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(p. 95) Eating Disorders and Borderline Personality Disorder: Strategies for Managing Life-Threatening and Therapy-Interfering Behaviors 

(p. 95) Eating Disorders and Borderline Personality Disorder: Strategies for Managing Life-Threatening and Therapy-Interfering Behaviors
Chapter:
(p. 95) Eating Disorders and Borderline Personality Disorder: Strategies for Managing Life-Threatening and Therapy-Interfering Behaviors
Author(s):

Lucene Wisniewski

, and Leslie K. Anderson

DOI:
10.1093/med-psych/9780190630409.003.0006
Page of

date: 16 September 2019

Individuals with eating disorders (EDs) tend to have elevated rates of comorbid borderline personality disorder (BPD). A number of studies have found that individuals with both ED and BPD present with a more complicated clinical picture compared to individuals with ED alone, both in terms of eating pathology and in terms of more severe problems with depression, anxiety, impulse control, and affect dysregulation. Therapists are often faced with clinical dilemmas with regard to limiting therapy-interfering behaviors and attending to health-threatening or self-destructive behaviors without reinforcing them while ensuring that these behaviors do not supersede the therapeutic focus on ED symptoms, potentially reinforcing self-destructive behaviors. This chapter offers guidelines for responding to therapy-interfering behaviors in this population from the perspective of dialectical behavior therapy, with a case example to illustrate these principles.

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