and the constant fear of abandonment. These overwhelming feelings can make life feel unpredictable and unmanageable. But what if there was a way to break free from this cycle of emotional turmoil and learn how to regulate emotions, build healthier relationships, and regain a sense of control over your life? Enter Dialectical Behavior Therapy (DBT), a groundbreaking treatment that has been transforming the lives of people living with BPD for over three decades.


Understanding BPD: A Life of Emotional Extremes


Borderline Personality Disorder is one of the most challenging mental health conditions to manage, both for the person living with it and for their loved ones. People with BPD experience profound emotional instability, often reacting with extreme intensity to minor triggers. Relationships feel like a rollercoaster, with feelings of idealization followed by rapid devaluation. The fear of abandonment can lead to desperate attempts to prevent it, sometimes causing behaviors that seem irrational or self-destructive.


At its core, BPD is about an inability to regulate emotions effectively. The intense and overwhelming feelings that come with BPD often lead to impulsive actions, self-harm, and an unstable sense of self. But what if these emotions could be understood, managed, and regulated? This is where Dialectical Behavior Therapy comes in.


What Is DBT? A Therapy Built for BPD


Developed by psychologist Marsha Linehan in the late 1980s, Dialectical Behavior Therapy was specifically designed to address the unique challenges of individuals with BPD. DBT is based on the idea that individuals with BPD experience chronic emotional dysregulation—where emotions feel out of control, and reactions are often extreme and destructive. The therapy combines cognitive-behavioral techniques with mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills.


One of the unique features of DBT is its focus on dialectics—the idea of accepting reality as it is, while simultaneously working toward change. In the context of BPD, this means learning to accept one's emotions and experiences without judgment, while also developing healthier coping mechanisms to change destructive behaviors.


How DBT Helps: A Transformational Approach


  1. Mindfulness: At the heart of DBT is mindfulness, a skill that helps individuals become more aware of their thoughts, emotions, and reactions in the present moment. For those with BPD, mindfulness is especially powerful because it encourages them to pause, observe their emotions, and resist the urge to act impulsively. Through mindfulness exercises, people with BPD can create space between their emotional reactions and their behaviors, leading to more thoughtful and intentional actions.


  2. Emotion Regulation: One of the hallmark challenges of BPD is emotional instability. Individuals with BPD may feel like their emotions are unpredictable or uncontrollable, but DBT teaches them how to understand and manage these emotions in healthier ways. Clients learn to identify and label their emotions, understand their triggers, and use coping strategies to manage overwhelming feelings without resorting to self-destructive behaviors like self-harm or substance abuse.


  3. Distress Tolerance: People with BPD often struggle with distress—feeling like they cannot cope with difficult emotions. DBT helps individuals develop distress tolerance skills, which teach them how to endure emotional pain without making it worse. Skills like self-soothing, distraction techniques, and radical acceptance (accepting the present moment without judgment) allow individuals to navigate difficult situations more effectively, without resorting to impulsive or harmful actions.


  4. Interpersonal Effectiveness: Relationships are often the most difficult aspect of BPD. The intense fear of abandonment and fluctuating emotions can lead to unstable or unhealthy relationships. DBT teaches people with BPD how to communicate more effectively, set boundaries, and assert their needs without falling into extremes of aggression or withdrawal. This skill set helps improve both personal and professional relationships and creates a sense of trust and mutual respect.


The DBT Process: From Chaos to Calm


DBT is structured and multifaceted. It typically involves individual therapy, group skills training, and phone coaching to help individuals apply their new skills in real-life situations. The therapy is collaborative, meaning that the therapist and client work together as a team to address the client’s specific challenges. DBT emphasizes the importance of validating the client’s experiences while also encouraging change. This approach is crucial for individuals with BPD, who often struggle with feeling misunderstood or invalidated.


The process of DBT is not quick—learning new ways of thinking, feeling, and behaving takes time and commitment. But the results can be life-changing. Individuals who engage in DBT often report a significant reduction in self-harm behaviors, suicidality, and emotional volatility. They also experience greater stability in relationships and a more consistent sense of self-worth.


Real-Life Impact: Stories of Transformation


While BPD can feel like an inescapable cycle of pain, DBT offers hope. Many individuals who have struggled with the overwhelming symptoms of BPD have found that DBT helps them develop the tools to create more stability and peace in their lives. They learn to manage their emotions, communicate more effectively, and navigate their relationships in healthier ways.


One person may share how DBT helped them understand their emotional triggers and, as a result, they no longer engage in impulsive behaviors like cutting or binge drinking when they feel overwhelmed. Another individual might reflect on how DBT empowered them to confront their fear of abandonment and build a supportive, healthy relationship with their partner.


The results may not be instant, but over time, the skills learned in DBT can transform the way a person with BPD views themselves and their relationships, leading to greater emotional stability and a more fulfilling life.


Conclusion: A Path to Healing


Dialectical Behavior Therapy isn’t just a treatment—it’s a lifeline for those living with Borderline Personality Disorder. By helping individuals build emotional resilience, regulate their reactions, and form healthier relationships, DBT offers a new way of living for those whose lives have been ruled by chaos. While BPD can be a debilitating condition, DBT provides the tools for people to regain control over their emotions, rewrite their relationship stories, and ultimately, live a more fulfilling life.


If you or someone you love is struggling with BPD, remember: Healing is possible. With DBT, the path from chaos to calm is not just a dream—it can be a reality.


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Facing Your Fears: How Exposure Therapy Can Help You Conquer Phobias

  • Writer: Julie Barris | Crisis Counselor | Therapist-in-Training
    Julie Barris | Crisis Counselor | Therapist-in-Training
  • Dec 2, 2024

Exposure therapy is a proven method that can help you conquer phobias by gradually desensitizing you to the feared object or situation, allowing you to regain control over your reactions. With patience and consistent practice, exposure therapy can empower you to face your fears and lead a life free from the limitations of phobias.

Facing Your Fears: How Exposure Therapy Can Help You Conquer Phobias

We all have fears. Some are rational—like the fear of walking alone at night or being in a dangerous situation. But for many, phobias go beyond ordinary fear and can disrupt daily life in ways that seem beyond our control. Whether it's the fear of heights (acrophobia), spiders (arachnophobia), or public speaking (glossophobia), these intense and irrational fears can feel overwhelming. Fortunately, there’s a scientifically backed approach to overcoming them: exposure therapy.


What Are Phobias, and Why Do They Happen?


Phobias are more than just occasional nervousness or discomfort; they are intense, often irrational fears of specific objects, situations, or creatures. A phobia can trigger a full-body panic response—rapid heart rate, shortness of breath, dizziness, or even fainting—at the mere thought or sight of the feared stimulus.


Phobias typically develop in childhood or adolescence, but they can emerge at any age. The exact cause of phobias is not entirely understood, but several factors may contribute to their development:


  • Traumatic Experiences: A particularly distressing or traumatic event, like being bitten by a dog, might create an association between the object or situation and fear.


  • Learned Behavior: Phobias can sometimes develop by observing others. For instance, a child who witnesses a parent or sibling reacting fearfully to a particular situation (like flying) might learn to fear it as well.


  • Genetics and Environment: Some studies suggest that phobias may run in families. If a parent or sibling has a phobia, a person might be more prone to developing one themselves. Environmental stressors, like childhood trauma or a lack of supportive relationships, may also increase the likelihood of phobias.


What Is Exposure Therapy?


Exposure therapy is a form of cognitive-behavioral therapy (CBT) that helps individuals gradually confront and deal with the things they fear in a controlled, systematic way. The goal is to desensitize the person to the feared object or situation, allowing them to gradually reduce their anxiety and regain control over their fear responses.


Exposure therapy typically follows a process that includes:


  1. Understanding the Fear: The first step in exposure therapy is acknowledging and understanding the phobia. This often involves discussing the thoughts, emotions, and physical sensations experienced when faced with the fear.


  2. Creating a Hierarchy of Fear: To avoid overwhelming the individual, the therapist and client work together to create a hierarchy or "ladder" of fear. The ladder consists of a series of steps, starting with less threatening situations and gradually building up to more challenging scenarios. For example, a person with a fear of flying might start by looking at pictures of airplanes, then progress to watching videos of flights, and eventually work up to visiting an airport.


  3. Gradual Exposure: The core of exposure therapy involves exposing the person to the feared object or situation in a safe and controlled environment. This can be done through real-life exposure (in vivo) or through imagination (in vitro), depending on the severity of the phobia. The exposure begins at the lowest point of the hierarchy and becomes progressively more intense. For example, someone with a fear of spiders might start by looking at pictures of spiders, then move on to watching videos, and eventually hold a spider.


  4. Repetition: Exposure therapy works through repeated exposure. The more the person faces the fear, the less anxious they become. This process helps break the cycle of avoidance and teaches the brain that the feared situation is not as dangerous as it seems.


  5. Cognitive Restructuring: During exposure, clients learn to identify and challenge irrational beliefs about the feared object or situation. For instance, if someone with a fear of dogs believes all dogs are dangerous, they might learn to recognize that many dogs are friendly and safe.


Types of Phobias Treated with Exposure Therapy


Exposure therapy can help treat a wide range of phobias, including:


  • Social Phobia (Social Anxiety Disorder): The fear of being judged or embarrassed in social situations. Exposure therapy for social phobia may involve starting with less intimidating social scenarios, such as speaking to a stranger, and gradually progressing to more complex interactions, like giving a presentation.


  • Agoraphobia: The fear of being in situations where escape is difficult, such as crowded places or open spaces. Exposure therapy helps individuals gradually confront these situations and learn coping skills for managing anxiety.


  • Specific Phobias: Fears of specific objects or situations, such as animals (spiders, dogs, etc.), natural environments (heights, water), or medical procedures. Each specific phobia can be addressed through a personalized exposure plan.


  • Panic Disorder: While not strictly a phobia, panic disorder often involves a fear of having a panic attack in certain situations. Exposure therapy helps people confront feared situations, reducing the chances of a panic attack occurring.


Overcoming the Fear: How Exposure Therapy Helps


  1. Desensitization: Repeated exposure to the feared object or situation gradually lessens the emotional response, making the person less fearful over time. This process of desensitization helps break the cycle of avoidance that reinforces the phobia.


  2. Cognitive Restructuring: Exposure therapy helps individuals recognize the irrational thoughts they associate with their fear. By challenging these beliefs and replacing them with more realistic ones, they can reduce the intensity of their phobia.


  3. Empowerment: Facing and overcoming fears provides a powerful sense of accomplishment and self-efficacy. Over time, individuals begin to feel more in control of their reactions and develop healthier coping mechanisms.


What Can You Expect During Exposure Therapy?


The first thing to know is that exposure therapy requires patience. It’s not about immediate results; it’s about progress, no matter how small. Some people might see improvement after just a few sessions, while others may need longer periods of exposure. Regardless, it’s essential to remember that confronting fears is a gradual process. While it can be emotionally challenging, exposure therapy is one of the most effective treatments for phobias.


For those struggling with severe phobias, exposure therapy is often done with the help of a trained therapist who can guide the process and provide the necessary support. In some cases, virtual or augmented reality can even be used to create realistic simulations of feared situations, further enhancing the exposure process.


Conclusion: Reclaiming Control Over Fear


Phobias can be limiting, but with the right treatment, they are conquerable. Exposure therapy offers a proven method for facing fears head-on and reclaiming control over one’s life. It’s not about eliminating fear entirely, but rather learning to navigate it with confidence and resilience. If you or someone you know is struggling with a phobia, exposure therapy could be the key to breaking free from the cycle of fear and moving toward a life filled with possibilities.


If you’re considering exposure therapy for yourself or a loved one, consult with a mental health professional who can guide you through the process. Remember, facing your fears is not only possible—it’s an empowering journey to a life with more freedom and less anxiety.

This article aims to offer a comprehensive overview of how exposure therapy can help overcome phobias and the process of desensitization and emotional healing that follows. It highlights not only the therapeutic techniques involved but also the hope and empowerment that come with confronting one's deepest fears.


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Honoring Heritage: How to Create a Culturally Inclusive Environment for Native Communities

  • Writer: Julie Barris | Crisis Counselor | Therapist-in-Training
    Julie Barris | Crisis Counselor | Therapist-in-Training
  • Nov 27, 2024

Creating a culturally inclusive environment for Native communities means recognizing and respecting the unique traditions, values, and healing practices that are integral to their identity. By incorporating these cultural elements into mental health care and community support, we can foster a sense of belonging and promote holistic well-being for Native individuals.

Honoring Heritage: How to Create a Culturally Inclusive Environment for Native Communities

In a world that increasingly values diversity and inclusion, it’s essential to recognize the cultural and mental health needs of Native communities. The impact of centuries of colonization, forced displacement, and cultural suppression has left deep scars on Native peoples. Yet, the resilience of Native cultures and communities remains a powerful testament to survival and strength. As we work towards building a more inclusive society, it is important to understand the unique cultural backgrounds, traditions, and challenges that Native individuals face in the realm of mental health and well-being.


The Mental Health Landscape for Native Communities


Native American communities face a range of mental health challenges rooted in historical trauma, marginalization, and systemic inequities. According to the National Indian Health Board, Native Americans are more likely to experience mental health struggles such as depression, anxiety, substance abuse, and suicide. However, these issues are often compounded by a lack of access to culturally competent healthcare, stigmatization, and the erasure of Native voices in mental health conversations. The mental health system, as it exists today, often fails to account for the unique cultural values and traditions that shape the lives of Native individuals.


Culturally relevant mental health care is essential for healing and supporting Native communities. Understanding the role of family, community, spirituality, and land in Native well-being can help bridge the gap between traditional practices and modern therapeutic approaches. By acknowledging the importance of culture and honoring Native traditions, we can begin to break down the barriers to healing and ensure that individuals feel seen, heard, and supported in ways that are aligned with their values.


Creating Cultural Inclusivity in Mental Health


To be truly inclusive, mental health systems must adapt to the cultural realities of Native communities, ensuring that services are not only accessible but also relevant and respectful. Here are several key steps to create a more culturally inclusive environment for Native individuals seeking mental health support:


1. Acknowledge Historical Trauma and Its Impact


Understanding the profound effects of historical trauma is crucial to supporting Native people’s mental health. This trauma, which stems from colonization, forced relocation, the boarding school system, and ongoing systemic discrimination, continues to affect generations. Acknowledging this history—not as a distant past, but as an ongoing struggle—can help open the door to healing. Mental health providers should learn about the impact of these historical events and integrate this understanding into their practice, fostering an environment where Native clients can feel safe discussing their experiences.


2. Incorporate Traditional Healing Practices


Native communities often have their own systems of healing, which include cultural practices such as ceremony, storytelling, sweat lodges, and talking circles. These practices emphasize the interconnectedness of mind, body, spirit, and community. To be culturally inclusive, mental health professionals should be open to incorporating traditional healing methods into therapeutic practices. This doesn't mean replacing Western medicine or therapy but rather supplementing them with culturally relevant approaches that align with the client's worldview.


3. Build Trust with Native Communities


Trust is a key component in any therapeutic relationship, and it’s especially crucial for Native clients who may have historically been mistreated by healthcare systems. Building rapport and trust involves being patient, showing respect for Native cultures, and acknowledging the legacy of discrimination that may lead to mistrust in healthcare providers. Mental health professionals can work to earn trust by being culturally competent, listening actively, and avoiding harmful stereotypes or assumptions.


4. Offer Culturally Relevant Education and Resources


Part of creating an inclusive environment involves educating both mental health professionals and the wider community about Native cultures, values, and mental health challenges. This means offering workshops, training, and resources on cultural competence and the unique needs of Native populations. It’s also essential to create space for Native people to share their own stories and perspectives, ensuring they have a voice in shaping the mental health services that serve them.


5. Respect Community and Family Structures


In Native cultures, the sense of community and family plays a central role in an individual’s mental health. Family is often seen as an extended network that includes not just immediate relatives, but also elders, cousins, and broader community members. Acknowledging the importance of these relationships is vital in therapeutic settings. Mental health providers should encourage family involvement when appropriate and work to understand the client’s support network as a critical factor in their healing journey.


6. Address Barriers to Access


Native communities often face significant barriers to accessing mental health services, including geographic isolation, language differences, and financial constraints. In remote areas, healthcare facilities may be scarce, and transportation can be a major obstacle. Providing telehealth options, community outreach, and mobile mental health services can help bridge the gap and make support more accessible. Additionally, language barriers can be addressed by offering services in Native languages and hiring culturally competent staff who understand the unique dialects of local communities.


Moving Towards True Inclusivity


Creating a culturally inclusive mental health environment for Native communities requires a shift in mindset and a commitment to understanding, empathy, and respect for diverse cultural practices. It’s about fostering environments where Native people can heal on their own terms, with access to care that respects and incorporates their cultural values.

The road to inclusivity is ongoing, and mental health professionals must be willing to learn, adapt, and actively engage in practices that promote cultural competency. As society continues to evolve, it’s essential to ensure that Native communities are not left behind in the conversation about mental health and wellness.


By honoring the wisdom of Native cultures, acknowledging the impact of historical trauma, and creating accessible, culturally relevant care, we can help pave the way for greater mental health equity and healing. Native communities have shown extraordinary resilience through generations of hardship, and together, we can build a future where healing is available to all, on their own terms.


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