Dynamic Deconstructive Psychotherapy

Dynamic Deconstructive Psychotherapy (DDP) is a 12-month treatment for borderline personality disorder and other complex behavior problems, such as alcohol or drug dependence, self-harm, eating disorders, and recurrent suicide attempts. DDP combines elements of translational neuroscience, object relations theory, and deconstruction philosophy in an effort to help clients heal from a negative self-image and maladaptive processing of emotionally charged experiences. Neuroscience research suggests that individuals having complex behavior problems deactivate the regions of the brain responsible for verbalizing emotional experiences, attaining a sense of self, and differentiating self from other, and instead activate the regions of the brain contributing to hyperarousal and impulsivity.

DDP helps clients connect with their experiences and develop authentic and fulfilling connections with others. During weekly, 1-hour individually adapted sessions, clients discuss recent interpersonal experiences and label their emotions, reflect upon their experiences in increasingly integrative, accepting, and realistic ways, and learn how to develop close relationships with others while maintaining their own sense of self.

In research studies, DDP has been shown to improve symptoms of borderline personality disorder, dissociation, and depression, to lessen complex behavioral problems, such as suicide attempts, self-harm, and substance misuse, to decrease institutional care, and to improve functioning.  DDP has been shown to be more effective for the treatment of borderline personality disorder than other common approaches.  Approximately 90% of clients who undergo a full year of treatment will achieve clinically meaningful improvement, and recovery usually progresses after treatment ends.  Because of these findings, the U.S. federal agency SAMHSA has included DDP on its National Registry of Evidence-Based Programs and Practices (see www.nrepp.samhsa.gov).

Training Opportunities in DDP

  • Individual clinical supervision provided to PGY-III psychiatry residents
  • Elective in DDP is available for senior residents and psychology interns, which includes didactic instruction, assigned readings, and clinical consultation
  • Fee-based workshops and individual or group consultation is available to individuals and agencies (see list of therapists with advanced competency in DDP)

Resources

  1. DDP Overview
  2. See Techniques
  3. Attribution Techniques
  4. States of Being
  5. Experiential Deconstruction
  6. Getting Started

Faculty

References

Gregory, R. J. (2004). Thematic stages of recovery in the treatment of borderline personality disorder. American Journal of Psychotherapy, 58, 335-348.

Gregory, R. J. (2005). The deconstructive experience. American Journal of Psychotherapy, 59, 295-305.

Gregory, R. J. (2007). Borderline attributions. American Journal of Psychotherapy, 61, 131-147.

Gregory, R. J., Chlebowski, S., Kang, D., Remen, A. L., Soderberg, M. G., Stepkovitch, J., Virk, S. (2008).A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder. Psychotherapy: Theory, Research, Practice, Training, 45, 28-41.

Gregory, R. J., Remen, A. L. (2008). A manual-based psychodynamic therapy for treatment-resistant borderline personality disorder. Psychotherapy: Theory, Research, Practice, Training, 45, 15-27.

Goldman, G. A., Gregory, R. J. (2009)Preliminary relationships between adherence and outcome in dynamic deconstructive psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 46, 480-485.

Goldman, G. A., & Gregory, R. J. (2010). Relationships between techniques and outcomes for borderline personality disorder. American Journal of Psychotherapy, 64, 359-371.

Gregory, R. J., Delucia-Deranja, E., & Mogle, J. A. (2010). Dynamic deconstructive psychotherapy versus optimized community care for borderline personality disorder co-occurring with alcohol use disorders: 30-month follow-up. Journal of Nervous and Mental Disease, 198, 292-298.

Chlebowski, S., & Gregory, R. J. (2012). Three cases of dissociative identity disorder co-occurring with borderline personality disorder treated with dynamic deconstructive psychotherapy. American Journal of Psychotherapy, 66, 165-180.

Deranja, E., Manring, J., & Gregory, R. J. (2012). A manual-based treatment approach for training psychiatry residents in psychodynamic psychotherapy. Journal of the American Psychoanalytic Association, 60, 591-598.