If you've been given a personality disorder diagnosis, there's a good chance your experience of mental health services hasn't been great. People with personality disorders, particularly Borderline Personality Disorder, are often treated badly by the very system that's supposed to help them. Dismissed as "difficult." Told they can't be treated. Turned away from services. I've seen it happen and it makes me angry.
Let me be clear: personality disorders are treatable. The evidence is solid. Recovery is not only possible, it's common with the right approach. If you've been told otherwise, you were given bad information.
Understanding personality disorders
A personality disorder means that the ways you think about yourself, relate to others, and manage your emotions have developed in patterns that cause significant distress. These patterns usually start early in life, often in response to difficult childhood experiences, and they become deeply ingrained over time.
The diagnosis itself can feel loaded. "Personality disorder" sounds like there's something fundamentally wrong with who you are. There isn't. What's happened is that you developed coping strategies to survive difficult circumstances, and those strategies, which made perfect sense at the time, are now causing problems in your adult life.
BPD and EUPD
The majority of my personality disorder work is with Borderline Personality Disorder, also known as Emotionally Unstable Personality Disorder. It's the personality disorder I see most and the one I have the most experience treating.
BPD can involve:
- Intense, unstable emotions that shift rapidly
- A deep fear of abandonment that drives frantic efforts to avoid it
- Unstable relationships that swing between idealisation and devaluation
- Chronic feelings of emptiness
- An unstable sense of identity, not knowing who you are
- Impulsive behaviour including spending, substance use, risky sex, or binge eating
- Self-harm or suicidal thoughts
- Dissociation or paranoid thinking under stress
- Intense anger that's hard to control
You don't need all of these to have BPD. Five out of nine is the diagnostic threshold. But diagnosis matters less to me than understanding what's actually going on for you and working out how to change it.
Schema-focused CBT
For personality disorders, standard CBT on its own often isn't enough. The patterns are deeper and more entrenched than a typical anxiety or mood problem. That's where schema work comes in.
Schemas are deep-rooted beliefs about yourself and the world that formed early in life. Things like "I'm defective," "people will always leave me," "my needs don't matter," or "the world is dangerous." These beliefs feel like absolute truths. They're not. They're conclusions a child drew from their experiences, and they've been running the show ever since.
Schema-focused CBT identifies these core beliefs, traces where they came from, and helps you develop healthier alternatives. It's deeper work than standard CBT. It takes longer. But it addresses the root of the problem rather than just managing symptoms.
We'll also work on practical skills: emotional regulation, distress tolerance, interpersonal effectiveness. These aren't abstract concepts. They're concrete techniques you can use in real situations when things feel overwhelming.
Reducing the stigma
I need to address this directly. People with personality disorder diagnoses face appalling stigma, not just from the public but from healthcare professionals. Being labelled "borderline" in some services is effectively a mark against your name. It shouldn't be, but it is.
In my clinic, your diagnosis is a starting point for understanding, not a label that defines you. I've worked with people who were terrified of telling me their diagnosis because of how they'd been treated before. That experience won't be repeated here.
You are not your diagnosis. You are a person who has developed certain patterns in response to certain experiences. Those patterns can change. I've seen it happen many times over 13 years.
What therapy looks like
This is longer-term work. For BPD/EUPD, expect a minimum of 20 to 30 sessions. Some people benefit from more. I'll be straightforward about the commitment involved from the start.
Early sessions focus on understanding your patterns, building a strong therapeutic relationship, and developing emotional regulation skills. We then move into deeper schema work, identifying and challenging the core beliefs that drive your difficulties. Later sessions focus on consolidating change and planning for the future.
The therapeutic relationship matters more in this work than almost any other area. I know trust doesn't come easily when your history has taught you that people let you down. I won't promise to be perfect. But I will be consistent, honest, and committed to the work.
Pricing and next steps
Sessions cost £60 for 50 to 60 minutes. I offer concessions for military veterans, serving personnel, and blue light workers.
If you've been struggling with emotional instability, relationship difficulties, or a sense that something is fundamentally wrong, get in touch. Book a free 15-minute consultation or call me on 07469 870 295.
You might also find it helpful to read about my general CBT approach or how I work with related areas like trauma, self-esteem, and addiction.
