Values are closely linked to emotions and patients with BPD experience significant fluctuations in their emotions. Psycho-education about the hierarchy, proximity, and temporality of values offers an opportunity to reduce impulsivity and increase hope.

Most effective forms of therapy address personal agency. For this, the clinician needs to create a non-blaming, non-judgemental, and compassionate milieu which can enable the patient to take responsibility for their actions. Values-based interventions can improve agency, increase motivation, and help the patient find meaning, which is negatively associated with depression, suicidality, and self-harm. Early empirical evidence supports the usefulness of working with the patient’s values in therapy using acceptance and commitment therapy (ACT), a modality that focusses on acting in accordance with one’s stated values. Empirical evidence from longitudinal observation suggests that an increase in agency in the patient’s life narrative is part of the recovery process.

Patients with BPD follow a different path in terms of recovery. Patients often find the word ‘recovery’ problematic and many feel that ‘discovery’ describes their journey more accurately. A significant proportion of people with BPD feel that they are not ill in the same way as people with other major mental illnesses but that they need help and support.