The Carlat Psychiatry Podcast

Crossing the Alphabet Divide: An Integrative Overview of BPD Treatments with Dr. Kenneth Levy

Nov 20, 2025
Dr. Kenneth Levy, a tenured clinical psychology professor specializing in borderline personality disorder (BPD) treatments, shares valuable insights on effective therapy approaches. He emphasizes the importance of integrating multiple evidence-based therapies, including DBT, MBT, and TFP. Levy discusses the shared core elements across these modalities and critiques the rigid treatment camps in mental health. He provides practical guidance for clinicians on when to adapt treatment and highlights key components like therapist compassion and self-reflection that drive success in therapy.
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INSIGHT

Core Clinical Features Of BPD

  • Borderline patients present with unstable identity, affective swings, and chaotic relationships with idealization and denigration.
  • These features often include suicidality and non-suicidal self-injury, requiring prioritized recognition of BPD.
INSIGHT

Differentiating CPTSD From BPD

  • Complex PTSD and BPD overlap symptomatically but differ in pattern and stability of self-concept and relationships.
  • CPTSD shows persistent negative self-view and withdrawal, whereas BPD shows vacillating identity and chaotic interpersonal swings.
ADVICE

Know The Five 'Big' BPD Treatments

  • Recognize five evidence-supported specialized treatments: DBT, MBT, TFP, schema therapy, and good psychiatric management.
  • Be aware these modalities differ in delivery but show similar overall effectiveness across patients.
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