Bipolar Bozukluk ve Sınır Kişilik Özellikleri Gösteren Bir Danışanın BDT Temelli Psikoterapi Süreci: Olgu Sunumu ve Formülasyon

This study presents the Cognitive Behavioral Therapy (CBT) process of a 33-year-old female client exhibiting symptoms of bipolar disorder and borderline personality traits. The client experienced prolonged grief due to the traumatic death of her primary caregivers—her grandparents—during early childhood. Her developmental history includes severe childhood traumas such as attention deficit, emotional neglect, physical abuse, and sexual trauma. In adulthood, she exhibited significant emotional instability, impulse control problems, and difficulties in interpersonal relationships. The client also has a family history of bipolar disorder, suggesting a genetic predisposition. Her early marriage, lack of family support, and emotional abuse by her spouse contributed to the development of low self-esteem and learned helplessness. Furthermore, the sexual trauma experienced at a young age underlies her deep-seated feelings of worthlessness and low self-worth. The therapy process focused on issues such as attention deficits, impulse control problems, low self-esteem, feelings of worthlessness, difficulties in setting boundaries, and unresolved grief. CBT interventions included the use of automatic thought records, cognitive restructuring, emotion regulation strategies, trauma-focused techniques, and the development of healthy boundary-setting skills. The client’s experiences of physical violence, emotional neglect, and sexual abuse in early childhood significantly contributed to her sense of worthlessness, low self-esteem, and learned helplessness. These issues manifested in adulthood as difficulties in social relationships, inability to establish boundaries, heightened anxiety, and inner conflict. In conclusion, the therapeutic process emphasized the resolution of past traumas, reconstruction of self-perception, and development of adaptive coping strategies. The client showed significant improvements in quality of life, gained skills in setting healthy boundaries, and enhanced her social functioning. For future cases with similar presentations, longer-term and integrative therapeutic approaches are recommended. Keywords: Bipolar disorder, borderline personality, cognitive behavioral therapy, trauma, low self-esteem, feelings of worthlessness, learned helplessness, boundary setting.