Borderline Personality Disorder

Although some view it as a disorder that’s difficult to remedy, Silver Hill can effectively treat your Borderline Personality Disorder (BPD) and co-occurring conditions. Your quality of life can improve over time. As a full-service psychiatric hospital, Silver Hill is unusually well-prepared among borderline personality disorder treatment centers to achieve positive outcomes.

Borderline Personality Disorder (BPD) is characterized by impulsivity and instability in mood, self-image, and personal relationships. This instability often disrupts your family and work, long-term planning and the your sense of self-identity. You may also experience a co-occurring condition with borderline personality disorder, such as depression, anxiety, substance abuse or eating disorders.

BPD often begins during your adolescence or early adulthood. Some people experience severe symptoms that require hospitalization, while others only require outpatient treatment. If you have BPD you experience intense emotions for long periods of time, and it’s harder for you to stabilize after an emotionally taxing event.

Symptoms

Your symptoms of borderline personality disorder may include:

• Extreme reactions to abandonment, whether real or perceived
• A pattern of intense and stormy relationships with family, friends, and loved ones
• Distorted and unstable self-image or sense of self
• Impulsive and often dangerous behaviors
• Recurring suicidal behaviors or threats or self-harming behavior
• Intense and highly changeable moods, with each episode lasting from a few hours to a few days
• Chronic feelings of emptiness and/or boredom
• Inappropriate, intense anger or problems controlling anger
• Having stress-related paranoid thoughts or severe dissociative symptoms

Although research hasn’t yielded a cause for BPD yet, it seems that genetics, environmental and social factors play a role.

There isn’t a test to diagnose Borderline Personality Disorder. In fact, you may have experienced that it is often misdiagnosed and underdiagnosed. Your diagnosis is even more complicated if you are suffering with a co-occurring disorder, like depression. This is why Silver Hill places so much emphasis on a careful evaluation and a multi-disciplinary approach to your diagnosis and treatment.

The good news is that your BPD can be successfully treated at Silver Hill, and you can return to a full and healthy life. To date, by far the most effective therapy for BPD is Dialectical Behavior Therapy (DBT), as practiced by our highly skilled clinicians.

We use DBT to help you learn to take control of your life and emotions through self-knowledge, emotion regulation and cognitive restructuring. Even with treatment, it takes time for you to improve, because you need to learn a whole new way of dealing with emotions and life stress; a way that is opposite of what you may have done previously. Learn more about the five core modules of DBT here.

Levels of Care
We offer three levels of adult care for borderline personality disorder that correspond with your level of need:

Inpatient – for crisis management
Inpatient treatment is the most intensive form of care, indicated if your illness enters a crisis phase that requires medical intervention for symptom reduction and stabilization. The inpatient program at Silver Hill offers a high clinician-to-patient ratio so that you receive the individual attention you require, and be prepared for subsequent levels of care.

The goals of inpatient treatment are diagnostic assessment, safe detoxification if indicated, symptom reduction and stabilization. Inpatient treatment includes the following elements:

• Psychiatric Diagnostic Evaluation
• Medical Detoxification (if necessary)
• Pharmacologic Therapies
• Individual and Group Counseling
• Structured Treatment Environment
• Aftercare Planning

Learn more about inpatient care.

Transitional Living – for continued therapeutic recovery
The Personality Disorder Center’s Transitional Living Program is a highly structured, intensive  program. It is right for you if you do not need close inpatient supervision, but are not able to manage successfully in an outpatient setting.

Our program is one of the very few programs in the country that focuses on treatment with Dialectical Behavior Therapy (DBT). We designed it to help you with emotional control, impulsivity, self-damaging behaviors and interpersonal disorganization. Through DBT skills training groups and coaching, you learn how to better regulate your emotions and to replace dysfunctional coping strategies with more adaptive behaviors.

You reside on the Silver Hill campus in a house that is staffed 24/7 with highly trained DBT personnel. Under the guidance of this staff, you “live” the skills and coping strategies you are learning, as you learn them.

The length of stay is 4 weeks, but you may opt to extend your treatment.

Learn more about Transitional Living care.

Intensive Outpatient Program – for ongoing care from home
You may choose to enter an intensive outpatient program to continue your treatment from home, if you are at low risk for self-harm and have a stable living environment. You will come to Silver Hill two or three days a week for skills training based on the five core modules of Dialectical Behavior Therapy (DBT), led by licensed clinicians.

Learn more about Intensive Outpatient care.

Adults suffering with Borderline Personality Disorder often have more than one diagnosis. These “co-occurring disorders” require a special understanding and corresponding treatment. Because Silver Hill is a true psychiatric hospital, we are uniquely qualified to provide comprehensive care for patients who need treatment for more than one disorder.

We find that one or more of these psychiatric conditions may co-occur and require simultaneous treatment along with Borderline Personality Disorder:

• Learn More about Depression
• Learn More about Anxiety
• Learn More about Substance Abuse
• Learn More about Eating Disorders

Dialectical Behavior Therapy (DBT)  is the foundation of treatment for Silver Hill’s Personality Disorders Program. It has proven itself at Silver Hill, and in numerous randomized controlled trials, to be most effective at treating adults with Borderline Personality Disorder. You can visit Behavior Tech for more research. DBT has also proven itself time and time again under real life conditions to those in the front lines of treatment: Silver Hill’s team of board-certified psychiatrists and world-class clinicians.

How It Works
According to Behavior Tech, a Lineham Institute Training Company, DBT works by assuming that many of the problems suffered by patients with Borderline Personality Disorder – and related or co-occurring conditions – are caused by a lack of skills that can be remedied with training. For instance, the core issue facing patients with Borderline Personality Disorder is considered to be difficulty with emotion regulation skills. Therefore, DBT concentrates on improving a patient’s ability to use effective emotion regulation strategies.

A Wide Range of Proven Effectiveness
Behavior Tech concludes that “use of DBT skills has been found to fully or partially explain improvements during standard DBT and DBT skills training in problems such as suicidal behavior, non-suicidal self-injury, depression, anger control, emotion dysregulation, and anxiety (Neacsiu et al., 2010; Neacsiu et al., 2014). In addition, improvements in emotion regulation (Axelrod et al., 2011), experiential avoidance (Berking et al., 2009), and assertive anger (Kramer et al., 2015) have been found to account for changes in outcomes such as substance use, depression, and social functioning during DBT. Taken together, these findings suggest that DBT works because it successfully increases clients’ ability to use effective coping skills, particularly strategies for expressing, experiencing, and regulating intense emotions.”

Take a look at our campus and treatment houses.

To make your entry into treatment as easy as possible, here is more detail on what you will experience as a patient at Silver Hill during each level of care for Borderline Personality Disorder:

Inpatient
Our Main House Inpatient Service takes place at the Patricia Regnemer Main House building. You will be assigned according to your diagnosis and the type of inpatient treatment that is best suited to assist in your recovery. The average length of stay varies by diagnosis, ranging from 5 to 12 days.

In this safe, supportive environment, you are able to explore:

• Problem solving
• Relapse prevention
• Managing emotions
• Self-esteem
• Coping ahead
• Health and medication education
• Communication skills
• Stress management

All inpatient units are locked for your safety and no personal computers or cellphones are permitted. Visits from are permitted during scheduled visiting hours.

Your 14-hour day includes:

• Breakfast, lunch and dinner
• Group therapy, including psychoeducational and skills groups
• Medication education
• Twelve-Step work, when appropriate
• Psychopharmacology
• Family program
• Recreational activities
• Nutritional consultation, when clinically indicated
• Cognitive Behavioral Therapy
• Dialectical Behavior Therapy
• Visiting Hours (Family members 12 years of age and older)

Your stay will include daily meetings with your psychiatrist and social worker.

Visit Adult Inpatient FAQs

Transitional Living
When you come to Silver Hill for treatment, you can expect a safe environment that promotes healing and recovery. During this 4-week program you will reside in River House, a 12-bed, co-ed house that overlooks the Silvermine River. The house has a large living room with a kitchen/dining area that opens onto a spacious outdoor patio. Rooms in the residence have private baths and accommodate two people. (Private rooms are available at an additional cost.) Visit Being at Silver Hill for additional details.

Your 14-hour day includes:

• Breakfast, lunch and dinner
• Dialectical Behavior Therapy skills training
• Group therapy
• Goal planning
• Mindfulness meditation
• Recovery discussion meetings
• Recreational activities
• Visiting hours

Intensive Outpatient
We offer you two Intensive Outpatient Dialectical Behavior Therapy Skills groups for Borderline Personality Disorder. The six-week program meets three days a week and the extended nine-week program two days a week. Visit the Events Calendar for dates and times.Both programs will continue your training in the core DBT skills of Mindfulness, Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance and the Middle Path.

In addition, the Women’s DBT and Safe Relationships Intensive Outpatient Program focuses on the education and skills needed to improve relationships, maximize the presence of supportive people, and let go of destructive relationships. You are guided through explorations of parallel relationships with self and others, personal values, and underlying emotional triggers. Self-esteem, healthy boundaries, stress management, and self-care issues are also addressed. The program utilizes core components from DBT and Seeking Safety treatment modules. Visit the Events Calendar for dates and times.

Family Participation
At Silver Hill, we believe your family’s support is important throughout your treatment, and we encourage your family members to meet with your social worker, psychiatrist or other members of the treatment team.

We also offer programs designed to educate family members about the patient’s illness and to improve family communication and functioning. Weekly Family Forums address coping strategies specific to the patient’s condition. Patients are encouraged to join Family Forums with family members over 13 years of age. Visit the Events Calendar for dates and times.

Wellness Services
You may choose to purchase our Wellness Services during your treatment, which offers a holistic approach to recovery in recognition of the integration of body, mind and spirit. Services include yoga, acupuncture, personal fitness training, meditation and massage therapy. These alternative therapies complement rather than replace traditional medical care. They are most effective when combined with medical treatment to help alleviate symptoms of pain and anxiety. The benefits, both short term and long, help promote a feeling of wellness.