Bridging the Surface and the Depths: An Integrative Application of Dialectical Behavior Therapy and Object Relations Theory

Date of Award

Summer 8-22-2026

Document Type

Doctoral Research Paper

Degree Name

Psy.D. in Clinical Psychology

Organizational Unit

Graduate School of Professional Psychology

First Advisor

Noelle Lefforge

Second Advisor

Monica Corrado

Third Advisor

Kritika Dwivedi

Copyright Statement / License for Reuse

All Rights Reserved
All Rights Reserved.

Keywords

Dialectical behavior therapy (DBT), Object relations theory (ORT), Psychotherapy integration, Borderline personality disorder, Complex trauma, Emotion dysregulation, Transference, Therapeutic relationship, Treatment-resistant presentations

Abstract

Clients with borderline personality disorder, complex trauma, chronic suicidality, and severe emotion dysregulation often exceed the reach of any single therapeutic approach. This paper argues that integrating Dialectical Behavior Therapy (DBT) and Object Relations Theory (ORT) offers a clinically robust, theoretically coherent framework for addressing both acute symptom burden and underlying characterological and relational dynamics. DBT (Linehan, 1993) provides structured skills for distress tolerance, emotion regulation, and interpersonal effectiveness. ORT (Fairbairn, 1952; Kernberg, 1975; Klein, 1946/1984; Winnicott, 1965) offers a depth-oriented account of how early relational experience becomes internalized as templates organizing self-experience and emotional reactivity. Though the two frameworks differ in their assumptions about suffering and change, this paper treats these differences as complementary rather than irreconcilable, with behavioral stabilization enabling later relational exploration.

A hypothetical case study illustrates this integration across three stages: stabilization and skill development, exploration of relational dynamics and internalized objects, and integration and growth. Clinical vignettes highlight the shifting therapeutic role, management of transference and countertransference, and the dual function of the therapeutic relationship as both skills-coaching alliance and site of transference enactment. The paper concludes with practical guidance for clinicians and directions for future empirical research.

Copyright Date

6-26-2026

Publication Statement

Copyright is held by the author. Permanently suppressed.

Rights Holder

Ana Clements-Benedict

Provenance

Received from author

File Format

application/pdf

Language

English (eng)

Extent

50 pgs

File Size

690 KB

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