When Your Loved One Has Borderline Personality Disorder
Treating a patient with borderline personality disorder is fraught with peril. Relationship management offers a way to understand the problem and to handle it. Relation- can lead to increasingly restrictive in- management therapy program . Dawson DF: Treatment of the borderline patient, relationship management. Relationship Management Of The Borderline Patient. From Understanding To Treatment. David L Dawson & Harriet L. MacMillan. View More.
How should I structure the home environment? People with BPD benefit from a home environment that is calm and relaxed. All involved family members including a boyfriend or girlfriend should know not to discuss important issues when the individual is in crisis mode. Stop to take a breath yourself when they do become emotionally reactive. People with BPD should have opportunities to talk about their interests and thoughts about the news, family events, and other leisure activities. Take the time to laugh at a funny joke or eat dinner together several times a week.
The less an individual feels like his or her mental illness is under the spotlight, the more opportunity they have to explore other aspects of themselves. How can I communicate effectively during a crisis? When a loved one becomes reactive, they may become to insult you or make unfair accusations.
The natural response is to become defensive and to match the level of reactivity. They struggle to gauge what is a minor issue and what is a full blown catastrophe. They interpret your defensiveness as not being valued. Instead, when they become reactive, take the time to listen without pointing out the flaws in their argument.
Try not to take it personally. If the person does point out something you could improve or have done wrong, acknowledge their point, apologize, and suggest a way you can improve on the matter in the future. What if they threaten to hurt themselves? A crisis is escalating if a person with BPD begins to threaten to harm themselves. Sometimes self-harm signs may be less overt, such as scratching the skin, eating less, coloring or shaving off hair, or isolating from others.
Relationship management therapy for patients with borderline personality disorder
Recognizing early signs can help prevent an emotional crisis from becoming more serious or requiring medical or psychiatric attention. Instead, you invite the individual to talk about their emotions and allow yourself to gauge whether professional assistance is necessary.
However, when any Axis II disorder is present, the treatment of coexisting depression is much less likely to be successful 4. Avoiding the diagnosis of BPD has not made the clinical problem go away.
We can call patients by a different name but still be in a quandary about what to do with them. BPD patients continue to present in emergency rooms and clinics suffering from overdoses and self-mutilation 5 and are frequently admitted to hospital 6. These are difficult cases for psychotherapy 7,8and they are also a challenge for psychopharmacological treatment 9.
Treatment of the borderline patient, relationship management.
Nevertheless, none of these observations need lead to undue pessimism. Psychiatrists treat many chronic patients with difficult clinical problems and do not expect quick and easy results. The prognosis for BPD is much better than that for most other personality disorders, including the antisocial type 10 and cluster A and cluster C disorders 11 ; it is also better than the prognosis for schizophrenia or BD Because of the shortage of References would be expected to decrease while psychiatric beds 7this finding has 1.
Factors associated with high use of public mental health services by persons with bor- py. However, this study reports the It is possible that the patients who derline personality disorder.
Relationship Management Of The Borderline Patient : David L. Dawson :
Psychiatric findings of the first implementation were discharged from the hospital for Services Is hospitalization useful for suicidal in a psychiatric hospital setting, and to discharge themselves from the hos- patients with borderline personality disor- it is important to know whether this pital remained disturbed in the com- der?
Journal of Personality Disorder Thus the financial savings settings. This study indicates that it from reduced hospitalization and 3. Treatment of the borderline patient, relationship management. Canadi- is possible to essentially stop using constant nursing observation may an Journal of Psychiatry Dialectical be- tients with borderline personality police or community mental health havior therapy for borderline personality disorder.
This more permissive ap- agencies. Although no malpractice disorder: Acta Psychiatrica Scandinavica suppl: In- threat of a lawsuit related to discharg- deed, the opposite was true; over the ing a disturbed patient may be a cost- 5.
Relationship Management of the Borderline Patient: New rious episodes of self-harm or com- ship management therapy. Our findings must be viewed as a 6. Munroe Blum H, Marziali E: A controlled Although not the primary goal of naturalistic pilot study.
The sample trial of short-term group treatment for bor- relationship management therapy, was small, and the study was not a derline personality disorder.
Journal of Per- sonality Disorders 9: Further- sociated with significant fiscal sav- more, a number of patients who were 7. Sealy P, Whitehead PC: Forty years of de- institutionalization of psychiatric services in ings.