Therapy Changes Brains of People with Borderline Personality

Person going into MRI machineResearch has shown transference-focused psychotherapy (TFP) improves outcomes in people with borderline personality, but a small study suggests the treatment could actually change participants’ brains.

Borderline personality (BPD) is characterized by unstable interpersonal relationships, a chronic fear of abandonment, disturbances in identity, difficulty controlling emotions, and sometimes acts of self-harm.

People with BPD often alternate between idealizing and devaluing the people they love. They may also behave aggressively when facing fears of abandonment, and they sometimes struggle with impulsive behavior, such as compulsive shopping or substance abuse. Because BPD affects emotional control and personal relationships, it can significantly affect quality of life.

Psychotherapy to Change the Brain

Transference-focused psychotherapy uses the occurrence of transference in therapy to help people with BPD better manage their emotions and their relationships. Transference occurs when someone transfers feelings about one person to another. For example, a person in therapy might take anger toward a controlling parent out on a therapist. By helping people navigate these emotions and offering significant additional support outside of psychotherapy sessions, TFP has helped many people with BPD lead happier lives.

To better understand how TFP affects the brain, researchers recruited 10 women with BPD to participate in a year of TFP. Using functional magnetic resonance imaging (fMRI), a technique that indirectly measures brain activity by looking at blood flow and oxygenation in the brain, researchers tracked how the women’s brains changed in response to therapy.

The brain imaging tests showed increased activation in regions of the brain associated with cognitive control and decreased activation in regions of the brain associated with emotional reactivity. Previous research has shown that experience changes the brain. Researchers say this study shows psychotherapy can also change the brain.

The study was published in Psychiatry and Clinical Neurosciences.


  1. DSM-IV and DSM-5 criteria for the personality disorders [PDF]. (2012). American Psychiatric Association.
  2. Treatment associated with changes in brain activity in borderline personality disorder. (2015, December 11). Retrieved from
  3. Therapy linked to brain activity in personality disorder – The Times of India. (2015, December 14). Retrieved from

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  • Louis


    December 21st, 2015 at 2:44 PM

    I am guessing that this is being viewed as something positive?

  • Pete


    December 22nd, 2015 at 2:44 PM

    So there would be parts of people that I would love to change but I would also fear that the parts that I loved about them would change too. That could be a scary thing because I don’t know that what kind of change, how much and to what extent… how would you ever regulate that?

  • Wally


    December 25th, 2015 at 4:44 AM

    Isn’t this what one would want-
    increased cognition and less emotion?

  • Gayle


    December 26th, 2015 at 1:40 PM

    Whether there are changes like this or not you have to know that most families living with this are simply looking for some sort of solution that can help the family. If there are some changes, then look at it as something that is positive and could lead to much more happiness in their lives.

  • Dona


    December 28th, 2015 at 10:30 AM

    BPD sounds like it would be terrible
    I think that most would be actively searching for any answers that could help them

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