Therapy for Borderline Personality Disorder in Seattle
Borderline personality disorder is one of the most misunderstood diagnoses in mental health. Many folks who come to me have heard it used as a warning, a criticism, or a reason to be turned away. Others have never been formally diagnosed, because many clinicians here are reluctant to use the label, but they've read about BPD and recognised something of themselves in it. Wherever you're starting from, you're welcome here.
What it can feel like
It might be that your emotions arrive quickly and with great force, and take a long time to settle. It might be that the people you're closest to are also the ones who can hurt you most, and that the fear of being left shapes more of your life than you'd like. You might have a shifting or uncertain sense of who you are, or find yourself doing things in moments of intense feeling that you later struggle to understand.
These experiences sit on a spectrum. For some people they show up mainly in close relationships or at times of stress; for others they shape much of daily life. You don't need to recognise yourself in all of it for therapy to help.
How I work with BPD
I have specialist training in Mentalization-Based Treatment (MBT) through the Gunderson Personality Disorders Institute at McLean Hospital. MBT was developed specifically for BPD. In plain terms, it helps you make sense of what's happening in your own mind and in other people's, especially in the moments when feelings run high and that becomes hardest to do.
My work also draws on psychodynamic therapy, which pays attention to how early experiences continue to shape relationships now, including the relationship between us. For many people with BPD, the therapy relationship becomes a place where familiar patterns show up and can be understood as they happen, rather than only talked about afterwards.
This is not quick work, and it won't always feel comfortable. I will invite you to slow down, to stay curious about what's happening inside you and between us, and to go at a pace that suits you.
A note on anger
It's really important to tell the difference between "gah, I'm at the edge" and shouting to scare or intimidate someone. One is a natural expression of life. The other is abusive. Anger isn't the problem. It usually means something matters, and what counts is what we do with it, and how we repair things afterwards.
For some folks, anger feels really dangerous. If you grew up with, or currently live with, anger that's scary or out of control, you might have learned to shove yours down so far you barely notice it, until it bursts out, or turns inward as shame or exhaustion. You might worry that if you let yourself get angry, you'll turn into the person who frightened you. In therapy, we can get to know your anger slowly and safely: what it's trying to tell you, and how to let it out in a way that feels like you.
As a therapist, I'm not afraid of anger. If you ever find yourself angry with me, it's welcome here. Being able to bring your hardest feelings into the room, whatever they turn out to be, is often a sign of trust, and I'm not going to abandon you for them.
There is reason for hope
BPD has a reputation for being hard to treat, but the research tells a more hopeful story. Long-term studies, including work from McLean Hospital, have found that many people with a BPD diagnosis improve substantially over time, particularly with specialised treatment.
Questions people often ask
Do I need a diagnosis to work with you?
No. Many of the people I work with have never been diagnosed, and some have been diagnosed and don't agree with it. What matters is what you're experiencing, not the label.
How is this different from DBT?
DBT (Dialectical Behavior Therapy) is a well-researched, skills-based approach, often offered in groups. My work is individual and relational, and focuses on understanding the patterns underneath. Some people come to me before trying DBT, some alongside it, and some afterwards. We can talk together about what might suit you best.
How long does therapy for BPD take?
It varies, but this is usually longer-term work, often a year or more. We'll review how things are going together along the way.
Do I need to live in Seattle?
No. All sessions are via telehealth, so I can work with adults anywhere in Washington State, from Seattle and Shoreline to Spokane.
What if I'm in crisis?
I'm not a crisis service. If you're in crisis, please call or text 988, or call 911. If you need more support than weekly sessions, we can talk about meeting twice a week.
Getting started
I offer a free half-hour consultation as a chance to talk about what has brought you to therapy and whether we might be a good fit.
Contact Me
mykelziolo@pm.me
(425) 842-1580