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Posted: January 18th, 2023
Borderline Personality Disorder (BPD)
• Review this week’s Learning Resources and consider the insights they provide on assessing, diagnosing, and treating personality and paraphilic disorders.
• Select a specific personality or paraphilic disorder from the DSM-5-TR to use for this Assignment.
• Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.
In 2–3 pages:
• Explain the controversy that surrounds your selected disorder.
• Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
• Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
• Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.
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Borderline Personality Disorder (BPD) as described in the DSM-5. BPD is a complex and controversial disorder characterized by a pervasive pattern of instability in mood, interpersonal relationships, self-image, and behavior.
One of the main controversies surrounding BPD is the high rate of misdiagnosis and stigma associated with the disorder. Many professionals view BPD as a "wastebasket diagnosis" that is overused and applied to patients who do not actually have the disorder. Additionally, BPD is often viewed as a "personality disorder" rather than a "mental illness," which contributes to the stigmatization of individuals who are diagnosed with it.
In my professional belief, Borderline Personality Disorder is a complex and multifaceted disorder that requires a comprehensive and holistic approach to treatment. It's important to recognize that individuals with BPD often have a history of trauma and neglect, which may contribute to the development of the disorder. It's also important to understand that BPD is not a static disorder and that individuals with BPD can make significant improvements with proper treatment.
In order to maintain a therapeutic relationship with a patient presenting with BPD, it's important to establish trust and a sense of safety within the therapeutic relationship. This can be achieved by being consistent and predictable in the therapeutic relationship, and by providing the patient with clear boundaries and limits. Additionally, it's important to validate the patient's feelings and experiences and to avoid being judgmental or dismissive.
In terms of ethical and legal considerations, it's important to be aware of the potential for self-harm and suicidal behavior in individuals with BPD. This may require taking additional steps to ensure the patient's safety, such as implementing a no-harm contract or involving other mental health professionals in the patient's care. Additionally, it's important to be aware of the potential for boundary violations in the therapeutic relationship, as individuals with BPD may be particularly vulnerable to manipulation and exploitation.
References:
Gunderson, J. G., & Lyons-Ruth, K. (2008). BPD's relational spiral: Role of attachment and borderline states of mind. Journal of Psychiatric Practice, 14(1), 36-46.
Gabbard, G. O. (2014). Long-term psychoanalytic treatment of patients with borderline personality disorder. American Journal of Psychiatry, 171(1), 9-14.
Bateman, A., & Fonagy, P. (2004). Treatment of borderline personality disorder with psychoanalytically oriented partial hospitalization: An 18-month follow-up. American Journal of Psychiatry, 161(2), 367-373.
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