One of the most devastating aspects suffered by clients with Borderline Personality Disorder is the chronic feeling of emptiness. At the Meehl Foundation, we address this in three seemingly separate yet ultimately connected topics: DBT and spirituality; beliefs and cognitive distortions; and medication.

As a student of spirituality, I have studied many religions. As a teacher of DBT, I see the dialectics evident in all religions. Monotheistic religions teach that there is one god, and that the path to salvation is to find that god. However, it is not the case that that God has left us, but that the divine is already within us. And it is by combining DBT and spirituality that we can redress irrational beliefs and cognitive distortions to the contrary. Because there is no purely chemical solution to a spiritual problem.

There is a problem when people speak glibly and naively about religious beliefs. Every religion has its own language, procedures, and policies. As you read this essay, try to find the kernel of truth (DBT skill) that best works for you.

In The Pathway to Spirituality, Bill O’Hanlon speaks of spirituality in terms of emptiness:

“When people seek therapy, they are often feeling isolated, disconnected, and disempowered in at least one area of their lives. Spirituality, in this definition, begins with the opposite of this experience. It is a movement toward feeling connected to something bigger within or beyond oneself that can evoke feelings of competence or okayness.” (New York:  W.W. Norton, 2006)

Similarly, Richard Rohr states “…you and I begin with a divine DNA, and inner destiny, as it were, an absolute core that knows the truth about you….your soul is who you are in God and who God is in you. You can never lose your soul; you can only fail to realize it.”

Many of my clients have been beaten with religion by well-meaning people who think they are helping them. It is impossible to spend all day feeling guilty about sin and also feel the light of the divine. We humans tend to focus on pain, death, suffering, and misery, not realizing that such negative thinking keeps us from finding the joy in our hearts. We latch onto our victimhood, blaming, and the need to be right. The answer to this is the (DBT skill) of mindfulness. To be effectively mindful( DBT Skill), we must stay in the moment and let go of vengeance, useless anger, and righteousness that hurts us and does not work.                                                                                                                                                                                                                                                             When I am observant of my thinking (another DBT skill), I can decide if it is my ego speaking or my core of goodness. While my ego may protect me as I go through life, it is concerned more with success, status, and fortune. My higher self–my soul–is revealed when my ego steps out of the way and allows the divine to speak through me. When I fully participate (DBT skill) and stop worrying about myself (how I look, whether people like me, what they think of me), my anxiety leaves so I can be fully present in the moment allowing me to fully participate (DBT Skill) in life

People with BPD are often devastated by guilt and shame. They cannot see themselves as separate from their behaviors or beliefs. What they have not been taught is that all behaviors are the product of cognitions and beliefs. Who you believe yourself to be shapes your behaviors. Mistakenly believing “I am bad” goes hand in hand with “bad” behaviors. Realizing and observing (DBT skill) that who you are is separate from your behaviors is the first conscious step toward change. Crisis generating behaviors common with BPD often do not work and lead to feelings of failure.

For the BPD client, this is disastrous as they often possess both the irrational belief that they must please everyone and a deep terror of abandonment. These irrational beliefs lead to devastating depression and an overwhelming sense of hopelessness.  Combining DBT and spirituality helps combat such beliefs by allowing the client to improve each moment (DBT skill) with imagery, prayer, meaning, relaxation, and encouragment (skills).

Targeting both irrational beliefs and their biochemical causes is a two-pronged approach to successfully change both cognitions and behaviors. Medication works with the limbic system (the emotional “core” of the brain) where these “feelings” originate from. Many clinical studies have successfully shown that depression remitted much faster when clients are treated with both DBT and medication, rather than when treated with medication alone. For more updates on research, please visit

Belief coupled with intense emotion creates an illusory reality that can be very convincing. Emotions magnify and reinforce our beliefs because we can physically feel them. Changing my beliefs of who I am may seem to be a daunting task, but each step toward my true self changes those beliefs as a whole. Recognizing your worth as a divine child of God with behaviors that can be changed is the first step in exclaiming, My behaviors are not me! They are my BPD.
In this way, the Meehl Foundation augments this process by combining DBT and spirituality to support the client from a truly holistic standpoint.