Peter Fonagy – psychotherapy for emerging borderline personality disorder

ESCAP 2015 Madrid keynote speaker Peter Fonagy

Peter Fonagy: psychotherapy for emerging borderline personality disorder

TV interview, original KEYNOTE presentation and abstract by professor Peter Fonagy (University College London) on psychotherapy for emerging borderline personality disorder, held at the ESCAP 2015 Congress in Madrid, Sunday June 21st 2015 (S3).


Despite past controversies concerning the desirability of diagnosing borderline personality disorder (BPD) in adolescence, accumulating epidemiological and clinical data amply support the reality of the diagnosis. In addition, evidence is accumulating on the similarities and differences between the clinical features and pathogenesis of BPD in adolescents and in adults. The treatments of choice for adult BPD are psychological therapies. There is no reason to suppose that emerging BPD in adolescents should not be approached in the same way. In this presentation, the evidence base for manualized psychological therapies will be reviewed, with particular reference to Dialectical Behaviour Therapy, Cognitive Analytic Therapy and Mentalization-Based Treatment. Rather than considering the relative effectiveness of these treatment approaches, the presentation will focus on (1) the elements that are common to these approaches, in the hope of arriving at an integrated model of why treatments work, and (2) the importance of a therapeutic approach which reinforces the young person’s capacity to benefit from benign aspects of their social environment. Despite our relative ignorance about the mechanisms of change that psychological therapies promote, there is sufficient evidence of short-term benefit from psychological therapies to warrant a change of practice – pointing to early identification and diagnosis-specific intervention for emerging BPD.

View or download the original presentation by Peter Fonagy (pdf, 136 slides).