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Aurora Counseling Associates

In plain terms

Borderline Personality Disorder (BPD)

Borderline personality disorder (BPD) is a pattern of intense emotions, unstable relationships, a shifting sense of self, and impulsive reactions, often organized around a fear of abandonment. Feelings arrive fast and strong and are hard to bring back down. BPD responds well to therapy, particularly dialectical behavior therapy, which builds concrete skills for intense emotion.

What it feels like

People with BPD often describe feeling things more intensely and for longer than those around them, with less of a buffer between a trigger and a reaction. Relationships can swing between closeness and rupture, self-image can shift with the situation, and the fear that people will leave can drive the very reactions that strain a relationship. It is a pattern of pain, not a character flaw, and it makes sense given how the nervous system learned to protect itself.

How it is treated

The most established treatment is dialectical behavior therapy, which teaches skills for riding out intense emotion, tolerating distress without making it worse, and steadying relationships. Work on trauma and depression often runs alongside it, since they frequently travel together. Change is real and well-documented, and many people move out of a diagnosis over time.

This page is part of our therapy glossary.

Where we work with this

Related areas we work in

Questions

Common questions

Can BPD get better?
Yes. BPD has one of the better long-term outlooks in mental health. With skills-based therapy like DBT, many people see intense symptoms ease substantially, and a meaningful number no longer meet criteria for the diagnosis over time.
Is DBT the only option?
DBT has the most evidence, but it is not the only path. Approaches that work with early relational patterns can also help, and the right fit depends on the person. What matters most is a steady, skilled therapeutic relationship.
Is BPD the same as being manipulative?
No. That is a harmful myth. The behaviors that get labeled that way are usually desperate attempts to manage overwhelming feelings and a fear of being left, not calculated tactics.

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References and further reading

Dialectical behavior therapy is the most established approach for BPD, and we offer DBT in Natick. For more, see the National Institute of Mental Health and the American Psychological Association.