Borderline Personality Disorder: GPM Model-Diagnosis & Treatment Tools
In Episode 2.6 of Psychiatry Boot Camp, we take a deep and structured look into one of the most clinically challenging psychiatric conditions: Borderline Personality Disorder (BPD).

Our guide for this journey is Dr. Lois Choi-Kain, Director of the Gunderson Personality Disorders Institute at McLean Hospital and Associate Professor of Psychiatry at Harvard Medical School. With her leadership in personality disorders research and education, Dr. Choi-Kain introduces us to the Good Psychiatric Management (GPM) model—a widely accessible and highly effective framework for managing BPD in everyday clinical settings.

🧠 In This Episode, You’ll Learn:

✔️ Core diagnostic criteria and clinical features of BPD
✔️ The natural course of BPD and its associated comorbidities
✔️ Epidemiological data on prevalence, gender, and comorbidity
✔️ How the GPM model provides a realistic and scalable treatment approach
✔️ How to identify and manage suicidality and emotional dysregulation
✔️ Effective strategies for maintaining boundaries and reducing clinician burnout
✔️ Key differences between GPM, DBT, and other structured therapies
✔️ Real-world case applications of GPM principles in psychiatric practice

📌 Why Focus on GPM?

While Dialectical Behavior Therapy (DBT) and Mentalization-Based Therapy (MBT) are highly effective, they can be resource-intensive. GPM was created by Dr. John Gunderson to offer an evidence-based, practical alternative that general psychiatrists and non-specialists can confidently use.

It teaches clinicians to:

Maintain clinical empathy while staying emotionally grounded

Focus on functionality over perfection

Use the narrative of recovery to reduce stigma and hopelessness

Identify interpersonal triggers and respond constructively

Develop therapeutic alliance while avoiding over-involvement

📚 Recommended Book:
📖 Applications of Good Psychiatric Management for Borderline Personality Disorder: A Practical Guide
Read or Order Here

🔍 Referenced Studies & Articles:

Grant et al. (2008) – Prevalence and Comorbidity

Trull et al. (2010) – Gender Differences & Substance Use

Gregory et al. (2021) – BPD in Suicidal Inpatients

Kernberg (1967) – Original Personality Organization Theories

Choi-Kain et al. (2017) – Treatment Effectiveness

Skodol et al. (2005) – Longitudinal Outcomes in CLPS Study

Temes & Zanarini (2018) – The Natural History of BPD

👩‍⚕️ About Dr. Lois Choi-Kain:

• Director, Gunderson Personality Disorders Institute, McLean Hospital
• Associate Professor of Psychiatry, Harvard Medical School
• International educator and co-author in the field of BPD treatment
• Lead trainer in GPM frameworks globally

Dr. Choi-Kain’s balanced, real-world approach offers hope and clarity for clinicians who often feel overwhelmed by the complexity of BPD.

🎯 Who Should Watch This Episode:

• Psychiatry residents and early-career clinicians
• General psychiatrists and primary care physicians
• Emergency and crisis mental health providers
• Therapists, psychologists, and social workers
• Hospitalists and consultation-liaison psychiatry teams

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💬 Comment Prompt:
Have you used GPM in your clinical setting? What’s your biggest challenge when treating BPD patients? Let us know your experience in the comments.

📌 Timestamps (Suggested):

00:00 – Intro to Dr. Lois Choi-Kain
02:50 – BPD: Diagnosis, Prevalence, and Natural History
07:10 – GPM Overview and Foundational Principles
12:00 – Managing Suicidality in BPD
16:30 – Case Vignettes and Clinical Examples
20:40 – Comparing GPM, DBT, and MBT
24:10 – Realistic Goals for BPD Recovery
28:00 – Resources and Reading List
30:00 – Final Reflections

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