The therapeutic relationship in borderline personality disorder: a cognitive perspective

Abstract

This article deals with the role of the therapeutic relationship in psychotherapy of patients with Borderline Personality Disorder (BPD) (APA, 2013). Firstly, the paper refers to the therapeutic relationship in BPD in general as well as more specifically in the light of Cognitive Psychotherapy, through the major principles and new developments in clinical practice and survey. Cognitive treatment regards the therapeutic relationship as a necessary but insufficient component for the therapeutic change. However, in recent years, it has attached special importance to it, as indicated by clinical studies. Then it goes on to an overview of the major theoretical and clinical approaches for BPD, mainly through the work of Linehan, Kernberg, Gunderson and Young, which is followed by an elaborate analysis of the difficulties and instability of relationships in BPD as major characteristics, as well as of the peculiarities that the therapeutic relationship between the therapist and a BPD patient displays. Psychotherapy with BPD patients, the difficulties and suggestions for a positive therapeutic outcome are the major points of the third part of the paper, which is completed with the potential of the cognitive therapist and the contribution of cognitive therapy through a focus in the present, structured treatment, identification of thoughts, emotions and behaviors, cooperative work, concrete boundaries and honest and substantial communication.