The treatment of maladaptive shame in borderline personality disorder: A pilot study of “opposite action”

This study sought to pilot test a short-term intervention for maladaptive shame in borderline personality disorder (BPD) based on the skill of “opposite action” from dialectical behavior therapy. Five women with BPD were treated with the intervention using a single-subject, multiple-baseline design. Results indicate that, although state ratings of shame are highly variable, it is possible to reduce shame about a specific event over a short period of time. This was verified by a new shame measure that was created for this study. Results from this study have several implications for the treatment of shame in BPD and other clinical populations. A detailed case example is provided.