Treating Borderline Personality Disorder with DBT and MBT

Individuals with Borderline Personality Disorder (BPD) commonly experience emotions with greater intensity and may notice rapid shifts in mood, sense of self, and relationship dynamics. These patterns are frequently linked to early attachment experiences and long-standing difficulties in emotion regulation. The responses and coping strategies that develop can be adaptive in earlier environments but may become less effective or more distressing in adulthood. The core challenge is not a lack of resilience or effort, but the need for new strategies that support stability and connection in the present.

In my work as a psychiatrist at McLean Hospital and in my private practice in Boston, I have seen meaningful change occur when treatment focuses on emotional understanding, consistency, and reflection. Two approaches that are particularly helpful in supporting this process are Dialectical Behavior Therapy (DBT) and Mentalization-Based Therapy (MBT).

How DBT Helps

DBT teaches practical skills for managing intense emotions and improving communication. Treatment focuses on four skill areas:

• Mindfulness
• Distress Tolerance
• Emotion Regulation
• Interpersonal Effectiveness

These skills help individuals notice emotional states earlier, respond more intentionally, and navigate challenging situations without becoming overwhelmed. Many people appreciate that DBT skills can be applied directly to everyday life.

How MBT Helps

MBT focuses on mentalization, which refers to the capacity to understand one’s own thoughts and feelings while also considering the internal experience of others. This ability can become harder to access when emotions are strong.

In MBT sessions, the pace is slowed down so that emotional experiences can be recognized and reflected on in real time. The goal is to improve emotional clarity, reduce misunderstandings, and support a more stable sense of self in relationships.

Why Using DBT and MBT Together Works Well

DBT provides skills to support emotional steadiness. MBT deepens awareness of internal experience and strengthens interpersonal understanding. Together, they can help individuals:

• Recover more quickly from emotional intensity
• Communicate needs with more clarity
• Develop a more consistent and grounded sense of self
• Build relationships that feel safer and more predictable

This combined approach supports both immediate coping and longer-term change.

Care With Dr. Adam Henderson

I offer DBT-informed treatment and Mentalization-Based Therapy in Boston for individuals seeking greater emotional stability and healthier relationship patterns. My approach is informed by my clinical training and ongoing work at McLean Hospital and Harvard Medical School, where I specialize in personality disorder treatment.