Borderline Personality Disorder is a complex condition in which sensitive individuals have come to experience and interact with their world. Those with this personality pattern are some of the most gifted, compassionate, and creative people to exist. They can also be some of the most tormented souls.

People with BPD are naturally biologically sensitive. They come straight from the womb with intense emotions. When they are sad, they're distraught; when angry, they're enraged; and when happy, they're elated—this occurs even in infancy! Big emotions aren't bad, but if they're paired with the child being born into an invalidating environment (any type of abuse, poor fit with the parents, or any situation in which the child is told they are wrong for being who they are), then the sensitive infant can develop into an adult with BPD. The "disorder" is just a set of personality traits and characteristics that result from these two conditions: 1. biological sensitivity and 2. an invalidating environment. When these combine, they can create a pattern of traits that we diagnose as Borderline Personality Disorder. This condition exists on a spectrum, ranging from barely noticeable to severely impairing. Anyone on that spectrum could be described as a Highly Sensitive Person, which is a less stigmatizing term.

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The traits of BPD include: emotionally intense mood swings, especially strong feelings of anger; impulsivity in areas such as spending, drug or alcohol use, sexual activity, or simply impulsive, emotion-based decisions; chaotic relationships with significant others, friends, family, or colleagues; intense fear of abandonment, often leading to extreme measures to stay in a relationship, being overly forgiving of partners' behaviors, or cutting off relationships to avoid being abandoned themselves; a chronic sense of emptiness; poor sense of self with a changing, chameleon-like identity; and, in its more extreme forms, self-harm behaviors like burning, cutting, hair pulling, or head banging; suicidal thoughts or attempts; and dissociation or possible paranoia. For a diagnosis, an individual would have more than half of these characteristics.

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Dialectical Behavior Therapy was created in the 1990s by Marsha Linehan to specifically address this hard-to-treat population. She found that therapies taking a soft, accepting, passive stance (humanist, person-centered, existential modalities) were not providing enough concrete change for these clients. On the other hand, the more logic-driven, change-oriented modalities, like Cognitive Behavioral Therapy, Behaviorism, and Exposure work, were not sensitive enough to the clients' need for validation and trust-building. Meanwhile, her clients exhibited some of the most severe and dangerous behaviors, including suicidal acts, self-harm, addiction, and other impulsive behaviors. Linehan created DBT to balance both change and acceptance by providing specific, concrete skills while respecting the dignity and worth of the relationship. It has been one of the most successful evidence-based treatments since its inception and has saved thousands of lives over the years.

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To provide Dialectical Behavior Therapy, a psychotherapist must obtain training beyond their graduate school programs, participate in a Consultation Team with other DBT therapists on a weekly basis, be trained in and provide both individual DBT therapy and DBT skills groups, and offer phone coaching.

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Stephanie Johnston is one of just a few clinicians in Arkansas who specialize in Borderline Personality Disorder and Dialectical Behavior Therapy. She has undergone the extensive full training from the Linehan Institute and has run the DBT program at the Mental Health Clinic at the Central Arkansas Veterans Healthcare System for several years. She has also been an adjunct professor in the Master of Social Work Program at the University of Arkansas Little Rock, where she taught both Acceptance and Commitment Therapy and Dialectical Behavior Therapy courses to future therapists.

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At her teletherapy private practice, Stephanie has historically offered the full DBT program, which includes Individual Therapy, a Consultation Group for DBT therapists, 24/7 Phone Coaching, and Individual Skills Training. At this time, she has partnered with her consultation team to provide skills coaching to individuals who are receiving individual therapy from other providers.

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The Skills Training is similar to a private tutoring session where you will learn the skills needed to regulate your emotions, tolerate distress, relate better with others, and practice mindfulness. (There won’t necessarily be any discussion about your history—you don’t have to share much personally if you don’t want to. All that’s required is that you show up, learn the skills, and do the homework.) It uses the 2nd edition of the Marsha Linehan Dialectical Behavior Therapy Skills Workbook.

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If all of this resonates with you or someone you love, you should text 501-902-5250 with any questions. DBT is often the answer for struggling souls trapped by their emotions. Please look into it further to see if this is the treatment you’ve been needing—you deserve to have a life worth living.