Integrating dream work into group schema therapy for individuals with borderline patients

INTRODUCTION: Borderline personality disorder (BPD) is associated with significant difficulties in emotional regulation and a higher prevalence of nightmares, which increase emotional instability and decrease quality of life. Dreams represent valuable therapeutic material that can reveal internal conflicts and support self-awareness.

OBJECTIVE: This article explores dreamwork in group schema therapy (GST) aimed at the early maladaptive schemas (EMS) and modes. The ultimate goal of these approaches is to support the Healthy Adult mode in processing the emotional needs of patients with BPD.

METHODS: TThe article presents the theoretical foundations and therapeutic techniques, including imagery, dream rescripting, chairwork, and amplification of dream images. Case vignettes illustrate how dreamwork can help recognise and process a patient's internal conflicts and thus aid the therapy process.

RESULTS: Dreamwork in GST helps patients better understand their emotional needs and schemas. The increased awareness helps to modify dysfunctional behaviour and improve emotional stability. The group therapy format allows patients to share their experiences and receive support from others, which increases the feeling of belonging and security.

DISCUSSION: Dreamwork in GST creates a safe space for processing internal conflicts related to EMS and connections with real possibilities in the patient's life. Dreamwork also brings challenges, such as the risk of slipping into intellectualisation or being overwhelmed by strong emotions and unable to resolve impactful dreams. Dedicated courses and research are needed to warrant effective implementation and elaboration of these methods.

CONCLUSION: Dreamwork in GST might be an effective tool for promoting self-awareness, processing emotional conflicts, and strengthening the Healthy Adult and Kind Parent modes.