Presenting Symptoms and Diagnostic Tests BPD is defined by the presence of at least five of eight behavioral symptoms. These are unstable interpersonal relationships, behavioral impulsivity, affective instability, inappropriate anger, self-mutilating acts, identity disturbance, chronic feelings of emptiness, and fear of abandonment (McGirr, Paris, Lesage, & Renaud, 2009)
In support of these findings mental health clinicians frequently report the co-existence of childhood trauma and BPD among patients in the clinical setting. The inter-relationships of genetics, parental psychopathology/family dysfunction, and repetitive abuse in childhood appear to be the major contributory variables to BPD (Sansone & Sansone, 2007)
While the therapist's response may be one related to self-protection in dealing with the BPD patient, the response is one that may be expected when relating to the person with Borderline Personality Disorder who is unusually sensitive to criticism and rejection. Therefore the consequence of such a therapist/BPD patient relationship perpetuates the cycle of mental illness, as the BPD patient does not receive the treatment that they need and instead receive treatment that reinforces their mental illness due to the stigmatization given to them by their therapist (Avirim, Brodsky, & Stanley, 2006)
Mentalization Mentalization is a form of psychodynamic psychotherapy with an aim of revealing the underlying psychic tensions of Borderline Personality Disorder. It was developed especially for BPD patients, with a theory that BPD patients have not developed a normal Mentalization framework for attachment relationships (Bateman & Fonagy, 2008)
Mentalization Mentalization is a form of psychodynamic psychotherapy with an aim of revealing the underlying psychic tensions of Borderline Personality Disorder. It was developed especially for BPD patients, with a theory that BPD patients have not developed a normal Mentalization framework for attachment relationships (Bateman & Fonagy, 2008)
Mentalization Mentalization is a form of psychodynamic psychotherapy with an aim of revealing the underlying psychic tensions of Borderline Personality Disorder. It was developed especially for BPD patients, with a theory that BPD patients have not developed a normal Mentalization framework for attachment relationships (Bateman & Fonagy, 2008)
Mentalization Mentalization is a form of psychodynamic psychotherapy with an aim of revealing the underlying psychic tensions of Borderline Personality Disorder. It was developed especially for BPD patients, with a theory that BPD patients have not developed a normal Mentalization framework for attachment relationships (Bateman & Fonagy, 2008)
A scale was developed specifically for this program, called BEST (Borderline Evaluation of Severity over Time), which measures how/if the BPD patient improves over time in therapy. There is strong group component to the program, which includes family members as well (Blum, Pfohl, John, Monahan, & Black, 2002)
Approximately 50% are clinically depressed, and 25% are classified with Post Traumatic Stress Disorder as well (BPD Today, 2010). Sexual abuse as a child is strongly associated with development of BPD, and some studies suggest between 40%-70% of those with BPD have been sexually abused (Bohus, Priebe, Dyer, & Steil, 2009)
(2009) state that results from longitudinal twin studies supports a causal link for genetics and environment in BPD, with an overall decline of BPD characteristics with advancing age. This last factor also supports the role of genetics being influenced by the environment in BPD, as greater stability in work, social, and personal relationships tends to be increase in the fourth decade of life and beyond (Bornovalova, Hicks, Iacono, & McGue, 2009)
It was developed especially for BPD patients, with a theory that BPD patients have not developed a normal Mentalization framework for attachment relationships (Bateman & Fonagy, 2008). Mentalization refers to the ability to understand oneself and others based on obvious behaviors; Mentalization is also seen as a form of mental activity that allows one to recognize behaviors based on internal mental states (Busch, 2008)
Regarding ethics in social work and therapeutic treatment, Canda (1998) talks about the need to incorporate a theme of spirituality into therapeutic treatment objectives. These include concepts of well being, mutual benefit, self-determination, a holistic view of the individual, and spiritual sensitivity (Canda, 1998)
He states that prevention measures should be targeted at identifying those in early childhood who are indicated for developing a personality disorder. Coid notes that BPD is the most commonly seen personality disorder for outpatient treatment, and that new policies must be developed to address prevention in childhood rather than crisis in adulthood (Coid, 2003)
In this model, therapists need to move themselves out of the role of adversary in the patient's view, which seeing others as adversaries, especially therapists, has been a chronic problem for those with BPD. The therapists recognize during DBT that the borderline patient requires a great deal of validation, while having the patient accept that criticism is not an attack and to accept responsibility for treatment (Dimeff, Linehan, & Koerner, 2007)
Distel et al. (2009) report that 35-45% of the variance in BPD can be explained by genetic factors, though the study did not find much evidence of the cultural transmission of the disorder from parent to offspring, suggesting a strong role for genetics (Distel, et al
Children use these safe figures as bases from which to explore from, and to which they can safely return to. Without this adult figure present, problems in attachment can occur, leading to wrong development of the child's psyche (Fonagy, 2001 )
The lifetime prevalence of those diagnosed with BPD in the general population is approximately 5.9% according to a recent study (Grant, et al
As chronic sufferers of BPD are often victims of abuse themselves, the pain associated with the early trauma may turn into a perpetuating cycle of repeated suffering as they struggle to cope with their disorder. As one doctor notes, there are nine potential symptoms of the disorder, and over 200 potential presentations; the possibility that the disorder may be misunderstood by society and by therapists is high (Hoffmann, 2007)
Karterud and Urn (2004) report that for those people undergoing day treatment programs of short duration and high intensity, that Mentalization processes work well in the group setting. Components included in the group therapy setting were art group therapy, cognitive group therapy, problem-solving group therapy, and both large and small group therapy (Karterfud & Urnes, 2004)
Koons (2008) reports on the success of DBT in reducing suicide rates and hospitalizations among women diagnosed with Borderline Personality Disorder. Koon describes aspects of DBT that the therapist can begin to use in the clinical setting such as structure and focus' of treatment (Koon, 2008)