Key analysis for the approach of borderline personality disorder

30.01.2021
Is the lack of emotional validation one of the possible causes of the development of borderline personality disorder? Do not stop reading this article to inform yourself.

Emotional validation is one of the key tasks for the approach to borderline personality disorder (BPD). Emotional validation is part of the essential strategies, within Dialectical Behavioral Therapy (DBT), developed by Marsha Linehan.

Roughly speaking, emotional validation is part of the essential strategies of DBT in conjunction with problem-solving strategies. It allows the person with BPD to feel understood in a stimulating and non-critical context . Something that may be different in its natural context.

The importance of emotional validation in BPD

Linehan observed the importance of certain strategies for the treatment of BPD, among them emotional validation of utmost importance. His model assumes a biosocial approach based on the interrelation between biological influences and learning principles .

The latter can mean that the person with BPD, in addition to experiencing intense emotions, may have experienced disabling parenting patterns. For this reason, when experiencing an intense emotion, difficult to control in the person with BPD, its context may have made the person see that they are wrong, that it is an exaggerated response and that it may be misfit .

In short, the person with BPD is often asked to change the way they express emotions, but they are not told how. In this case, Linehan simplifies it to "teach a child who does not have legs to walk as if he had them."

In this way, the person with BPD may have lacked emotional validation since childhood . In addition to emotional vulnerability, these types of people may not trust their own emotions, since the environment has often told them that they were wrong. Here, these people can enter into conflict between what the environment asks of them and what they feel, developing states of frustration and guilt for not meeting the expectations of the environment.

Dialectical Behavioral Therapy (DBT)

As discussed in previous lines, emotional validation, together with problem solving, form the essential strategies in DBT . With these, change strategies are also carried out aimed at modifying maladaptive behavior patterns.

The basic objectives of DBT are for people with BPD to learn to modulate extreme emotionality and reduce maladaptive behavior patterns that are dependent on their mood. Linehan puts his emphasis on acceptance and emotional validation from there to achieve change .

Treatment modes

DBT provides a very complete therapeutic support that includes 4 modes of therapy:

  • Individual therapy : therapy with a weekly periodicity that lasts between 50 and 60 minutes. although it can reach 90 minutes
  • Skills training: applied in a group format and trained in mindfulness , discomfort tolerance, interpersonal effectiveness and emotional regulation skills
  • Skills Generalization - Telephone consultations are used to reinforce skills taught in the skill group
  • Therapeutic team: it serves as the basis for the therapists responsible for the therapeutic process as a mode of supervision and prevention of burnout .

Keys to emotional validation in BPD

In DBT it is established that no change can be achieved without acceptance . Therefore, emotional validation turns out to be an essential strategy to help people with BPD to relate in a different way with the emotions that arise, changing certain behavioral patterns that make it difficult for them to lead their life.

Emotional validation then turns out to be the basic acceptance strategy, and problem solving the change strategy. The essence of validation, simply described, means making the person with BPD see that their behavior makes sense according to the present context or situation, accepting the person and communicating it to them.

In summary, the keys to emotional validation could be compressed into the following:

  • Show interest in the person, adopting a listening attitude
  • Reflect the thoughts, feelings and emotions of the person with BPD, attending in turn to the verbal and non-verbal language, to give a feedback of this information to the person and see that they have been understood
  • Also express those issues that the person has not communicated, but have been omnipresent in the person's speech. (Linehan calls this " mindreading " )
  • Contextualize the behavior of the person, making it make sense according to the circumstances that surround it . Here, biological and learning factors are mentioned to give an explanation to the person's problem.
  • Analyzing the antecedents and consequences of dysfunctional behaviors (such as, for example, substance abuse), as a way to see that these types of behaviors may be used for a momentary relief of their emotional distress

In any case, DBT is usually a very extensive therapy in its content to describe it accurately, in addition to the risk of reducing it to emotional validation strategies. Therefore, it is considered as a complete intervention for people with BPD and other pathologies; such as eating disorders, substance abuse, and suicide risk, in addition to other accommodations.

When we reason about a problem, we tend to use a simple and useful outline most of the time. This way of thinking is what is known as linear thinking.

In couple relationships there is always a certain degree of commitment and, of course, seeking the company of the person you love. However, some people have an excessive emotional dependence on their partners .