General psychiatry and psychotherapy with outpatient clinic

Borderline personality disorder is a psychiatric disorder that affects about 1.5% of the population. Most people with borderline personality disorder have problems dealing with their feelings, they suffer from a disorder of emotion regulation. Violent, often prolonged, unpleasant feelings determine their experience, their sense of self and their actions.

A main characteristic of borderline disorder is very sudden strong inner tension that cannot be clearly classified emotionally. The person is very tense, but often does not know whether he or she is angry or afraid, for example. In the context of a borderline disorder, impulsive and harmful behaviours often occur (e.g. suicide attempts, alcohol consumption, binge eating and uncontrollable anger). In 70-80% of cases, sufferers also use self-harm to reduce internal tension. Because the disorder can become chronic and because about 5-7% of those affected who are not in therapy take their own lives, psychotherapeutic treatment is definitely advisable!

In the treatment, both medical-biological and psychosocial factors of borderline personality disorder are taken into account. The most important goal of DBT is to help those affected to achieve their personal life goals. In order to be able to achieve important life goals, patients must first become more stable, i.e. they must learn to stop dangerous or very stressful behaviour patterns, to cope better with crises, and to perceive and regulate feelings more effectively. Further goals are set by the patients according to their personal life situation and their wishes for the future. Through treatment, they therefore not only learn new skills, but also become experts on their disorder and learn how to more consciously perceive and implement their own strengths and possibilities.

Requirements for participation in therapy

Before admission as an inpatient

If you are interested in being admitted to our clinic, first make an outpatient appointment at the Borderline Consultation.

Borderline consultation

In one or two preliminary outpatient consultations, we will clarify whether inpatient treatment is necessary and whether our offer is suitable for you. If this is the case, you will be placed on our waiting list, you will have to check in with us regularly in order to keep your place on the waiting list, you will have to take part in our preparatory information group and you will receive an offer of treatment as soon as a place is available for you.

The inpatient treatment is then divided into three stages:

• In the first stage (weeks 1-3), we determine the therapy agreements and goals with the patient. A treatment plan is developed together and the patient receives information about his or her disorder. The clarification of the motivation for therapy plays a central role.
• In the second stage (weeks 4-9), patients work on their treatment goals with our support.
• The third stage (weeks 10-12) includes various preparations for discharge.

DBT Individual Therapy
Individual therapy is defined as an intensive working relationship limited in time, in which the psychotherapist has a function as a coach, i.e. he or she should help the patient to use existing resources and the resources of the inpatient setting in such a way that the treatment goals are achieved. In individual therapy, one works, among other things, on formulating and accompanying the implementation of weekly and daily therapy goals, the analysis of harmful behaviours and the individual implementation of skills.

Telephone counselling
In the context of stress testing, e.g. overnight stays at home, the team is available by telephone if patients are in an acute crisis and need support.

Reference care discussions
In regular individual meetings, patients receive support according to the requirements of the current stage of therapy, e.g. problem solving and implementation of skills in current situations.

Morning round
In the morning round, daily goals are set and evaluated (How did it work?).

Mindfulness Group
Awareness or mindfulness has been at the center of the Japanese philosophy of Zen for centuries. Mindfulness plays a central role in DBT: we must first learn to be mindful of feeling in order to regulate that feeling. By practicing mindfulness, for example, we can learn to get distance from overwhelming feelings and distressing thoughts, and we can get a better sense of who we are.

Skill Training (Skills Training)
By "skills" we mean skills that have been shown to be helpful for borderline patients in the short term and also in the long term, and that are not harmful. Skills training is delivered as group therapy and is divided into five modules: Mindfulness, Stress Tolerance, Managing Emotions, Interpersonal Skills, and Self-Esteem.

Reference group
All borderline patients on the ward form the reference group. As a reference group, they meet without therapists to exchange experiences and clarify current issues that affect everyday life on the ward. Experienced persons support newly admitted patients in the task of analysing harmful behaviour with the help of specific protocols.

Basic group
Information group about the development and maintenance of borderline personality disorder. Biological, social, medical as well as psychological factors play a role. In addition, interactional phenomena within the reference group and organisational questions can be clarified here.

Body awareness, movement therapy, occupational therapy, music therapy and design
In these groups, patients are given the opportunity to shape and express feelings and thoughts through alternative and non-verbal strategies.

Therapeutic offers

In the development of DBT trauma therapy, proven methods of DBT were supplemented and further developed with trauma-specific methods. At the centre of the treatment is the confrontation with stressful memories. This has the goal of better coping with difficult feelings, reviewing negative assumptions about oneself and the world, and reducing avoidance strategies that perpetuate the disorder.

Requirements for participation in therapy

Before admission as an inpatient
If you are interested in being admitted to our hospital, first make an outpatient appointment with the trauma clinic.

Trauma consultation

In one or two preliminary outpatient consultations, we will clarify whether inpatient trauma-specific treatment is necessary and whether our services are suitable for you. In this case, you will be placed on our waiting list, you will have to check in with us regularly in order to keep your place on the waiting list, as well as participate in our preparatory information group, and you will receive an offer of treatment as soon as a place is available for you.

The inpatient treatment is divided into three stages:

• In the first three weeks of treatment (stage I), therapy agreements are established and knowledge about the disease is imparted. In addition, it is jointly analysed which symptoms hinder the implementation of trauma-confrontative elements. In a team presentation, the treatment plan drawn up jointly by the patient and the reference therapist is presented.
• In the second stage (weeks 4-10), you will learn skills to endure and regulate distressing feelings. Unfavorable evaluations about the trauma and its aftermath are challenged and changed. After the trauma-confrontational obstacles have been removed, a realistic reorientation is worked out in the protected re-experiencing of the stressful memories (confrontation).
• The third stage (weeks 11 and 12) focuses on various aspects of discharge preparation.