What Is Gestalt Therapy?

It’s normal for difficulties in the past to persist in the present. There is no reassurance that old problems won’t haunt you in the future if you don’t address them or find a solution. With the help of a certified counselor, gestalt therapy can be an incredibly beneficial resource for individuals in this situation.  Instead of focusing on the past or worrying about the future, gestalt techniques encourage change through interactive activities. As a unique approach to psychotherapy, gestalt techniques focus on increasing an individual’s self-direction, freedom, and awareness. The Gestalt method, which is supervised by clinicians, also encourages human growth by emphasizing needs, feelings, and wants.

When Is Gestalt Therapy Used?

Following its inception, Gestalt therapy has become a proven and effective therapeutic approach for addressing and treating various mental health issues. Gestalt therapy is known to benefit the following mental conditions:

    • Anxiety: If you have anxiety, you can learn to minimize catastrophic thinking styles by focusing on the present moment. This also enables people to identify any existing ideas, emotions, or behaviors that may be causing them to worry.

    • Depression: If you have depression, these exercises can teach you mindfulness practices to recognize stress-inducing triggers that worsen your symptoms.

    • Low self-esteem: If you struggle with low self-esteem, these sessions can help you to identify and overcome underlying factors contributing to your poor self-image such as intrusive thoughts and negative thinking patterns.

    • Relationship difficulties: You can benefit from identifying unhealthy patterns of behavior that may negatively impact your relationships. With gestalt techniques, you learn to focus on modifying your negative habits and changing your relationships for the better.

    • Self-awareness: Instead of talking about the past, you are encouraged to experience life in the present and to take responsibility for the management of your positive and negative thoughts, feelings, and behaviors.

Since the 1950s, gestalt therapists have employed experiential exercises that focus on awareness and understanding the present moment. Each session also encourages individuals to take responsibility for their actions and become more aware of how they interact with the world around them. As a result, this type of therapy helps you gain insight into your thought patterns, emotions, and behaviors so you can make changes to better manage your mental health. 

What to Expect in Gestalt Therapy

When you work with a Gestalt therapist, you can expect them to inquire about your current experiences in that present moment. During these sessions, you will also work with your therapist to explore your thoughts, feelings, beliefs, values, and behaviors in order to gain insight into how these things may be affecting your life. As you discuss your current situation, close attention will be focused on your experience and how you are feeling.

Gestalt therapy aims to increase the client’s awareness of their current experience. Although it may seem paradoxical, paying close attention to what you are going through may help you gain insight into harmful behaviors and change them. For this reason, your therapist will focus on your current situation in order to help you gain insight into why you behave the way you do. 

Similarly, your counselor may ask questions about your history to better understand why certain situations bring up certain emotions or reactions in you. Throughout your time in therapy, you will also participate in various exercises and activities that can help you gain a better understanding of yourself or your relationships with others. 

Gestalt Therapy Techniques in Treatment

Exercises and experiments are used to practice Gestalt therapy in individual and group settings. Gestalt often uses hands-on exercises to bring about actions, emotions, or goals. In fact, a key element of this therapy is experimentation. As a result, you can explore several techniques to better understand the elements that contribute to conflict in your life.

Gestalt techniques3 include:

    • Empathy/empathetic

    • “I” statements

    • Problem-solving

    • Artistic exercises

Knowing your therapist’s goal is to increase your awareness of the “here” and “now”, gestalt techniques often include mindfulness practices. Mindfulness techniques can help you focus on the present moment without getting distracted by worries over past or future situations. 

The Empty Chair

The empty chair technique is a popular role-playing exercise, allowing you to envision and take part in a conversation with another person or a metaphorical part of yourself. In this approach, you will sit in front of an empty chair while your therapist offers instructions on how to imagine a particular scenario. For example, your counselor may suggest picturing someone else (such as an angry or judgmental past self) seated in the chair. During this activity, you engage thoughts, emotions, and behaviors as the imaginary situation unfolds. In turn, these mental exercises can help you grow more aware of your surroundings and mindful of different aspects of yourself.


When using the exaggeration technique, your therapist may urge you to make an exaggerated motion or to repeat the same action throughout the session to give body language a voice. This might be especially useful if you need help putting what is taking place right then into words. Through these sessions, you can become more conscious of the emotions driving your behavior as well as the current sensations as a result.

How Gestalt Therapy Works

Gestalt therapy is a physical, mental, and emotional activity in which your therapist considers your body language in addition to hearing what you say and how your movements relate to your emotions. The gestalt method emphasizes developing a dialogue-based connection grounded in your personal experiences, being conscious of one’s own bodily and emotional feelings, and engaging in “here and now” or present moment exercises. Emotions must be expressed to be resolved.8

Gestalt therapy concentrates on the present because the past cannot be changed. Since the present is the only thing that can be actively changed, gestalt sessions attempt to bring previous issues into the present. This process takes place using gestalt exercises through client-therapist interactions.4

Gestalt Therapy Pros and Cons

It’s always a good idea to remember that therapy of any kind is better than no therapy, especially if you are dealing with a mental illness.

Pros of Gestalt Therapy

Gestalt therapy has been proven incredibly successful with more pros than cons. With that being said, each client enters treatment with their own unique experiences that will influence therapeutic needs.

Pros of gestalt therapy include:

    • A stronger sense of self-control

    • Enhanced capacity to control and keep track of thoughts and emotions

    • Heightened consciousness of emotional demands

    • Increased emotional intelligence

    • Increased awareness and improved communication skills

Cons of Gestalt Therapy

Cons of the gestalt method include:5

    • May take more time than other therapeutic methods

    • Present-focused techniques may not be appropriate for those with unresolved trauma who need to confront and heal from past experiences.

    • Therapists may use Gestalt exercises incorrectly if they lack a thorough comprehension of the theory and its applications.

How to Get Started

For several reasons, you might want to consider Gestalt therapy. For instance, this treatment can be beneficial for you if you have trouble controlling your emotions. Similarly, gestalt techniques may be helpful for keeping you in the present. This is especially true if you tend to reflect on past mistakes or worry about messing up in the future. These sessions do not follow specific guidelines, and depending on the situation, gestalt methods urge therapists to be creative in their methods.9

It is important that you are willing and ready to use these therapeutic approaches to reap the greatest benefits. Although the empty chair and exaggeration techniques may seem strange at first, try to have an open mind to your therapist’s instructions.

Reach Out

During treatment for substance abuse, gestalt therapy can be a highly effective method of change. The gestalt method is fundamentally about respecting the potential and unpredictability of ongoing interactions between people on a daily basis. Both sides evolve as a result of those interactions and together, they create new realities and experiences.

If you or a loved one is struggling with addiction, please call us today at 888-965-3085 to find the right level of care for your unique situation. Gestalt therapy is one of our evidence-based therapy offerings and it has assisted many of our clients during treatment for substance abuse and in recovery.

Gestalt Therapy FAQs

Gestalt therapy’s fundamentals have not altered over time. However, our understanding of “the self” and the most therapeutically effective techniques is constantly being explored and broadened through several theoretical and practical approaches.

Gestalt therapy addresses fundamental concerns in each individual since it is process oriented. Working with material that comes up in therapy can involve any element of the individual, including behavior, cognitions, beliefs, physical sensations, imagination, and dreams.

The Gestalt approach is about the therapeutic, which is certainly not only “therapy” in the traditional sense.6

Awareness is the key factor in the gestalt-based approach to therapy. Bringing a change and shift in client awareness levels is primary. Any further changes are their choices and responsibility.

In general, gestalt methods have two possible limitations: It exclusively concentrates on the present and demands a high level of personal development and knowledge from the therapist.

What Is CBT Therapy?

Cognitive behavioral therapy (CBT) is a type of behavioral therapy offered by Aliya Health Group’s treatment providers to help treat and manage mental health and substance use disorders.

CBT is often referred to as talk therapy. This is because the main portion of healing in CBT occurs during discussions with your therapist. The evidence-based practices found in cognitive behavioral therapy focus on altering unwanted behaviors by teaching you to identify and change unhealthy or inaccurate thoughts. 

According to the American Psychological Association (APA), the core principles of cognitive behavioral therapy include:

  1. False beliefs and unhealthy thought patterns are partially responsible for psychological distress.
  2. Unhealthy learned behaviors can negatively influence symptoms of mental health conditions.
  3. Problems with mental health can be minimized with healthy coping skills.

Together, the core principles of CBT are meant to help you understand how your thoughts, emotions, and behaviors can influence each other. 

How Does Cognitive Behavioral Therapy Work?

CBT is an incredibly beneficial therapy approach that instills healthier ways of thinking by teaching you to notice the negative patterns in your day-to-day thoughts. In general, cognitive behavioral therapy works by combining two therapeutic approaches—cognitive therapy and behavioral therapy.

Centered around the term cognitive, meaning “to recognize,” cognitive therapy helps you develop a clear understanding of your own thoughts, moods, and expectations. The goal of cognitive therapy is to identify your false beliefs and change them to reflect a more positive outlook. In doing so, this form of therapy aims to lessen the negative impact of stressful situations by minimizing the importance you attach to the issues in your life.

Behavioral therapy functions under the belief that human behavior is learned and can be unlearned or relearned. The focus of behavioral therapy is to find out if your behaviors intensify the problems in your life. After that, you and your therapist work together to change your problematic behavioral habits.

By integrating the practices found in cognitive and behavioral therapy, CBT provides an engaging environment to help you change your thoughts and behaviors for the better.

CBT’s therapy approach includes:

  • Identifying unwanted behaviors or issues
  • Analyzing unhealthy thought patterns and their impact on life
  • Challenging false beliefs and reframing mindset
  • Learning and practicing healthy alternative behaviors

You learn to engage in mindful strategies that introduce healthier, more realistic expectations. The techniques also help you cope with and decrease maladaptive thoughts and behaviors as you work through CBT therapy.

To promote a healthier internal monologue, CBT techniques help you implement healthy coping methods to handle negative emotions, stress, and low self-esteem.

CBT Techniques

CBT techniques highlight the relationship between thoughts, feelings, and behaviors. This can provide clarity and support logic-based responses to handle stressful situations. As you reframe your perspective and address unhealthy beliefs, you also learn healthier, alternative coping skills. In doing so, CBT techniques can help relieve your symptoms and allow you to become more effective in your life.

Core CBT techniques include:

  • Emotion Management: Addresses insecurities while treating anxiety and depression for a healthier state of mind.
  • Behavior Shifts: Replaces negative behaviors and reduces emotional reactions to everyday situations by introducing healthy coping skills.
  • Mental Maintenance: Applies cognition and reasoning to focus on the connection between emotions, behaviors, and the healing process.

As you practice CBT therapy techniques, you will begin to recognize false narratives within your thinking patterns that lead to irrational thoughts, overwhelming emotions, and unwanted behaviors.

CBT techniques to change unhealthy thinking patterns can include:

  • Identify your cognitive distortions (false beliefs) and then reevaluate them from a rational perspective with fact-based thinking
  • Gain a better understanding of the behaviors of others instead of taking their actions personally
  • Use healthy problem-solving skills so that you can cope with stressful situations
  • Develop a greater sense of confidence in your abilities

CBT techniques to change unhealthy behavior patterns can include:

  • Face your fears instead of avoiding anxiety-inducing situations
  • Participate in role-playing activities to prepare for stressful scenarios
  • Practice relaxation techniques to calm your mind and body

This form of behavioral therapy focuses on the “now” rather than the past, which develops goal-oriented thought patterns. So, instead of focusing on past wrongs or harboring resentments, CBT therapy teaches you how to move forward and succeed in recovery. Participating in CBT techniques during substance abuse treatment can also help you identify high-risk situations and triggers to prevent relapse. 

What Happens in CBT Therapy?

You and your therapist will analyze your thoughts, feelings, and behaviors to better understand how you perceive yourself and the world around you. In doing so, you are able to identify irrational and unhealthy thought patterns and determine how your beliefs affect your day-to-day life. As a result, your therapist will be able to help you figure out how to challenge unrealistic or unhelpful thoughts and encourage healthy behaviors.

CBT sessions for substance use can include:

  • Motivational intervention
  • Contingency management
  • Relapse prevention
  • Psychoeducation
  • Cognitive reframing
  • Skills training
  • Behavioral strategies

CBT is effective in both individual therapy and group therapy. For example, clients practice CBT techniques in group settings to work through unhealthy thought patterns with the help of others. Similarly, those with co-occurring disorders can participate in cognitive behavioral therapy to help work through emotions with their primary therapist.

CBT therapy can help you work through emotions including:

  • Fear 
  • Stress
  • Anger
  • Worry
  • Self-doubt
  • Low self-esteem
  • Guilt and loss

CBT coping skills allow you to engage in healthier ways of thinking by teaching you to notice the negative patterns in your day-to-day thoughts. You learn to engage in mindful strategies that introduce healthier, more realistic expectations as a result. 

Addiction treatment programs that utilize CBT for substance abuse help you instill healthy alternative reactions to triggers and cravings in the same way. In time, you learn to cope with and lessen destructive thoughts and behaviors, ultimately feeling more power over your life in recovery.

What Is CBT Used For?

Cognitive behavioral therapy is designed to help people identify, understand, and change dysfunctional behavior. CBT focuses on the “now” rather than the past. As a result, CBT can help you understand underlying core beliefs that feed self-doubt, anxiety, and anger. Integrating cognitive behavioral therapy as a psychological treatment can also be effective for a range of conditions. 

CBT assists in the treatment of:

  • Depression
  • Anxiety disorders
  • Panic disorder
  • Mood disorders
  • Eating disorders
  • Sexual disorders
  • Post-traumatic stress disorder (PTSD)
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Obsessive-compulsive disorder (OCD)
  • Phobias
  • Anger management
  • Family conflict
  • Chronic pain
  • Substance use disorders

Cognitive behavioral therapy has helped all different types of individuals and can also help you by identifying unhealthy thoughts and behaviors that feed addictive behaviors. There are many CBT strategies used in individual and group therapy during alcohol and drug rehab that can help you reframe your mind and recover from addiction. 

Cognitive Behavioral Therapy in Addiction Treatment

The goal of CBT during substance abuse treatment is to lessen the mental hold of addiction by building coping skills. For this reason, a key benefit of cognitive behavioral therapy in addiction treatment is that it teaches you how to identify high-risk situations and triggers. In substance abuse treatment, CBT therapists guide relapse prevention groups in developing ways to cope with those triggers and manage the effects of cravings.

Studies support CBT as an effective treatment for substance use disorders due to its successful outcomes in the following:

  • Thought analysis
  • Strategies to avoid triggers
  • Building problem-solving skills
  • Drug refusal
  • Coping skills

By understanding the impact cravings have on your moods and reactions, you also can practice mindfulness throughout your daily life and utilize CBT skills as a form of relapse prevention. As a result, you begin to build self-confidence and self-motivation as you continue to maintain your sobriety. 

Reach Out

If you or a loved one is struggling with addiction, please call us today at 888-965-3085 to find the right level of care for your unique situation. CBT is one of our evidence-based therapy offerings and it has helped many of our clients heal during treatment and in recovery.

How Does Hypnotherapy Work?

To achieve your goals in recovery from substance abuse, it’s essential you know about your treatment options.  Many people are aware of traditional treatments like individual and group therapy, but there are also several holistic techniques available like hypnotherapy. Whether you struggle with impulsivity or self-destructive behaviors, hypnotherapy sessions could be an effective option for you.

Does Hypnotherapy Work?

A lot of people disregard hypnotism as a pseudoscience (practices that claim to be scientific, but are not). As a result, you may associate the healing practice with things like palm reading and fortune telling. While mainstream portrayals of hypnotism often make it out to be a humorous side act, hypnotherapists know it is the main event.

In fact, the healing power of hypnotism speaks for itself. In treating various conditions, our hypnotherapists obtain quicker results that otherwise may have taken months or even years to unearth. While many find healing through traditional therapeutic interventions, hypnotherapy is a unique therapeutic approach to mental health counseling.  In certain cases, hypnotherapy has been known to provide faster results than evidence-based practices like psychotherapy and behavioral therapy.

This is not to say that traditional therapy practices are without merit — in fact when paired with regular group therapy sessions, you may be able to embrace hypnotherapeutic methods with even more success. Learning additional coping skills in group and individual therapy alongside hypnotherapy may help you discover a deeper understanding of the underlying factors that once fueled your substance misuse.

What Is Hypnotherapy?

Hypnotherapy is an alternative form of psychotherapy that offers relief from symptoms of anxiety, substance abuse, and other disorders. Working at a subconscious level, hypnotherapy uses the power of suggestion to change your behavior, thoughts, or feelings. 

In order to be effective, hypnotherapy requires a trained therapist who uses repetition, visualization, and imagery techniques. These hypnotic techniques aim to relax you into a state where you’re more open to suggestions. In fact, hypnotherapy can be a powerful tool that eases the process of healing and creates lasting change. Hypnotherapy helps you to:

  • Uncover negative patterns and beliefs
  • Untangle false narratives
  • Resolve trauma
  • Restore inner peace 

Through the use of relaxation techniques, guided hypnosis lulls you into a tranquil state of intense concentration. This hypnotic state helps you to achieve a heightened state of mindfulness.

Hypnosis is a psychological therapy process that’s often misunderstood. As a result, it is not widely used in the treatment of substance use disorders. In spite of this, medical research continues to support hypnosis as an incredibly beneficial therapy tool.

What to Expect During a Hypnotherapy Session

During hypnotherapy, certified master hypnotists help you use your mind in new, unconventional ways to heal from challenges like trauma. Certified master hypnotists aim to strengthen your resolve in recovery by harnessing the entirety of your mind’s power. They do so by accessing your subconscious through a process known as hypnosis.

While using hypnosis techniques, hypnotists guide you into a state of relaxation that is free from negative emotions. As you’re in this hypnotic state, your therapist works with you to replace behaviors that are no longer serving you.

The five steps of hypnotherapy include:

  1. Explanation: Identify and review your problem behavior
  2. Creation: Develop a plan to redirect energy during the sessions
  3. Induction: Encourage a receptive mindset with calming techniques
  4. Suggestion: Introduce the strategy for change through suggestions
  5. Evaluation: Follow up to review the positive shifts in behavior

During hypnosis, the hypnotist will often give suggestions that can help you address the issue at hand. For example, a hypnotherapist may suggest visualizing yourself in a different situation that is more positive or relaxing.

Used to treat symptoms of anxiety, phobias, and substance abuse, hypnotherapy is a helpful therapeutic tool. The altered state of increased relaxation helps to keep you focused and open to the power of suggestion. As a result, you can examine unhealthy beliefs and behaviors without fear. Introducing therapeutic suggestions that encourage positive behavioral change within your subconscious mind is a key part of hypnotherapy’s benefits.

Is Hypnosis the Same Thing as Hypnotherapy?

Hypnotherapy is the practice of hypnosis within the parameters of a therapeutic treatment. This means that hypnosis is the tool and hypnotherapy is the healing application of that tool. Another way to look at it: hypnosis is to hypnotherapy as horses are to equine therapy.

Simply put, hypnosis is a state of relaxation and concentration in which the hypnotherapist can access the subconscious mind. The therapist then gives suggestions that are intended to help you overcome your condition. 

Without the guidance of a qualified hypnotherapist, hypnosis is whatever the person providing the service wants it to be. This is why it’s important to experience hypnosis in a professional, therapeutic setting with licensed hypnotists.

What Does Hypnotism Feel Like?

During a guided hypnosis session, the certified hypnotist or hypnotherapist guides you into a deep state of relaxation. Most commonly regarded as a trance-like state, our clients often describe this experience as if they are in a daze, or being gently soothed into a calming daydream, unburdened and light.

While in this state of calm, you may feel as though you drifting off to sleep, yet you remain fully aware of your surroundings.

How Does Hypnosis Work?

The process begins as a certified hypnotherapist guides you into a state of intense concentration.  The therapist helps you achieve this state through repeated verbal cues. By entering an altered mental state of heightened relaxation and concentration, you can focus on accepting the therapeutic suggestions of a certified hypnotist.

As you settle into tranquility, hypnotherapists introduce suggestions designed to promote introspection and reflection as a means of accomplishing the chosen goal for the therapy session. The course of the session and the content of the verbal cues are dependent on the hypnotherapist and your goals, both for the session and the long term. Sessions can focus on anything from phobias to recalling events. Once the session has come to an end, the therapist will “wake” you from your trance-like state, or you may exit the state yourself.

Why Does Hypnosis Work?

The hypnotic state induced during hypnotherapy is meant to both relax the mind and heighten focus. As a result, you are able to contemplate the guided suggestions without experiencing the instinctual reflex to reject or avoid potentially painful topics. This is because the subconscious mindset helps to put a barrier between you and the painful memory or topic. This allows you to acknowledge the details surrounding the pain without consciously re-experiencing the traumatic event(s).

Hypnotherapy’s mind-body intervention eases you into a mental state of increased suggestibility, offering the therapist a clean slate to work with as they introduce healthier, alternative behaviors in replacement of your unwanted behaviors that were discussed earlier in the sessions.

In essence, the mindset induced during a session of guided hypnosis frees you from experiencing any negative reactions to the suggestions during the therapy session. 

What Does Hypnotherapy Treat?

Hypnotherapy’s focus on relaxation can be an incredibly helpful tool for those struggling with conditions like addictive behaviors, anxiety, and trauma. Our certified master hypnotists aim to help you progress in recovery by harnessing the entirety of the power of your mind. As a very effective method for accessing subconscious thoughts, hypnosis helps you remove unhealthy behaviors without triggering any feelings of stress, fear, or self-doubt.

As a treatment geared toward identifying and replacing maladaptive behaviors, guided hypnosis can help if you suffer from mental blocks. Hypnotherapy is a great tool that helps you remove unhealthy beliefs that impede your ability to acknowledge the need for change and introduce new, positive behaviors into your daily life. 

Hypnotherapy assists in the treatment of:

  • Anxiety disorders
  • Phobias
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorder (SUD)
  • Codependency and relationship issues
  • Grief and loss
  • Sleep disorders
  • Chronic pain

Hypnotherapy can assist you in your recovery from both physical and mental conditions. It can also help you implement healthier alternatives to replace unwanted behaviors like drug and alcohol use. 

How Can Hypnosis Help People With Addiction?

Many who want to end their addiction make several attempts to recover but have a difficult time staying sober. Trying a variety of therapy techniques in treatment without seeing lasting success can be incredibly discouraging and may lead to feelings of hopelessness. 

Hypnotherapy can increase your chance of success by addressing some of the contributing factors to dependence including low self-esteem and emotional trauma. It can also help resolve conflicts between conscious and subconscious motivations.

During a clinical study focused on hypnotic states, Harvard researchers determined that hypnosis elevates two key areas within the brain that control and process the internal workings of the body. Similarly, the area of the brain that controls your actions and your awareness of your actions also shuts down or slows significantly during sessions of hypnosis.

The study also found that the effects of a hypnotic state include: 

  • A dissociated control state
  • Increased positive feelings
  • Decreased negative feelings
  • Improved visual imagery
  • Heightened attention

Simply put, key portions of the brain — areas that affect our levels of awareness and control — are noticeably altered during hypnosis. For this reason, hypnotherapy is an extremely beneficial form of treatment for those suffering from mental health and substance use disorders when administered in a safe and secure environment.

Recovering From Trauma in Hypnotherapy

Unfortunately, a person’s past experiences — especially after receiving judgment and blame — can result in the development of defensive mechanisms such as increased anger and volatility when confronted with evidence of their poor behavior. Others may shut down and withdraw from the thought of change following years of shame and rejection from loved ones. 

Normally, once you associate the concept of change with negative interactions from the past, your initial gut reaction to therapeutic healing methods can trigger confrontational responses that will often impede your progress.

It is important to understand that feelings and memories related to trauma can “hide” in your unconscious memory. On a conscious level, you may not realize the impact of the trauma you experienced. In fact, you may not remember the traumatic event at all. During these sessions, you will gain the ability to ruminate over questions that you otherwise might have brushed off, ignored, or reacted defensively against, were you in your default mindset. 

Hypnotherapy provides a space for you to separate yourself from the walls you have built throughout the years. It is within the space between your walls of defense that your hypnotherapist works, guiding you toward healthier emotional outlets, and motivating you to accept change with open minds, hearts, and arms. 

Reach Out

If you or a loved one is struggling with addiction, please call us today at 888-965-3085 to find the right level of care for your unique situation. Hypnotherapy is one of our holistic therapy techniques and it has helped many of our clients heal in recovery.


Phenomenological state effects during hypnosis: a cross-validation of findings; V. K. Kumar PhD, Ronald J. Pekala, Michael M. McCloskey; 23 February 2006; https://doi.org/10.1002/ch.145

The Four Subtypes of Borderline Personality Disorder

Borderline personality disorder (BPD) is the most common personality disorder found in clinical settings. Even so, not many people know that there are subtypes of borderline personality disorder.

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) is the standard classification of mental disorders used by mental health professionals in the U.S.) It defines the main features of BPD as “a pervasive pattern of instability in interpersonal relationships, self-image, and affect, as well as impulsive behaviors.” 

According to the DSM-5, a person must have at least five of the nine DSM-5 criteria to receive a BPD diagnosis. That means that there are 256 different combinations of the criteria needed for a BPD diagnosis. With such a large amount of combinations, there is an incredibly diverse range of personality types within this one mental health disorder.

While they have yet to be officially outlined in the DSM-5, the subtypes of BPD are characterized by certain diagnostic criteria for borderline personality disorder. In fact, the main subtypes of borderline personality disorder are based on many studies of the condition. 

The four subtypes of BPD include:

  1. Quiet borderline personality disorder 
  2. Impulsive BPD 
  3. Petulant BPD 
  4. Self-destructive borderline personality disorder

With that said, studies have shown that all forms of BPD experience:

  • Significant psychological and social distress
  • Lower quality of life
  • Excessive mortality rates 

For instance, people within each of the BPD subtypes often feel like they don’t have control over their emotions, and may engage in reckless behavior and self-harm. 

In this article, we will discuss the signs and symptoms of each of the four subtypes of borderline personality disorder, as well as how to get help.

Quiet Borderline Personality Disorder

People with borderline personality disorder frequently struggle to control their emotional reactions to catastrophic events, extreme stress, or abandonment crises. Instead of lashing out, quiet BPD sufferers will lash inward at themselves and internalize their feelings as self-hatred and shame.

Some examples of the quiet subtype of borderline personality disorder include:

  • Internal (and external) verbalization of self-hate
  • Extremely negative internal monologue 
  • Self-blame and shame
  • Approval-seeking behavior
  • Burnout
  • Suicidal ideation
  • Self-harm (cutting, burning, bruising, starvation)
  • Self-destruction
  • Suicide attempts 

Commonly, quiet BPD sufferers pressure themselves to be “the best” until they break. Instead of setting healthy boundaries, they push their own limits trying to be all things for all people.

While public perceptions of BPD typically associate the disorder with the inability to hold a job, this isn’t always the case with the quiet, high-functioning borderline personality disorder type.

In contrast, people with quiet BPD typically lean toward professions related to helping others such as nursing, teaching, and mental health counseling. Job settings that lend to helping others have a natural draw to those with quiet BPD. In essence, those with quiet BPD wish to provide others in need the help they were never provided as children.

These settings are often where individuals with quiet BPD can flourish and gain a sense of purpose. However, if they meet challenges within a professional setting — whether it is a large roadblock or a small inconvenience — they often have a strong reaction. The reaction to the challenge, unlike the typical BPD personality, will be an internal battle. An individual with quiet BPD is more likely to turn inward and become self-blaming, sometimes even self-harming.

The Role of Stress in the Subtypes of Borderline Personality

When there is a trigger, or activation, of borderline personality traits, those with quiet, high-functioning BPD typically turn inwards with their intense emotional reaction. Overwhelming feelings of guilt, humiliation, and fear can set off an episode of catastrophizing—thinking the worst—which presents as “pure” borderline traits.

“Pure” BPD personality traits include:

  • Despair
  • Fragility
  • Abandonment crises

Similarly, sufferers of borderline personality disorder—especially quiet BPD—are often incredibly perceptive of other people’s moods. In the case of quiet BPD, the person’s natural empathy helps them to understand the wants and needs of others. Unfortunately, this often results in codependent relationships in which they continue to give everything they have to offer but refuse to take the help they need. 

Due to the prevalence of negative self-talk and blame, people who suffer from borderline personality disorder are much more likely to have co-occurring depression and anxiety disorders which only work to make the symptoms of BPD worse. 

Petulant BPD 

Not all subtypes of BPD react inwardly following a traumatic event, immense stress, or perceived abandonment. Easily overwhelmed by negative emotions, petulant BPD sufferers will express their displeasure outwardly, defining their role as the victim. 

If a person with petulant-histrionic BPD fears judgment, rejection, or abandonment, they will likely display their emotions in a dramatic fashion. Instead of a sincere apology, this form of BPD presents histrionic traits, seeking out pity and comfort during confrontational situations. 

Some examples of the petulant subtype of borderline personality disorder include:

  • Manipulation
  • Victimization
  • Passive-aggression
  • Controlling
  • Entitlement
  • Narcissistic
  • Defiant
  • Irritable
  • Temper tantrums

Histrionic traits found in petulant BPD include:

  • Child-like attention seeking
  • Superficial reactions
  • Overwhelming emotions
  • Distorted self-image
  • Emotional dysregulation
  • Relationship dissatisfaction

Individuals with petulant BPD traits often suffer from cycles of feeling unworthy and unloved to fits of intense rage and sadness. Due to unmanageable feelings of inadequacy, petulant BPD sufferers often believe they can only gain love through trickery. As a result, they develop relationships based on manipulation and exploitation to avoid being rejected or abandoned. For the most part, the unequal power dynamics result in friendships and partnerships that feel hollow and one-sided.

The power imbalance found in the relationships of individuals with petulant-histrionic borderline personality disorder type typically shows up in their professional lives as well.

Their need to dominate the decision-making process and assert power over others can lead to workplace issues and toxic work environments. Unfortunately, their controlling nature will often negatively impact their romantic and professional relationships. Focused on meeting their wants and needs above all else, their decisions are rarely in the best interest of their partnerships and group objectives.

Petulant-Histrionic BPD Versus Histrionic Personality Disorder

The difference between someone with petulant-histrionic BPD and a true histrionic personality disorder (HPD) is the relationship to rejection. Someone with HPD isn’t overwhelmed with hurt from another person’s disappointment or rejection. As opposed to emotional devastation, a person with HPD will experience feelings of discomfort when they are not the center of attention.

On the other hand, when an interaction begins to veer from the petulant BPD sufferer’s way of doing things, they interpret the other person’s involvement as a direct assault on their needs and outright rejection. Even more, they would be significantly affected by the potential for rejection, losing control of their emotions. This is because the feeling of rejection holds so much weight in their interpersonal relationships.

Impulsive BPD

Similar to petulant-histrionic BPD, impulsive BPD expresses itself outwardly when triggered. That being said, impulsive BPD may include fits of inconsolable rage. Incapable of managing their emotional response, impulsive BPD sufferers will burn all bridges during an episode, cruelly blaming others for their negative emotions.

Some traits of the impulsive subtype of borderline personality disorder include:

  • 50% narcissistic
  • 50% borderline
  • Manipulative
  • Victim complex
  • Quick to rage
  • Overt aggression
  • Low distress tolerance
  • Impulsive, dysregulated outbursts
  • Volatile, externalized blame
  • Highly unstable identity

Also referred to as angry externalizing-impulsive BPD, this type of borderline personality disorder is the most infamous form of BPD.

Their impulsive displays of dangerous behavior are often a form of stress relief. Whether used to get their feelings out, self-soothe their damaged ego, or as punishment to those who hurt them, these unhealthy behaviors can be incredibly dangerous.

Impulsive behaviors used as unhealthy coping skills include:

  • Binge drinking 
  • Abusing drugs
  • Reckless driving
  • Risky sexual activity
  • Spending money
  • Self-harm
  • Breaking objects

Many people confuse these impulsive behaviors with mania, a symptom of bipolar disorder because the person will often appear agitated and out of control. While impulsive BPD sufferers do not have a chemical imbalance that makes them incapable of self-control like those who have bipolar disorder, they often lack the emotional regulation skills to prevent a total breakdown. 

Without proper medical care, these emotional outbursts will typically escalate in severity to maintain the attention of others. As a result, this destructive pattern of behavior ultimately puts the person with BPD and others in harm’s way.

Self-Destructive Borderline Personality Disorder

Self-destructive borderline personality disorder is a particularly dangerous subtype of borderline personality disorder. Also known as depressive-internalizing BPD, people with this type of BPD often feel like they are not worthy of living. They engage in self-harm behaviors to cope with their feelings of emptiness and despair.

Some examples of the self-destructive BPD subtype include:

  • Self-defeat
  • Self-disruption
  • Severe internalized self-loathing
  • Dysphoric and depressive mood
  • Mental and physical exhaustion
  • Difficulty holding and securing employment

This type of BPD is characterized by behaviors and thoughts that lead to self-harm and self-destruction. People with this  BPD subtype often feel like they don’t deserve to live, and may engage in passive self-harm behaviors such as neglecting themselves or others in their care. Their self-destructive tendencies can also make it difficult to successfully seek out help in treatment, therapy, and medical visits.

Additionally, self-destructive BPD is characterized by a cruel and unforgiving internal monologue that leads to self-harm and self-sabotage. Ever critical of their own thoughts and behaviors, they read into the facial and body expressions of others, creating false narratives founded on their failures. As a result, their fixation on failure and shame leads to self-isolation and mental flogging.

In fact, people with self-destructive borderline personality disorder will immediately spiral into passive self-harm behaviors. When experiencing rejection, it’s common for someone with self-destructive BPD to think, “I don’t know why I exist. I don’t know who I am or why I exist. I shouldn’t be alive — I deserve to die.” This can be very dangerous, as it can lead to accidental or intentional suicide. 

Get Help for Co-Occurring Subtypes of Borderline Personality Disorder

Without treatment, each of the four subtypes of borderline personality disorder can be detrimental to a person’s well-being. People with BPD often feel like they are not worthy of living and engage in self-harm behaviors as a way to cope with their feelings of emptiness and despair. 

If you or someone you know is struggling with borderline personality disorder, it is important to get help right away. Many resources are available for people dealing with this condition, and there is no shame in seeking out assistance. We can help. Get a free, confidential consultation: 888-965-3085.