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Occupational Therapy and Borderline Personality Disorder

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Living with Borderline Personality Disorder (BPD) can be a challenging experience, impacting many areas of a person’s life. As an occupational therapist who has also been diagnosed with BPD, I have seen the power of occupational therapy interventions in helping individuals with BPD manage their symptoms, improve their quality of life, and work towards their goals.

Occupational therapy is a holistic approach to health care that aims to support individuals in participating in their valued daily activities, or occupations. This can include self-care, leisure, and productivity activities such as work, school, or volunteering. Occupational therapists work collaboratively with clients to identify areas of difficulty in these areas and develop strategies to make them easier and more fulfilling.

When working with clients with BPD, occupational therapists take a trauma-informed approach, recognizing that many individuals with BPD have experienced significant trauma in their lives. This means creating a safe and supportive environment for clients to explore their experiences and work towards their goals.

One of the main focuses of occupational therapy is to look at the environments in which people live, work, and play, and how these environments either act to prevent or encourage participation in daily activities. For individuals with BPD, this can mean looking at how the environment triggers symptoms such as anxiety, depression, or emotional dysregulation and working together to modify aspects of the environment to support engagement in valued activities.

In addition, occupational therapists can work with clients with BPD to develop coping strategies for symptoms such as fatigue, headaches, sensory sensitivities, and self-injurious behaviors. Strategies such as learning how to conserve energy, reduce pain, release emotional pain through activities, and accepting a diagnosis can help with getting back into normal daily life such as cooking, having a shower, engaging in leisure interests, and finding employment. These strategies can also help build a sense of hope and purpose in life and see oneself beyond the diagnosis.

As occupational therapists, we must harness this creativity to empower clients to create a new narrative of hope and recovery.

Occupational therapists can also run group therapy workshops that focus on managing stress, acceptance, and commitment therapy, and creative activities such as cooking classes and the arts to help build self-esteem and explore self-identity. Additionally, they can work with clients to explore their sensory needs and sensitivities to reduce feeling overwhelmed in different environments, empower them to build and maintain their daily routines, and encourage the use of occupations to release and manage difficult emotions.

An important focus of occupational therapy is helping our clients to see and reach their potential. This means working from a strengths-based approach. Many of the clients I work with have an incredible ability to live through enduring hardships and trauma. Often people with BPD and complex trauma have found creative ways to release emotional pain and express their needs. This creativity can be seen in creative ways of dressing, make-up, artwork, music, cooking, redecorating, starting new hobbies and projects or creatively finding ways to live through difficult situations.

Occupational therapy is a powerful tool for individuals living with BPD to manage symptoms, improve their quality of life, and work towards their goals. By taking a trauma-informed approach, occupational therapists can work collaboratively with clients to identify areas of difficulty and develop strategies to make them easier and more fulfilling. With the right support and strategies, individuals with BPD can live fulfilling lives and achieve their goals.

Learn More through our BPD and OT Training Webinar or join our FREE Networking Group BPD and Complex Trauma

Looking for support for living with BPD or wanting training on working with BPD? Please reach out to Laura at

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