When Your Loved One Has Borderline Personality Disorder
The second of the more extreme personality disorders and one that has received considerable attention recently is the borderline personality. It is not very aptly named because it suggests that someone has a personality that is only acceptable in a borderline way. However, the borderline is between neurotic traits (extreme anxiety, emotional instability) and psychotic tendencies (as in schizophrenia). At even more extreme moments, persons with the borderline personality disorder may engage in self-mutilation (usually cutting themselves). They also occasionally suffer psychotic withdrawals from reality in which they lose all sense of time and place. Because of the extremes to which 'borderline' cases swing, they also tend to be diagnosed with other disorders such as depression, generalised anxiety, agoraphobia, and so on. Whereas the anti-social personality disorder is more common in men, the borderline disorder is more common in women. Borderline personality disorder is not well...
Eventually, even though the nurses who had to deal with Emily became sick of her, they managed to track down some medical records for her. They found that she had had a long history of appearing at various hospitals, seeking admission and treatment for a very wide range of problems. Although all of the patient notes were written in a relatively guarded way, it was obvious that Emily always treated people in this unpredictable way. Her history also showed a similar pattern with her family members and friends. Emily was suffering with a borderline personality disorder and so leading all of those who tried to help her to despair. In the end, she was very difficult to help or even to feel any sympathy for.
The third type are dysphoric or have borderline personality disorders. This group is depressed, psychologically distressed, and emotionally volatile. They engage in moderate to severe levels of psychological and sexual abuse, as well as physical violence toward their partners. They are likely to be dependent on the woman and suspicious of her activities and motives. Intense jealousy characterizes these men. Approximately one-fourth of those who enter treatment are personality-disordered batterers.
Since the 1970s there has been an increased interest in narcissistic and borderline character disturbances. Heinz Kohut's psychology of the self in the understanding of narcissism and Otto Kernberg's application of psychoanalytic object relations theory to the development of psychoanalytic techniques in the treatment of borderline patients gained center stage. Their observations have profoundly influenced notions of the nature and kind of transference manifestations that appear in treatment.
Consider, for example, the personality disorder diagnostic categories. There is currently a considerable amount of clinical literature concerning the treatment of each diagnostic category (e.g., Beck, Freeman, and Davis, 2003 Benjamin, 2002). The APA (2001) has even published an authoritative guideline for the treatment of borderline personality disorder. It is the concern of many clinicians that much of this experience and wisdom will be lost if the diagnostic manual shifted to a dimensional model of classification. This concern, however, is addressed in a number of ways. First, many of the alternative dimensional models of personality disorder concern dimensions that are currently the explicit focus of treatment and treatment outcome research (e.g., dimensions of emotional dysregulation, self-harm, social avoidance, workaholism, and impulsivity). It would require very little, if any, additional training to have clinicians focus their clinical attention on these maladaptive...
Lepromatous patients are treated with dapsone for a minimum of 2 years. Tuberculoid and borderline patients are treated with dapsone and rifampin for 6 months. Cases of treatment-induced reactions require quick diagnosis and treatment with high-dose steroids until the reaction subsides. Attention must be given to areas of the body that have lost sensation.
American Psychiatric Association. (2001). Practice guidelines for the treatment of patients with borderline personality disorder. Washington, DC Author. Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York Guilford. Trull, T. J., Widiger, T. A., Lynam, D. R., & Costa, P. T. (2003). Borderline personality disorder from the perspective of general personality functioning. Journal of Abnormal Psychology, 112, 193-202.
Further, 21 patients with psychosis were significantly discriminated from 25 patients with borderline disorders on the WAIS V-P discrepancy, with the former group showing a more depressed Performance IQ (Hymowitz, Hunt, Carr, Hurt, & Spear, 1983). Finally, Gruzelier and Hammond (1976) did not report mean Verbal and Performance IQs for their sample, opting to present only age-corrected scaled scores for the separate subtests the means for the 6 Verbal subtests (7.4) and 5 Performance subtests (7.9), estimated from a bar graph of the 11 scaled scores, were not strikingly different.
To describe someone as abnormal depends on the circumstances. What is abnormal in one culture or at one time might not be abnormal in the next culture or a few years later. One way of looking at abnormality is statistically. This equates the abnormal with the rare. At first sight this might seem reasonable. In Western culture, the two types of reaction described at the start of this chapter are relatively rare. Fortunately, either for themselves or for those around them, not many people suffer from paranoia or from borderline personality disorder. But, there again, even fewer people win a Nobel Prize or run a 4-minute mile. This is even more abnormal, but such achievements do not have anything negative about them.
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