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Working With the Borderline Client

Dick Schwartz Demonstrates How to Minimize Reactivity and Connect

When a troubled, possibly borderline, client begins a first session feeling out of control, shifting erratically through different mood states, then periodically going numb, many therapists experience a sense of dread.

According to Dick Schwartz, originator of the Internal Family Systems model, working effectively with clients like these depends on your capacity to tolerate your own reactivity  and to bring a real open-hearted desire to work collaboratively with your client’s “parts.”

In this video role-play, Dick shows us how he introduces his “parts” approach to clients—including his most challenging—in the very first session.

This clip is taken from our Webcast Series Tough Customers: Treating Clients with Challenging Issues featuring Clifton Mitchell, Wendy Behary, Richard Schwartz, Janina Fisher, William Doherty, and John Norcross. For a short time only, we’re making this 6-session Webcast series available for only $97 as part of our Spring Webcast Special.






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4 Responses to Working With the Borderline Client

  1. The idea of presenting the problem to the client as a “part” of themselves is brilliant. As a therapist, I can see this helping on a number of levels. First, it is a concept that is easy to grasp. Second, it is more manageable to break it down into parts. Third, it seems less threatening and may allow the client to detach enough from the issue to truly evaluate it. Thanks for sharing.

  2. Theodore A. Hoppe says:

    These is not a new approach and it need not by limited to “personality disorder.” While therapist have always framed treatment in an individualistic paradigm we may need to reconsider whether a coherent personality isn’t the product of “teamwork” among the the multiple selves.

    Both Paul Bloom and Rita Carter have written about a multiplicity of self approach.
    An example of this that is easy to grasp, is one which Paul Bloom use in his article “First Person Plural” in “The Atlantic,” almost two years ago, the “dieter” and the cake “eater”.

    Any person on a diet will knows what it is to experience a fatigue in will power as the day wears on, it’s a lot easier to resist a doughnut in the morning than it is a desert in the evening. The operative approach is to “bind” the behavior of the cake eater by putting the “dieter” in control of buying the food. The result is the there are fewer treats for the ” cake eater” to binge on late at night.

    It’s easy to see how this applies to other “parts” of self. Think about Tiger Wood and Anthony Weiner. The real issue here is that the therapist usually has the “dieter” as the client and not the cake eater.

  3. Zea Eagle says:

    Family Therapist Virginia Satir’s universal mantra was, ‘peace within, peace between, peace among’. She helped people identify the different ‘parts’ in their families and within themselves, ‘sculpt’ their families or the different parts within, using actors and actresses to represent each part. One technique was to have a Parts Party where actors/actresses would boldly represent each part (coached by the client for accuracy) at a party representing what it may be like in the client’s mind. There would follow a chance for each actor/actress to share what it was like to play that role in the party (e.g. I felt ignored and frustrated, I felt deliciously powerful, etc.), and allow the client to reflect and debrief.

    I have used this idea most recently with a client suffering from severely debilitating anxiety. Viewing the internal ‘voices’ as a family of voices, we had some fun teasing out the identifiable parts on a white board, naming and describing them, and noticing which of the parts were allies, which were intimidating, which had the power, etc. We also noticed there was no mediator or chairperson between the parts, making it feel chaotic and out of control. It became clear to the client who was ‘holding the floor’ and who needed encouragement to ‘speak up’. She reflected on times in her past experience when this had happened and noted that there was less anxiety then.

    I have found that when I introduce the idea of parts, clients fear that I’m heading towards a diagnosis of schizophrenia or multiple personality disorder, so I am careful to clarify that we all have parts or different voices that feel more dominant at different times.

  4. Richard Schwartz’s work is a gift to the complex trauma survivor and those who care for and about them. We have integrated these techniques with gentle, in-the-moment Ericksonian utilization techniques and EMDR. For this role-play, it would be something like “The part of you who is talking right now is reaching out for help.” When the client says or does something that reveals a switch into feeling beyond help, we use EMDR to identify those quick negative thoughts, and re-affirm the part that wants to and IS getting better (reframing the in-the-moment corrective connection to the therapist). Used over and over, this way of relating deepens trust and attachment in a wonderful way. The client’s innate ability to notice healing parts seems to get unleashed and accelerates change dramatically.

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