Practice Specialty

At Nicholas Barrington Therapy, I specialize in helping people living with borderline personality disorder, other personality disorders, and severe mood instability. I understand that mood dysregulation may feel destabilizing in your life. The ups and downs might lead to you feeling good in one moment, only for a relationship, a job, or your internal sense of self to come crashing down in the next. You might even feel like you are powerless to put an end to dysfunctional behavior or relationship patterns. With my experience in treating personality disorders, I’m here to help you work through this challenging time while you find your balance within so that you can find your life worth living.

How Do I Know if I Have Borderline Personality Disorder?

You might be wondering if you might have borderline personality disorder. Or maybe someone in your life has told you that you need help from a therapist. People who experience borderline personality disorder, commonly known as BPD, typically describe their life and relationships like they are riding a roller coaster, with moods and relationships going up and down. They may notice that at any moment something might set them off into an intense wave of anger, fear, or depression. They might even feel like the people around them could be ready to abandon them at any moment. These intense feelings often bring people to the point of engaging high-risk behavior, self-harm (such as cutting or burning), or suicide attempts. BPD is a complex condition, so working with a qualified licensed professional will be the best way to determine if this diagnosis fits your symptoms.

Is There Hope For Me?

Many people who experience BPD and emotional instability feel like they have been burned to the point of despair. They may even have moments where they wonder if life is worth living at all anymore. While you may feel like your life is falling apart right now, there is still hope for the future! With the right treatment and some consistent work, you can set yourself not only to recover, but to find your passion and achieve your life worth living.

Treatments for Borderline Personality Disorder

In the therapy community, there are four mainline treatments for BPD: Dialectical Behavioral Therapy (DBT), Transference Focused Psychotherapy (TFP), Mentalization Based Therapy (MBT), and Schema Focused Therapy (SFT). Each of these has strong research backing involving years of both case studies and clinical trials. While all of these treatments have been established as effective in treatment for people with borderline personality disorder, they each have different focus and benefits. At my practice, I work through both DBT and TFP, both of which I will discuss below.

Dialectical Behavioral Therapy (DBT)

Most people who have heard about specialized treatments for this condition are familiar with Dialectical Behavioral Therapy (DBT), which is often considered the gold standard in treatment for people living with BPD given its long history and its close connection to the Cognitive Behavioral Therapies (CBT) many Americans are familiar with. A comprehensive DBT program consists of twice weekly treatment involving individual therapy and group skills practice for the client; brief, as-needed phone coaching for the client during the week to support in skills application; and a consultation group for the therapists providing services for the client to ensure that the therapist is adhering to DBT effectively. Many therapists also provide variations of this model, considered DBT-informed work. They may also work individually with the client while collaborating with outside colleagues who offer skills classes that their clients can attend. The skills component is considered a core part of DBT because research has shown that practice in specific mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills has demonstrated significant improvement in symptoms of clients who are struggling with impulsive, self harming, or suicidal behavior. In most cases, standard comprehensive DBT lasts between 6 months and 1 year, depending on severity, and once a client has finished with the program, their relationship with the DBT therapist typically ends, regardless of whether the client decides to continue with therapy for other issues.

Transference-Focused Psychotherapy (TFP)

Another well-known treatment for people living with BPD is Transference-Focused Psychotherapy (TFP). Much in the way that Dialectical Behavioral Therapy is a close relative to CBT, Transference-Focused Psychotherapy would be considered a relative to psychoanalysis, and it is considered an evidence-based psychodynamic psychotherapy. The structure of treatment in TFP also involves treatment twice per week in individual therapy sessions. Unlike with DBT’s focus on developing supportive skills, in TFP the therapist takes a more hands-off approach in some respects and assumes that the client has the capacity to develop their own skills and reasoning over time. After completing a comprehensive evaluation of the client’s personality to explore the different areas of deficit and their severity, the therapist and client work together on a verbal treatment contract to mitigate any potentially dangerous, self-destructive, or chronically maladaptive behavior. During the treatment, the client and therapist explore different issues that emerge with an emphasis on exploring issues that emerge between the client and therapist. Over time, the client works on their own ability to reflect on issues affecting their emotional stability and challenges navigating relationships, with the emphasis on developing more nuanced and less black-and-white or all good vs. all bad thinking that frequently emerges in BPD and other personality disorders. Given its focus on not just changing surface-level symptoms but also on changing long-standing internal personality structure and dynamics, TFP is an intensive therapy that typically lasts between one and three years.

Which Therapy Treatment Should I Seek?

Choosing therapy treatment is a lot like choosing which diet to follow. There are a lot of effective ones out there, but each person may respond differently depending on their own unique traits. If you think you might have BPD, the most important part is to consult with a qualified professional with an expertise in personality disorders. At my practice, I don’t choose a one-size-fits-all approach, and I tailor my treatment to each of my client’s needs. When you come in for treatment, I work together with you and tailor the treatment based on your current needs, challenges, and your unique history.

The Intake Process for BPD and Other Personality Disorders

Given the uniqueness of each client and the complexity of personality disorders, my intake process for clients with BPD and other personality disorders is not a quick one-session assessment. We will usually spend several meetings together both conducting a thorough personality interview, discussing my recommendations, and then exploring the frame of treatment. This may be unfamiliar to many people who have come into therapy for an intake and started the “therapy” at their second session. 

However, there is a reason that people with personality disorders such as borderline and narcissistic personality disorders spend years going through numerous therapists and multiple often conflicting or confusing diagnoses. Our current medical insurance model is based on getting people in and out of treatment as quickly as possible to save a few quick dollars. This might seem cost-effective in the short term. In the long term, it leads to repeated cycles of short-term or even long-term treatment where the client’s symptoms are temporarily reduced, or where they leave treatment early feeling frustrated and misunderstood.

When we complete and review our assessment, you will leave having a clear understanding of your diagnosis, what my rationale was, and the likely prognosis based on your severity. Thus, even if you decide not to continue therapy with me, you will at least leave knowing a little more about yourself and what the best recommended treatment is based on your needs.

Get Help Today

If you are ready to end your suffering and find your life worth living, I invite you to contact me today for a free 15-minute consultation.