Encyclopedia of Couple and Family Therapy

2019 Edition
| Editors: Jay L. Lebow, Anthony L. Chambers, Douglas C. Breunlin

Borderline Personality Disorder in Couple and Family Therapy

  • Alan E. FruzzettiEmail author
  • Alexandra King
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-49425-8_442


Borderline personality disorder (BPD) is a pernicious disorder in which the vast majority of people struggle with painful emotions and a consequent lack of self-control related to trying to escape from, or alleviate, those emotions, resulting in nearly 10% lifetime suicide rate and a self-harm rate upward of 80–90%. BPD is characterized by pervasive instability across multiple domains: affect/emotion, social and interpersonal functioning, identity/self-image, cognition/problem solving, and overt behavior control (Gunderson et al. 2018). However, although pervasive emotion dysregulationis at the core of BPD, transactions within the individual’s social and family context are essential for the development, maintenance, and remediation of problems related to severe and chronic emotion dysregulation. Emotion dysregulation occurs when a person is unable to accept or change different components of the emotion process and thus experiences enough distress, due to high negative...

This is a preview of subscription content, log in to check access.


  1. Edlund, S. M., Carlsson, M. L., Linton, S. J., Fruzzetti, A. E., & Tillfors, M. (2015). I see you’re in pain: The effects of partner validation on emotions in patients with chronic pain. Scandinavian Journal of Pain.  https://doi.org/10.1016/j.sjpain.2014.07.003.CrossRefPubMedGoogle Scholar
  2. Fruzzetti, A. E. (2018). DBT with parents, couples and families to augment stage 1 outcomes. In M. Swales (Ed.), Oxford handbook of dialectical behaviour therapy. London: Oxford University Press.Google Scholar
  3. Fruzzetti, A. E., & Iverson, K. M. (2006). Intervening with couples and families to treat emotion dysregulation and psychopathology. In D. K. Snyder, J. Simpson, & J. Hughes (Eds.), Emotion regulation in couples and families: Pathways to dysfunction and health (pp. 249–267). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  4. Fruzzetti, A. E., & Payne, L. G. (2015). Couple therapy and the treatment of borderline personality and related disorders. In A. Gurman, D. Snyder, & J. Lebow (Eds.), Clinical handbook of couple therapy (5th ed., pp. 606–634). New York: Guilford Press.Google Scholar
  5. Fruzzetti, A. E., & Payne, L. (in press). Assessment of couples, parents and families in dialectical behavior therapy. Cognitive and Behavioral Practice.Google Scholar
  6. Fruzzetti, A. E., & Worrall, J. M. (2010). Accurate expression and validation: A transactional model for understanding individual and relationship distress. In K. Sullivan & J. Davila (Eds.), Support processes in intimate relationships (pp. 121–150). New York: Oxford University Press.CrossRefGoogle Scholar
  7. Fruzzetti, A. E., Shenk, C., & Hoffman, P. D. (2005). Family interaction and the development of borderline personality disorder: A transactional model. Development and Psychopathology, 17, 1007–1030.CrossRefPubMedGoogle Scholar
  8. Fruzzetti, A. E., Crook, W., Erikson, K., Lee, J., & Worrall, J. M. (2008). Emotion regulation. In W. T. O’Donohue & J. E. Fisher (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (2nd ed., pp. 174–186). New York: Wiley.Google Scholar
  9. Fruzzetti, A. E., Gunderson, J. G., & Hoffman, P. D. (2014). Psychoeducation. In J. M. Oldham, A. Skodal, & D. Bender (Eds.), Textbook of personality disorders (2nd ed., pp. 303–320). Washington, DC: The American Psychiatric Publishing.Google Scholar
  10. Fruzzetti, A. E., Payne, L., Hoffman, P. D. (in press). Dialectical behavior therapy with families. In L. A. Dimeff, K. Koerner, & S. Rizvi (Eds.), Dialectical behavior therapy in clinical practice: Applications across disorders and settings (2nd ed.). New York.Google Scholar
  11. Greenberg, L. S., & Safron, J. D. (1989). Emotion in psychotherapy. American Psychologist, 44, 19–29.CrossRefPubMedGoogle Scholar
  12. Grove, & Crowell, S. (2017). Invalidating environments and the development of borderline personality disorder. In M. Swales (Ed.), Oxford handbook of dialectical behaviour therapy. London: Oxford University Press.Google Scholar
  13. Gunderson, J. G., Fruzzetti, A. E., Anruh, B., & Choi-Cain, L. (2018). Competing theories of borderline personality disorder. Journal of Personality Disorders, 32, 148–167.  https://doi.org/10.1521/pedi.2018.32.2.148.CrossRefPubMedGoogle Scholar
  14. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
  15. Linehan, M. M. (2014). DBT skills training manual. New York: The Guilford Press.Google Scholar
  16. Shenk, C., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30, 163–183.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PsychiatryMcLean Hospital/Harvard Medical SchoolBelmontUSA
  2. 2.University of Nevada – RenoRenoUSA

Section editors and affiliations

  • Farrah Hughes
    • 1
  • Allen Sabey
    • 2
  1. 1.Employee Assistance ProgramMcLeod HealthFlorenceUSA
  2. 2.The Family Institute at Northwestern UniversityEvanstonUSA