CMA POST 10 Response

QUESTION:  Before you answer this week's discussion, please access the Symptom Media Film library and click on the DSM-TR-5 heading. Choose Personality Disorders and click, go to Borderline Personality Disorder Vol.1 and view.

Access the Symptom Media Library:  Film Library 

Next access the following article and review the information provided. Choose "read full text" option:

https://www.researchgate.net/publication/321685070_A_Case_Study_of_Dialectical_Behavior_Therapy_for_Borderline_Personality_Disorder

After reading the article, answer the following:

Clare is brought to the ER after slashing her wrist with a razor. She had previously been in the ER for drug overdose and has history of addictions. She can be sarcastic, belittling and aggressive to those who try to care for her. She has a history of difficulty with interpersonal relationships at her job. Clare is diagnosed with borderline personality disorder. First, identify the defense mechanisms Clare is using, and second, discuss the various dialectical behavioral activities that can be utilized with Clare. 

Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook). Reply to at least one classmate's initial discussion post by Friday at 11:59 PM ET.

STUDENT’S POST: In this particular Symptoms Media discussion, Claire presents with several hallmark characteristics of borderline personality disorder (BPD), including unstable relationships, self-harm behaviors, impulsivity, emotional dysregulation, a history of substance misuse, and hostility towards providers. Clients with BPD often utilize maladaptive coping methods or defense mechanisms to protect themselves from uncontrollable emotions and fear of rejection or abandonment. In Claire’s case, her primary defense mechanisms were projection, splitting, devaluation of providers, and acting out. Splitting was evident in her tendency to see others as good one moment and entirely bad the next, which contributes to her unstable relationships personally and professionally. Projection was seen when she displaced her own painful feelings, insecurities, and anger onto others. Acting out was evident in her use of self-injurious behaviors, including a prior drug overdose and wrist cutting; these methods were to express emotional distress rather than verbalize it. Devaluation was reflected in her belittling, cynical, and aggressive responses towards the clinician attempting to help her. These defense mechanisms temporarily reduce emotional discomfort but can also intensify relational conflicts and reinforce maladaptive behaviors in future situations (Prasad, 2026).

Dialectical Behavior Therapy (DBT) is considered the first-line and gold standard for individuals suffering from BPD and has shown great effectiveness in decreasing self-harm, suicidal behaviors, interpersonal dysfunction, and improving emotional stability. Rizvi and his colleagues' case study reflects DBT’s ability to help individuals correct maladaptive behaviors with healthier coping skills and emotional regulation techniques. DBT modules focus on four major skills training areas, with the foundation grounded in acceptance and change. These modules include mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

Mindfulness would benefit Clare by increasing her awareness of her feelings, behaviors, thoughts, and impulses without reacting impulsively. Studies have indicated that mindfulness techniques are associated with better emotional regulation as well as self-awareness and clarity amongst individuals diagnosed with BPD (Tawfik Hafez & El Salam Dewedar, 2026). Distress tolerance skills, such as distraction, crisis-survival techniques, and self-soothing, could provide an alternative to cutting during times of extreme emotional distress. Emotional regulation strategies could also assist Clare in recognizing her emotional triggers, thereby reducing emotional vulnerability and helping contain intense mood changes. Researchers have proposed that by improving emotional processing, patients can reduce self-contempt and promote healthier psychological functioning (Kramer et al., 2026). Finally, interpersonal effectiveness training would teach Clare assertiveness while communicating, boundary setting, and conflict-resolution skills, helping her direct personal and workplace relationships more efficiently.

DBT also promotes maintaining a strong patient-client alliance when addressing treatment-affecting behaviors. Enhancing therapist receptiveness and repairing partnerships has been proven to heighten treatment engagement amongst individuals suffering from BPD (Boritz et al., 2026). Furthermore, evidence suggests that DBT is more effective than psychopharmacological management with an SSRI alone in reducing suicidality among patients with BPD, accentuating its importance as a first-line treatment option in individuals with this disorder. Through routine participation in DBT, Clare can decrease self-harm behaviors, learn healthier coping skills, improve emotional stability, and develop more meaningful and stable relationships in her near future.

References

Boritz, T., Di Bartolomeo, A. A., Alter, U., & Cooper, M. B. (2026). Enhancing therapists'

recognition and responsiveness to alliance ruptures in treatments for borderline personality disorder: Protocol for a pilot randomized controlled trial. Counselling & Psychotherapy Research, 26(3), 1–13. https://doi.org/10.1002/capr.70215

DBT more efficacious than SSRIs in reducing suicidality in borderline personality disorder.

(2026). Brown University Psychopharmacology Update, 37(3), 3–4. https://doi.org/10.1002/pu.31417

Kramer, U., Grandjean, L., Beuchat, H., & Kolly, S. (2026). Undoing self-contempt in borderline

personality disorder: A controlled test of change in emotion processing in psychotherapy. Clinical Psychology & Psychotherapy, 33(5), 1–11. https://doi.org/10.1002/cpp.70335

Larivière, N., & Corbière, M. (2026). Validation of the Quality of Work Life Questionnaire in

individuals with borderline personality disorder. Scandinavian Journal of Occupational Therapy, 33(1), 1–8. https://doi.org/10.1007/s44474-026-00012-4

Matthews, E. L., Marceau, E. M., & Grenyer, B. F. S. (2026). Autobiographical memories as a

window into effect, identity, and relationship deficits in borderline personality disorder: A controlled investigation. British Journal of Clinical Psychology, 65(1), 160–179. https://doi.org/10.1111/bjc.70011