QUESTION:
Dr. Heller,
If someone has behavior problems, mood swings, lying when truth is better, doing something even when they know it goes against their values, cheating, can you treat the behaviors without knowing what causes the behaviors?
ANSWER:
The obvious answer is that it depends. Mood swings are almost invariably a
medical problem. Sometimes lying is done when the individual feels so bad that
protecting against the fear is crucial. Sometimes the individual doesn't interpret
reality correctly and seems to be lying. If the BPD is present, it needs to be
treated medically first. I believe strongly that the BPD is a medical problem that
needs to be treated medically.
There are some "behavioral" schools of therapy that concentrate on behavior
rather than the causes.