Psychodynamic approaches to Borderline Personality Disorder

Psychodynamic approaches to Borderline Personality Disorder (BPD) are particularly relevant to understanding the aetiology, treatment, and even prevention of BPD. Psychodynamic approaches contribute an understanding of the core deficits surrounding identity, object relations (self and other relationships), and emotion dysregulation in terms of personality organisation, motivational processes (e.g., attachment needs), affects, conflict, and defences. Psychodynamic approaches complement non-psychodynamic approaches to BPD. There are two major psychodynamic approaches to treating BPD: Transference-Focused Psychotherapy and Mentalisation-based Treatments. Both have demonstrated clinical utility and share common features with respect to the development of self- and other-reflection. Both the conceptualisation and classification of personality disorders have received longstanding criticism for various reasons, including comorbidity and poor reliability of assessment. Nevertheless, the view that personality (however conceptualised) can be disordered is generally accepted, and psychodynamic approaches have a long history of contributing to both our description and understanding of 'character pathology'. Furthermore, psychodynamic accounts are particularly well-suited to understanding and guiding the treatment of personality disorders.