Complications of psychotherapy for borderline personality disorder: A clinical perspective

Objective: Psychotherapy is the mainstay of treatment for Borderline Personality Disorder. There are unique benefits for patients through psychotherapy, however there are also complications that are under-recognised and have not been neatly summarised for clinicians and trainees. We present a clinical perspective on the potential complications that may arise from treatment.

Conclusions: Addressing complications is an essential part of high quality and ethical clinical practice. Potential complications of psychotherapy for Borderline Personality Disorder include: escalation of Non-Suicidal Self-Injury (NSSI) and suicidal behaviours, dependency, boundary violations, demoralisation, re-traumatisation, labelling, opportunity cost, and financial issues. Recognition and management of these complications may improve treatment and recovery for patients, and is essential to high quality psychotherapy training and peer review. Further research is needed on the broader challenges and complications associated with non-psychotherapeutic aspects of BPD management.