Treating Borderline (Feat. Fern of @therapyontheborderline)Treating Borderline (Feat. Fern of @therapyontheborderline)
Bold Beautiful Borderline
Sara and therapist Fern talk about treating Borderline Personality Disorder, from stigma and burnout in mental health systems to therapy approaches beyond DBT. Their conversation highlights longer-term work, safety in the therapeutic relationship, and why people with BPD deserve therapists who genuinely choose to work with them.
38:32•25 Oct 2026
Treating Borderline: A Therapist’s Honest Take with Fern
Episode Overview
- Stigma from mental health professionals can be deeply traumatic and often becomes part of the story clients bring into therapy.
- Short-term treatment programmes can leave people feeling failed when deeper, long-standing patterns need longer-term work.
- Understanding the origins of fears and beliefs in childhood can help make sense of current relationships and emotional responses.
- Clients are encouraged to view initial sessions as interviews for the therapist and to prioritise safety and fit over pleasing the clinician.
- BPD traits often arise where emotional regulation was never modelled, so expecting perfect regulation in adulthood is unfair and unrealistic.
“Treat your initial consultation as an interview for the therapist. You don't need to sell yourself to get help.”
Curious about how others manage their sobriety journey while also living with Borderline Personality Disorder? This conversation brings together Sara and Fern, an art psychotherapist based in the UK, to talk frankly about what treatment for BPD actually looks like from the therapist’s chair. Fern shares how a placement on a specialist personality disorder unit turned into a decade-long career working primarily with people who have BPD.
She describes a therapeutic community with flattened hierarchy, larger and smaller groups, art therapy, drama, and psychodrama – a space where, as she puts it, “everything genuinely made sense” for the first time. You’ll hear them tackle the heavy stuff head-on: soul-destroying stigma from clinicians, burnout in mental health systems in both the UK and US, and how short-term, 12-week programmes can leave people feeling like failures when they’ve spent a lifetime building their personality.
Fern doesn’t mince words about that: expecting someone to “deconstruct” a lifetime of patterns in a few weeks is “kind of bollocks”. There’s a big focus on therapy beyond DBT. Fern explains her blend of psychodynamic work, mentalization-based treatment and group analytic training, all grounded in the idea that “knowledge is power”.
She talks about helping people link present fears to past experiences, build safety before skills, and even create their own practical tools, like a relationship “flow chart” instead of rigid worksheets. Sara weaves in her own experiences with sobriety, family systems, grief, and the painful reality that healing sometimes means losing relationships. Together, they question why people with BPD are expected to regulate emotions better than everyone else, when many never had emotional regulation modelled in childhood.
By the end, Fern offers down-to-earth advice: treat your initial consultation like an interview, and remember, “your symptoms don't define you as the person.” If you’ve ever wondered whether therapy is worth the risk, this chat might help you decide what kind of support you actually want – and deserve.
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