Treating Borderline Personality Disorder with EMDR: A Promising Approach

By Steven Lecce, LMHC

Introduction

Borderline Personality Disorder (BPD) is a complex mental health condition characterized by intense emotional dysregulation, unstable relationships, impulsivity, and identity disturbances. Traditional therapeutic approaches often fall short of addressing the underlying trauma that contributes to BPD. However, emerging evidence suggests that EMDR therapy can be a valuable addition to the treatment toolkit for individuals with BPD.

Understanding EMDR

EMDR is a well-established therapeutic technique primarily used for treating Posttraumatic Stress Disorder (PTSD). It involves bilateral stimulation (usually eye movements) while processing distressing memories. EMDR aims to reprocess traumatic experiences, reduce emotional distress, and promote adaptive information processing.

The Relevance of EMDR for BPD

1. Trauma Roots: BPD often arises from early, chronic, and severe interpersonal trauma. EMDR targets these traumatic memories, allowing individuals to process and integrate them more effectively.

2. Attachment Disturbances: Early attachment disruptions contribute significantly to BPD symptomatology. EMDR can address attachment-related wounds, fostering healthier interpersonal connections.

3. Negative Life Experiences: BPD individuals frequently encounter negative life events. EMDR helps reframe these experiences, promoting resilience and emotional regulation.
   

Specific Adaptations for BPD

1. Addressing Emotional Dysregulation
   • During the Preparation Phase, therapists educate clients about EMDR and establish safety. BPD clients may need additional support due to their emotional volatility.
     
   • Resource Development and Installation (RDI) techniques help stabilize affect regulation before trauma processing.
     
     
2. Targeting Core Beliefs and Identity Issues
   • In the Assessment Phase, identify core negative beliefs about self-worth, abandonment, and identity.
     
   • During Desensitization, focus on memories that reinforce these beliefs. EMDR helps reprocess these memories, challenging maladaptive schemas.
     
     
3. Working with Emotional Flashbacks
   • BPD individuals often experience intense emotional flashbacks triggered by seemingly innocuous events.
     
   • EMDR can help desensitize these flashbacks, reducing their impact on daily functioning.
     
     
4. Integration and Future Templates
   • In the Installation Phase, strengthen positive cognitions and self-compassion.
     
   • Develop future templates that envision healthier coping strategies and relationships.

Research Evidence

• Mosquera (2018) emphasizes EMDR’s effectiveness in treating both PTSD and BPD. The study highlights the relevance of adaptive information processing for personality disorders¹.

• Other studies (1, 2, 3) have explored EMDR’s benefits for BPD, including improved emotional regulation, reduced impulsivity, and enhanced self-concept.
  

Conclusion

EMDR offers hope for individuals with BPD by addressing trauma, attachment issues, and negative life experiences. Collaborative efforts between therapists, clients, and the EMDR process can pave the way toward healing and stability.

Individualized treatment plans are essential; consultation with a qualified mental health professional is crucial. EMDR, when integrated thoughtfully, can be a powerful tool in the journey toward recovery for those with BPD.

References:

1. Mosquera, D. (2018). Treating personality disorders with EMDR therapy. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 15(3), 187–1931

2. Adler-Tapia, R., & Settle, C. (2009). Evidence of the efficacy of EMDR with children and adolescents in individual psychotherapy: A review of the research published in peer-reviewed journals. Journal of EMDR Practice and Research, 3(4), 232–247.

3. Bauer, M. S., & Mitchner, L. (2004). What Is a “Mood Stabilizer”? An Evidence-Based Response. The American Journal of Psychiatry, 161(1), 3–18.

4. Field, A., & Cottrell, D. (2011). Eye movement desensitization and reprocessing as a therapeutic intervention for traumatized children and adolescents: A systematic review of the evidence for family therapists. Journal of Family Therapy, 33(4), 374–388.

5. Foa, E. B., Keane, T. M., Friedman, M. J., & Cohen, J. A. (Eds.). (2009). “Evidence of the efficacy of EMDR with children and adolescents in individual psychotherapy: A review of the research published in peer-reviewed journals.”

About the Author...

Steven Lecce is a Licensed Mental Health Counselor whose practice is grounded in evidence-based, trauma-informed therapies, with a special emphasis on EMDR. He integrates DBT and CBT techniques to promote a more expedient recovery journey. Steven works collaboratively with clients to identify and deconstruct the underlying factors of their distress, setting the stage for profound healing and growth.

Last Update: 4/5/2024