When people start treating the border personality disorder (BPD), the first conversation is often about what is going wrong. Therapists ask about emotional outbursts, impulsive decisions. self harmunstable relationships and other symptoms that prompted the client to seek treatment. These questions are important because they help us understand a person’s difficulties and determine how to keep them safe.
But once that assessment is complete, where should it be? therapy start?
Most evidence-based treatments aim to reduce symptoms naturally. It makes sense. After all, people seek treatment because they are suffering.
As a researcher and clinician specializing in BPD, I approach therapy by asking, “Who do you want to be?” A more powerful question than “Who do you want to stop being?”
Another starting point
BPD compass (2026) an evidence-based treatment For BPD, my colleagues and I have designed treatment to match the underlying personal processes that cause each person’s symptoms, without assuming that everyone needs the same intervention.
In clinical trials, participants showed significant improvements BPD symptoms, co-occurred symptoms such as depression and worryand personal characteristics save difficulties.
One feature that often surprises clinicians is that we begin treatment with a clarification of values before introducing any coping skills. These values are not more important than symptom reduction. Rather, values provide the goal of reducing symptoms. In other words, it encourages you to imagine the person you want to be.
Values identification is the process of clarifying the kind of person you want to be and the life you want to create. Instead of focusing on what you want to stop feeling or doing, it asks what you want to try. In therapy, this often means exploring the qualities you want to bring to different areas of your life.
“Who do you want to be?” big question. So we break it down into important areas of life. For example, what kind of partner do you want? What qualities do you hope your friends would use to describe you? What makes work feel meaningful? How do you see? spiritualitycommunity service or visible health in your life? There are no right or wrong answers. The goal is not to determine what you should value, but to determine what is important to you.
A more useful way to think about behavior
Starting with values also changes how we evaluate behavior in therapy. I do not believe that it is the therapist’s job to decide whether a behavior is inherently good or bad. Behaviors almost always make sense in context, especially when they develop as ways of coping with overwhelming emotions or difficult life experiences.
Instead of asking clients to stop behaviors that I believe are problematic, we ask, “Is this behavior moving you closer to or further away from the person you want to be?”
Take something as simple as not answering the phone. For one person, letting a call go to voicemail can be an act of avoidance that takes them away from the value of maintaining a close relationship. For someone else, silencing their phone during a family dinner may reflect the value of being completely with their children. The behavior looks the same, but its function and whether it matches the person’s values are different.
Values help build a sense of identity
One of the defining characteristics of BPD person discomfort Many people describe not knowing who they are or finding that their emotions change dramatically depending on the situation, the emotions they are experiencing, or the people around them.
Values are more stable. Unlike emotions, values do not necessarily change from one day to the next.
You may not always feel confident, but you can always appreciate courage. You may not always feel confident, but you can still appreciate closeness. You may not always be patient, but you can appreciate being a thoughtful, not reactive, parent.
Most people, with or without BPD, have never sat down and defined their values. This process is really powerful; most of my clients describe it as challenging, surprising and enlightening. Additionally, repeatedly acting on these values over time helps people develop a more consistent sense of self.
Values are worth the effort
Changing long-held personality patterns is hard work. It’s awkward to talk about after years of avoiding confrontation. Trusting someone after repeated disappointments is dangerous. Resisting impulsive urges can seem almost impossible right now.
If the goal is simply to stop doing something, it’s easy to lose it motivation when change becomes difficult.
Values give reason to continue. They remind us of this personality change It’s not about having “better” features. It’s about becoming more like the person we aspire to be. When healing begins with this vision, each difficult step has a purpose and each new skill becomes a tool to build the life you want.
