A 18 y/o girl was brought to emergency after she cut her wrist using shaving razor. The patient was found to have multiple superficial cuts and dressing was done for the same. The patient repoed that she didn’t have an intention to kill herself, and that ‘physical pain numbs my psychological pain’. This episode was triggered by a fight with her boyfriend. Mother gave history of multiple similar episodes of self harm in the past, and history of multiple sho lasting relationships in the past. Mother fuher said that the patient has always been a very moody person and no one can predict what she will do next? What is the psychotherapy of choice in this patient?

**Core Concept**
The patient described exhibits signs of borderline personality disorder (BPD), characterized by unstable relationships, emotional dysregulation, impulsivity, and recurrent suicidal behavior or self-mutilation. Effective psychotherapy for BPD requires a therapeutic approach that addresses these complex issues.

**Why the Correct Answer is Right**
Dialectical Behavior Therapy (DBT) is a type of psychotherapy specifically designed for individuals with BPD. Developed by Marsha Linehan, DBT combines cognitive-behavioral techniques with concepts of mindfulness and acceptance. The goal of DBT is to help patients manage their emotions, tolerate distress, and improve relationships by teaching skills such as mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.

**Why Each Wrong Option is Incorrect**
**Option A:** Cognitive-behavioral therapy (CBT) is a helpful approach for various mental health conditions but may not be as effective for BPD, which requires a more comprehensive and structured approach like DBT.
**Option B:** Psychodynamic therapy may be beneficial for some individuals with BPD, but it may not be as effective in addressing the complex and immediate needs of this patient, who requires a more structured and skills-based approach.
**Option C:** Family therapy may be helpful in addressing family dynamics and relationships, but it may not be sufficient as the primary treatment approach for the patient's BPD.

**Clinical Pearl / High-Yield Fact**
DBT is a time-limited therapy that typically lasts 6-12 months, with the goal of teaching patients the skills needed to manage their symptoms and improve their quality of life. A key component of DBT is the use of a "chain analysis" to identify and change maladaptive behaviors.

**Correct Answer:** D. Dialectical Behavior Therapy (DBT).

✓ Correct Answer: A. Dialectical behavioural therapy