The Riggs Blog

Treatment for Borderline Personality Disorder at the Austen Riggs Center

by Nicholas Holliday, MD, Director of Psychopharmacology and Medical Services

Nicholas Holliday, MD, assumes the role of Director of Psychopharmacology and Medical Services at the Austen Riggs Center. The Austen Riggs Center offers a unique, comprehensive, and integrated program for the treatment of borderline personality disorder. Recognizing that the instability of emotions and sense of self characteristic of the disorder is generally the product of early developmental disruption, inconsistent relationships, and trauma, rather than a simple imbalance of neurochemistry, our treatment approach is built around relationships and engagement in the life of our vibrant therapeutic community

At the heart of our treatment, psychotherapy four times per week with a doctoral-level clinician allows for the development of a trusting relationship.  The patient continues with the same therapist throughout treatment, providing a secure space for self-reflection, discovering meaning, and developing capacities to put feelings into words, contain impulsivity, and self-soothe. This process, at times quite challenging, over time promotes identity consolidation and addresses the developmental disruption, inconsistency, abandonment, neglect, and betrayal so prevalent in the early lives of individuals with borderline personality disorder. Our treatment seeks to forge a life narrative to contextualize and explain the individual’s difficulties; this understanding helps decrease the burden of shame and self-hatred so common in those with borderline personality disorder. 

In addition to the individual therapy, engagement in family therapy deepens the work and understanding and seeks to address entrenched family dynamics.In addition to the individual therapy, engagement in family therapy deepens the work and understanding and seeks to address entrenched family dynamics which have often kept the individual (unwittingly) locked in the role of “patient.” A psychopharmacologist, a social worker, nurses, and other staff provide additional elements of the treatment (such as medication), as well as regular opportunities for engagement. Concurrently, a rich provision of groups helps individuals find their way out of isolation and learn about mutuality and their impact upon others. 

The Therapeutic Community Program further enhances this learning and provides rich experiences of citizenship and leadership. Patient government positions help an individual with borderline personality disorder find what has so often been silenced or gone unheard – their unique voice – and promotes the use of it in the service of self-expression, responsibility, and autonomy. In tandem, the Activities Program offers the opportunity to work in the role of student, fostering the creativity and self-direction necessary for a more fulfilling life.    

Read more about BPD and its treatment:

 

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