Is couple therapy indicated for borderline personality disorder?

The healing aspects of intimate relationships are being recognized by therapists and supported by empirical findings. Little has been written regarding the indications for couple therapy for individuals with borderline personality disorder. This paper proposes a three-level hierarchy for deciding on the suitability of couple therapy for patients with borderline personality disorder. The hierarchy is based on three separate borderline behavioral clusters--impulsive, identity, and affective--that should be utilized to direct the application of couple therapy to specific patients. The three levels are illustrated by case examples. Delineation of the indications for couple therapy for borderline patients will foster further theoretical and empirical work in the area.