Linehan’s Biosocial Model and Borderline Personality Disorders

Linehan’s biosocial theory of borderline personality disorder (BPD) (Diagnosis and treatment of mental disorders: cognitive-behavioral treatment of borderline personality disorder, Guilford Press, 1993) is among the most thoroughly delineated etiological models of borderline pathology, and it is a marked theory to elucidate the pathway of developing BPD. Linehan (Diagnosis and treatment of mental disorders: cognitive-behavioral treatment of borderline personality disorder, Guilford Press, 1993) suggests that the fundamental predilection of BPD is a pervasive difficulty in the regulation of one’s emotions. In other words, she posited that BPD individuals have a biological preparedness toward emotional dysregulation. A biosocial model posited that individuals with BPD have a biologically inherent predisposition toward emotional dysregulation. In other words, emotion dysregulation is considered an essential vulnerability that leads directly to the development and maintenance of BPD and other related cognitive, behavioral, interpersonal, and identity difficulties and dysregulations. The core assumption of the biosocial theory is a transaction between emotional vulnerability and an invalidated environment. According to this theory, the severe difficulties in the emotion regulatory system, which lead to emotional dysregulation, is a consequence of the interaction between innate biological vulnerability in the system of emotional regulation and an erratic environment, which is labeled as an invalidated environment. Dialectical behavior therapy has been developed by Marsha Linehan (Diagnosis and treatment of mental disorders: cognitive-behavioral treatment of borderline personality disorder, Guilford Press, 1993), which is considered a psychotherapy approach for chronically suicidal individuals. DBT is a multicomponent and integrative psychotherapeutic approach that synthesizes principles of Zen practice, behavioral theory, and dialectics. Theoretically, DBT has roots in the biosocial theory which considers BPD as a disorder of the emotion regulation system that contributes to the activation of a behavioral pattern of instability as a coping mechanism. DBT helps these clients to find a way to establish lives that are worth living. DBT concentrates on (1) the balancing between acceptance and validation of behavior as it is in the moment; (2) treating therapy interfering behaviors; (3) the therapeutic relationship as a crucial element of psychotherapy, especially in working with suicidal patients; and (4) dialectical processes.