Therapeutic Alliance in Borderline Personality Disorder

Therapeutic Alliance in Borderline Personality Disorder BPD Treatment Print Therapeutic Alliance in Borderline Personality Disorder By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on December 23, 2017 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 31, 2020 Blend Images / Ned Frisk Brand /X Pictures / Getty Images More in BPD Treatment Diagnosis Living With BPD Related Conditions If you have a mental illness like borderline personality disorder (BPD), you are likely used to a whole way of feeling and reacting. For those with BPD, that may mean intense emotions, destructive actions, rapid mood swings, and feelings of abandonment. You may have gone years feeling this way and do not know any other way of living. If you are considering going to therapy, it can be overwhelming, scary, and frustrating. Psychotherapy sessions  ask you to completely change how you think and rationalize behaviors. It can be a stressful and emotional experience, but a strong therapeutic alliance can help you through it. What Is a Therapeutic Alliance? The foundation for any course of therapy is the therapeutic alliance, the strong bond designed to help you through your recovery. It is the relationship you have with your therapist and the level of trust you have in her. This is what keeps you moving during therapy, even when its difficult or painful, because you know she has your best interests in mind. This connection may be hard to build but involves the following components: Genuine interest: A good therapist gives you her undivided attention. She listens to what you have to say and asks clarifying questions. She does not seem preoccupied, does not sift through email,s and she doesnt only give you her thoughts or opinions.Specialization: Your therapist needs to have an understanding of what youre going through in order to help you. This means she should have a background in studying BPD and working with patients who have BPD.Comfort: You need to be comfortable telling your therapist anything, even if its embarrassing. She should put you at ease and ensure you know your conversations are confidential.Common Goals: You both should have the same goals so that you are working towards the same endpoint. Building a Therapeutic Alliance A strong therapeutic alliance does not happen overnight and may not be possible with just any therapist. Many people with BPD will visit several healthcare providers or psychiatrists before they find one they can click with. When you are beginning therapy, its perfectly okay to have consultations with several mental health professionals. Ask questions about their approaches to therapy, what techniques and theories they often use, and their background in treating BPD and other personality disorders. Its also a good idea to inquire how available they are. The Importance of Access to Therapy Many people with BPD who engage in self-harm or have suicidal thoughts will often need to be able to call their therapist at odd hours during an emergency. Your potential therapist should be happy to answer your questions. If he seems annoyed, impatient, defensive, or keeps checking his watch, its time to move on and find someone else. A good therapist is worth the extra homework in order to help you on the path to long-term recovery. A Word From Verywell If youre having trouble finding a therapist with a background with BPD, talk to your general practitioner or primary care physician to see if he has any recommendations. He will likely have many different therapists, counselors, psychiatrists,  and psychologists on the file he can refer you to.