When Your Loved One Has Borderline Personality Disorder
Sometimes trauma, particularly repeated trauma, is considered to lead to long-term alterations in personality development, structure, and functioning. Some professionals postulate that personality disorders can develop. Some have proposed the concept of the posttraumatic personality to characterize these more pervasive and integrated forms of posttraumatic reactions. Allen (2001) cites that research has revealed a global relationship between trauma and personality disorders. He states that patients with a diagnosis of Personality Disorder are more likely to report a history of childhood physical abuse, sexual abuse, or both. Borderline Personality Disorder (BPD) is the most common disorder found. He states, Those with BPD were more likely to have experienced multiple abuses by multiple perpetrators and to have been abused by both parents. Sexual abuse, verbal abuse, physical abuse, and being adopted all contributed independently to the likelihood of a BPD diagnosis.
The personality disorders (American Psychiatric Association, 1994) are defined as an enduring pattern of inner experience and behaviour that is pervasive across a wide range of personal and social situations and deviate markedly from the expectations of the individual's culture. The personality disorders that are most frequently encountered in dermatology include Borderline, Narcissistic and Histrionic personality disorders which all fall in the 'Cluster B' (American Psychiatric Association, 1994) category in the DSM-IV and Obsessive-compulsive personality disorder (which is categorised in 'Cluster C'). Borderline personality disorder is associated with a pattern of instability in interpersonal relationships, affects and self-image, and impulsive behaviours. Such patients are often 'difficult' as their instability in interpersonal relationships and self-image are also manifested in their relationship with their dermatologists and other health care providers. Such patients often try to...
These patients are also impulsive and manipulative, but they are more emotionally unstable and they are less aggressive. The manipulativeness of borderline patients is aimed at getting emotional gratification rather than aimed at financial or power motivations.
Borderline Personality Disorder Borderline patients react with rage and emptiness when feeling abandoned. Dependent patients react with more submissive behavior when feeling abandoned. Self-destructive behavior and unstable relationships are unique to Borderline patients.
Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York Guilford Press, 1993. The author provides an overview of the symptoms of borderline personality disorder followed by an extensive description of an exploration of the foundations of dialectical behavioral therapy. Specific treatment strategies are clearly described, and the book contains several helpful charts and checklists.
Marsha Linehan first developed dialectical behavior therapy (DBT) for Borderline Personality Disorder. Since then it has been developed for use with other disorders. However, its use with Borderline Personality Disorder may have, in fact, lent itself directly to a PTSD application, as some professionals believe that Borderline Personality Disorder is a form of complex PTSD in and of itself. Melia and Wagner (2000) state that DBT is a form of cognitive-behavioral therapy but different in two additional underlying, guiding theories (1) the biosocial theory of emotional dys-regulation and (2) the theory of dialectics and its inclusion of Eastern philosophy and mindfulness practices. Dialectical behavioral therapy is suggested as one possible approach to those patients who have difficulty engaging in the more common therapies and whose lives are characterized by instability, chronic crises, and living difficulties. Dialectical behavioral therapy may be particularly well suited for these...
Hallucinations can be visual (e.g., seeing a dead person), auditory (e.g., hearing a baby crying), gustatory (e.g., tasting something bad), tactile (e.g., feeling worms under one's skin), olfactory (e.g., smelling rotting flesh), or somatic (e.g., feeling electricity in one's body). Lindley, Carlson, and Sheikh (2000) report that 30 to 40 percent of combat veterans with PTSD report auditory or visual hallucinations or delusions. These occur in the absence of an identifiable Psychotic Disorder or Mood Disorder with psychotic symptoms. They are often considered linked to more severe cases of PTSD, and symptoms include increased levels of paranoia, violent thoughts, and higher depression. They are typically nonbizarre and related to the trauma. Auditory hallucinations may involve hearing a voice of a dead enemy calling to them or even hearing their name called. Delusions can also be trauma related or nontrauma related, such as believing someone is attempting to poison them. In addition...
Borderline personality disorder can be associated with anhedonia, poor concentration, past history of emotional trauma and dissociative states similar to flashbacks. Other features of BPD such as avoidance of abandonment, identity disturbance, and impulsivity will distinguish BPD from PTSD.
Theory of mind has a developmental trajectory. A baby as young as 9 months old will point to an object when it intends for mother to look at it, and will look where mother points, because the baby recognizes what its mother intends 59 . When very young children read another's mind it is very egocentric 55, 56 . If a child wants to go out for a walk, when you put on your tennis shoes, the child will assume you want to go out for a walk. Not until the child is about 5-6 years old do they recognize that others may have mental agendas that differ from their own. All forms of psychoanalytic therapy rest on the maturation of this capacity. Some individuals completely lack theory of mind ability, most notably people who suffer from autism or Asperger's syndrome. It is proposed that patients with borderline personality disorder have impairments of theory of mind, which underlie their difficulty in affect regulation and in interpersonal relationships 60 .
The transplant psychiatrist evaluates for any psychiatric disorders that may interfere with the transplant. He or she should also screen for self-destructive behaviors, compliance with medical treatment and the transplant workup itself, and any personality traits or disorders that may prove to be maladaptive. Psychotic disorders may make the patient unacceptable for a transplant if he or she becomes paranoid and noncompliant. However, a diagnosis of schizophrenia alone should not be an absolute contraindication to transplantation if the patient has a history of compliance with medication and is stable both psychiatrically and socially. Recurrent depressive disorders with multiple suicide attempts or failure to take care of one's needs would also be considered a contraindication. Even severe conditions such as borderline personality disorder could interfere with the ability of a patient to comply with the transplant protocol. Rapid shifts in mood, inability to sustain a positive...
This supposed gender bias is theorized to be related to the greater prevalence of borderline personality disorder and histrionic personality disorder among women compared to men. Perhaps some of the diagnostic symptoms of this disorder, such as emotionality or fears of abandonment, have been behaviors more often associated with the female population than the male population.
Traumatization of women, such as borderline personality disorder and dissociative disorders. Before that, the trauma model had been practically abandoned in psychiatry since Freud 25 launched his forbidden fantasy hypothesis as an alternative explanation for the observed relation between mental disorders and reported sexual abuse. Several cultural developments in the field of sex roles have helped place sexual trauma as a potential pathogenic factor back on the research agenda.
The personality disorders of cluster B are borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, and histrionic personality disorder. The cluster B personality disorders are described as dramatic, erratic, and emotional. The behavior of people with such a disorder creates significant impairment in establishing and maintaining interpersonal relationships. Borderline personality disorder (BPD) is the most prevalent personality disorder. It is diagnosed twice as often among women as men and is characterized by a long-standing and inflexible pattern of emotional instability and unstable personal relationships. Individuals with BPD have an intense fear of abandonment and tend to form intense and unstable relationships with others. They tend to fluctuate between having posi
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