Now let us turn to psychotherapy. There are three main approaches:

Now let us turn to psychotherapy. There are three main approaches:

1. Psychodynamic therapy

This is the classic form of talking therapy. The therapist primarily listens to you and intervenes little. The aim is to explore your past and your personal history. This long-term work provides access to deeper aspects of your personality. Because this approach rests on many theories, it remains complex to study and can seem rather nebulous.

2. Cognitive behavioural therapy (CBT), Cognitive behavioural therapy (CBT) is a brief method that helps gradually replace negative thoughts and maladaptive behaviours with ideas and responses more in tune with reality. Patient and therapist work hand in hand to identify and analyse three key components:

1. Emotions (what we feel),

2. The thoughts that accompany these emotions,

3. The behaviours that result from them.

This approach focuses on difficulties encountered here and now and rests on a shared understanding of the problem. Step by step, CBT helps reduce symptoms that impede everyday life: rituals and repeated checking, stress, avoidance behaviours, inhibition, aggressive reactions, poor self-esteem or any other form of psychological distress.

3. Dialectical behaviour therapy (DBT), called TCD in French, was developed by Professor Marsha Linehan to treat borderline personality disorder. It is a form of what is known as ‘ third-wave cognitive behavioural therapy’, because it combines several theoretical approaches and offers a wide range of practical tools to help patients in everyday life.

At the heart of DBT lies the idea of dialectics: learning to accept two opposing points of view simultaneously, in order to find a fair balance between extreme attitudes or emotions. In practical terms, this encourages mental flexibility and openness, essential for regulating one's reactions more effectively.

Treatment is structured around several complementary modules (for example: emotion regulation, distress tolerance, interpersonal effectiveness, mindfulness). These modules form a ‘winning combination’: each provides specific skills, but it is their integration that enables effective progress.

Studies show that DBT is very effective: more than 60% of people following this programme see a rapid and significant improvement in their borderline symptoms. It rests on clear principles and a ‘therapeutic contract’ established with the patient, which includes a commitment not to act on suicidal impulses.

Treatment generally takes place in two main phases:

1. Strengthening self-control The patient learns to recognise and manage problematic behaviours (impulsivity, self-harm, outbursts of anger), gradually taking responsibility again for their choices and actions.

2. Reducing emotional suffering The aim is to decrease the intensity and frequency of distressing emotions, then normalise relationships with oneself and with others.

Beyond borderline disorder, DBT has demonstrated its value for other conditions: addictions, eating disorders, attention deficit disorder with or without hyperactivity (ADHD), and even certain mood disorders in people on the autism spectrum.

Despite its reliability and relevance, DBT remains relatively undeveloped in France.