Specialism
Therapy for emotionally unstable personality disorder (EUPD / BPD)
Steadier ground with emotions that arrive at full volume, and relationships that swing between too close and too far away.
Does this sound familiar?
Feelings arrive at full volume and with no warning, and they take hours to come back down when other people seem to reset in minutes. In the middle of one, everything you believe about yourself and everyone else can flip completely.
Relationships run hot. Someone becomes very important very quickly, and then a delayed reply or a changed plan lands like proof they are leaving. You may find yourself testing people, or getting out first, or apologising for days afterwards for something that felt entirely justified at the time.
Underneath it there is often a sense of not quite knowing who you are without someone else in the frame — and a great deal of shame about all of the above. The label EUPD or BPD may have been given to you in a way that felt more like a judgement than an explanation.
There is usually a lot of competence in the picture too, which rarely gets mentioned. People with this diagnosis are often perceptive, loyal and unusually good at reading a room — the same sensitivity that makes the emotions so loud. That is worth saying because the label is so often delivered as though it described a character defect.
How I work with this
First, the honest bit about scope. The specialist treatments with the strongest evidence for EUPD — dialectical behaviour therapy and mentalisation-based therapy — are structured programmes, usually delivered by a team over a year or more. I am one CBT and EMDR therapist working individually. If that programme is what you need, I will tell you at assessment and help you work out how to get to it.
What I do offer, and what many people want alongside or after such a programme, is individual CBT that borrows heavily from DBT skills: recognising an emotion earlier, riding out the intensity without doing the thing that costs you, tolerating distress without self-harm, and unpicking the beliefs about abandonment that fire so fast.
Very often there is trauma underneath — and EUPD frequently sits on top of a childhood where emotions were dismissed or unsafe. I am accredited with EMDR Europe and, once you have enough stability to work with, trauma processing can change the ground rather than just the surface. We build that stability first, deliberately and without rushing.
The therapeutic relationship itself gets talked about openly, rather than being left to run in the background. Ruptures happen — a missed session, something I say that lands badly, the ending — and in this work repairing them out loud is not a detour from the therapy, it is a good deal of the therapy.
What to expect
Assessment takes longer here — usually two or three sessions — because getting the fit right matters more than starting quickly. We agree what we are working on, what happens if things get difficult between sessions, and who else is involved in your care.
Work is typically longer than for a single anxiety problem, often six months or more of weekly 50-minute sessions, and we review it properly every couple of months rather than drifting. Endings are planned well in advance and talked about openly, because an ending that arrives suddenly is its own kind of harm.
I am not a crisis service, and we will agree a clear plan for out-of-hours support before we need it. Sessions run online across the UK and worldwide, or in person at Sanctuary Therapy Centre in Prestwich and Hebden Bridge.
Common questions
Is EUPD the same as BPD? Yes — emotionally unstable personality disorder is the term used in the ICD, borderline personality disorder in the DSM. Same picture, different manual.
Do you offer DBT? Not as a full programme — that is a team-delivered treatment with groups, individual sessions and phone coaching. I use DBT-informed skills within individual CBT, and I will be honest at assessment about whether that is enough for what you are describing.
Is it true that this cannot be treated? No, and it is a damaging thing to have been told. Outcomes for EUPD are considerably better than the reputation suggests, and many people no longer meet the criteria over time.
What if I self-harm between sessions? We will talk about it openly and plan for it rather than pretend it will not happen. Therapy does not stop because of it. If you are injured and need medical help, call 999 or go to A&E; Samaritans are free on 116 123 at any hour.
I was given this diagnosis and nobody explained it. That is unfortunately common, and it is worth an hour of proper explanation on its own. Understanding what the label does and does not mean is often the first useful thing that happens.
How do I know whether individual therapy is enough for me? That is what the longer assessment is for, and I will give you a straight answer rather than a hedged one. Broadly, individual CBT and EMDR suit people whose safety is reasonably steady and who want to work on specific patterns — emotional intensity, relationships, trauma, self-criticism. Frequent crises, repeated hospital admissions or high risk generally need a team around you, and I would rather tell you that at the start than six months in.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.