Thursday, May 7, 2009

Borderline Personality Disorder

You know, I’d never really understood the hype about Borderline Personality Disorder; I kind of thought of it as an over diagnosed phenomenon with a huge stigma attached to it. 

I’m starting to get it. 

I have a client with a diagnosis of BPD.  I have one more who meets at least as many criteria.  And they really are hard clients to deal with.  If it wasn’t for the fact that we have a good supervisor, I think this client could have caused a huge stir around here very quickly with a couple accusatory emails she fired off yesterday and today.  Thankfully our supervisor realizes that we actually are doing what we’re suppose to do and has not sided with the client.  Because the staff involved have a good working relationship she has not been able to turn us against each other.  It’s a good thing.

All that being said, I still think it’s an overdosed phenomenon with a huge stigma attached to it. 

Currently, our staff is doing all the right things, and I hope that the client, and us, will be able to learn something from it.  Because we work as a team, we’ve decided to be consistent in the way we approach her and deal with her.  This virtually eliminates her success in playing us against each other.  Further, we had a community meeting with all her service providers (and her mother), and came up with a plan.  We’re sticking with the plan and trying to reinforce it with her.  This means redirecting accusations of “you’re not doing anything for me” to “did you get on the list for this class”? 

It also means ignoring some of her more exasturbating emails and reminding her to come in for her appointments.  This reinforces our team’s boundaries, because from what I’ve read, and what I’m observing, boundaries are going to be everything.  Fighting with her, is obviously unprofessional, but more over, it’s not going to work.  Accusing her of things is not going to help her or us in any way, shape, or form. 

1 comment:

David G. Markham said...

You got it.

I am glad you are coming to appreciate the challenges of BPD. The best book I have read is The Borderline Mother. I have a number of posts on this on my blog.

I am very glad you have good supervision and you are working as a team.

All the best,

David Markham