Parts Therapy Worksheet for Borderline Personality Disorder (Internal Parts Mapping Tool)

This parts therapy worksheet helps clinicians and clients map internal emotional parts that become activated during stress, conflict, or perceived abandonment. It provides a structured way to identify protective, vulnerable, critical, avoidant, and impulsive parts that drive emotional and behavioral patterns in Borderline Personality Disorder. By increasing awareness and fostering a more compassionate relationship with these parts, this tool supports emotional regulation, reduces reactivity, and promotes integration of a more stable and grounded sense of self.​This parts therapy worksheet helps clinicians and clients map internal emotional parts that become activated during stress, conflict, or perceived abandonment. It provides a structured way to identify protective, vulnerable, critical, avoidant, and impulsive parts that drive emotional and behavioral patterns in Borderline Personality Disorder. By increasing awareness and fostering a more compassionate relationship with these parts, this tool supports emotional regulation, reduces reactivity, and promotes integration of a more stable and grounded sense of self.

​This worksheet is part of a comprehensive Borderline Personality Disorder treatment hub that includes assessment tools, symptom trackers, and DBT-based interventions.

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Parts Therapy Worksheet for Borderline Personality Patterns

Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC-TMC, ASDCS, NATC, CCTP, CCTP II, ADHD-CCSP, C-DBT, C-PD

Double Board Certified Counseling Services, Inc.

Scoreable treatment worksheet with AI-style clinical summary

SEO Information

SEO Title: Parts Therapy Worksheet for Borderline Personality Disorder | Scoreable Clinical Tool

SEO Description: Scoreable parts therapy worksheet for Borderline Personality Disorder patterns. Includes parts mapping, severity ratings, AI-style summary, and printable PDF format.

Parts Therapy for Borderline Personality Patterns

This parts therapy worksheet helps clients and clinicians map internal parts that may become activated during emotional threat, abandonment fears, shame, conflict, trauma reminders, or relationship instability. It supports compassionate self-understanding, emotional regulation, and integration by identifying protective parts, vulnerable parts, critical parts, avoidant parts, and the grounded healthy adult self.

Clinical use note: This worksheet is a clinical support tool for treatment planning, insight-building, skill selection, and progress monitoring. It does not replace diagnosis, risk assessment, crisis planning, medical care, or clinical judgment.

Client / Session Information

Client Name

Date

Primary clinical focus Select oneEmotional dysregulationRelationship instabilityTrauma-related responsesIdentity disturbance / self-conceptAttachment insecurityShame and self-criticismAvoidance and detachmentImpulsivity / maladaptive copingChronic emptiness or disconnection

Treatment phase Assessment and formulationStabilization and skillsPattern recognitionCorrective emotional experienceIntegration and relapse prevention

Presenting problem

Parts Activation Ratings

Rate each item: 0 = none, 1 = mild, 2 = moderate, 3 = high, 4 = severe.

1. Protective part becomes activated during emotional threat

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

2. Wounded / vulnerable part carries shame, fear, grief, or abandonment pain

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

3. Critical part attacks, judges, or shames the self

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

4. Angry part escalates to protect against hurt or rejection

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

5. Avoidant part shuts down, detaches, distracts, or withdraws

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

6. People-pleasing part overfunctions to prevent rejection

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

7. Impulsive part seeks immediate relief from distress

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

8. Numb / dissociated part disconnects from emotion or body cues

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

9. Fearful part anticipates danger, betrayal, or abandonment

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

10. Healthy adult / grounded self is difficult to access under stress

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

11. Parts conflict creates confusion, guilt, or rapid emotional shifts

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

12. Client can identify part needs and respond with compassion

0
None 1
Mild 2
Moderate 3
High 4
Severe

Clinical examples / notes

Treatment Interventions Selected

Psychoeducation and formulation Emotion regulation skill building Behavior chain / pattern analysis Mindfulness and grounding Imagery / chair-work Compassionate self-talk Boundary / interpersonal effectiveness Corrective emotional experience Trauma-informed stabilization Relapse prevention / trigger plan

Clinical Formulation and Homework

Core pattern or working formulation Protective factors / strengths Homework / practice plan

Score + AI-Style Clinical Summary

Score + Generate Summary Download / Print as PDF

Your score and AI-style clinical summary will appear here.