Borderline Personality Disorder and Music Therapy: Adjusting the Self-Pattern

Instability appears to be a key symptomatic feature of borderline personality disorder (BPD); subjects commonly exhibit affective dysregulation, an unstable sense of self, and instability in their interpersonal relationships. To conceptualize how trauma plays a key role in generating instability, I propose that the persistent activation of 'traumatic imprints' involves distortions to central elements of what Shaun Gallagher (2024) terms 'the self-pattern'. Since music therapy can tap into the embodied, affective, prereflective, and cognitive processes that comprise the self-pattern, it holds great potential to foster a more stable sense of self. I examine how instrumental improvisation, in particular, can target narrative processes of the self-pattern by allowing subjects to explore their life story and make sense of painful memories. I then discuss how joint improvisation with a therapist has potential to target intersubjective processes of the self-pattern, which can help subjects with BPD to build their capacities for co-regulation and for navigating misattunements in social interaction.