EMDR and Borderline Personality Disorder: New Research

Borderline personality disorder (BPD) involves intense emotional swings, unstable relationships, and a fragile sense of identity. Difficult early experiences are common in the backgrounds of people diagnosed with it, and PTSD frequently occurs alongside it. Despite that overlap, guidelines for treating PTSD have often not been followed when someone also has BPD. The reason is a familiar one: many clinicians have assumed that people with BPD would struggle to tolerate trauma-focused therapy, and that attempting it might do harm. As researchers have pointed out, conclusive evidence for that assumption has never actually been produced. So the question is worth asking directly. Two recent trials have. The first, by Marcelo Nvo-Fernandez and colleagues, published in *Alpha Psychiatry* (2025), randomly assigned participants with BPD to receive either EMDR or CBT, delivered by teletherapy. Both treatments significantly improved trauma symptoms and BPD symptoms, and both increased post-traumatic growth, the positive psychological change that can follow adversity. The second is larger and more instructive. Aishah Snoek and colleagues, writing in *Psychotherapy and Psychosomatics* (2025), studied 124 patients with PTSD and significant BPD symptoms. They were randomly assigned either to EMDR alone or to EMDR combined with dialectical behaviour therapy, the well-established treatment for BPD. Both produced large reductions in PTSD symptoms, with no significant difference after a year, and both reduced BPD symptoms comparably. Notably, adding DBT did not improve outcomes, and patients receiving the combined treatment were twice as likely to drop out of the EMDR component. The authors concluded that EMDR on its own was both safe and effective for this group. These are early findings, and the first trial in particular was small, with relatively few participants completing it. BPD is complex, and treatment decisions should always be individual. Even so, the emerging message is important, and echoes what research has shown for people with psychosis: a diagnosis that clinicians once treated as a barrier to trauma therapy may not be a barrier at all. For people carrying both a BPD diagnosis and unresolved trauma, that is a meaningful shift. *Sources:* - *Nvo-Fernandez, M., Salas, F., Miño-Reyes, V., et al. (2025). Effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in Treating Borderline Personality Disorder: A Randomized Controlled Trial. Alpha Psychiatry, 26(2), 40031.* - *Snoek, A., van den End, A., Beekman, A. T. F., et al. (2025). Eye Movement Desensitization and Reprocessing with and without Dialectical Behavior Therapy for Posttraumatic Stress Disorder and Comorbid Borderline Personality Disorder Symptoms: A Randomized Controlled Trial. Psychotherapy and Psychosomatics, 94(3), 175–193.*