"Knowing the proper diagnosisis is the first step to treatment. Some therapists are reluctant to inform the patient or family of the diagnosis of BPD. Yet growth cannot occur without understanding. Patients wih BPD have a right to the truth just as much as patients who suffer from other incurable, life-threatening conditions, especially since over 10 percent of individuals with BPD commit suicide. Just as the diabetic must learn to manage sugar intake and output, the individual with BPD must learn to manage emotional input and output. Psychotherapy, combined with antianxiety and antidepressant medications, can significantly enhance the borderline's quality of life." p.51
The diagnosis of Borderline Personality Disorder is one of the most controversial in the field of psychiatry. Many mental health professionals avoid, and prefer not to work, with people diagnosed with Borderline Personality Disorder because of the dramatic presentations, sometimes seemingly ongoing drama and crises, the emotional lability, and the "spitting", that is the idealization and the demonization of the same person in often instantaneous flips, and the playing of one person off another.
The borderlines ability to "split" staff on inpatient psychiatric units and in community residences is legendary. In my experience, working with people with borderline disorder on an outpatient basis is very difficult if they require inpatient hospitalization unless staff have the time and are willing to make the effort to coordinate the care and treatment. When one client of mine was hospitalized for depression and suicidal ideas, the client assumed the role that Dr. Lawson describes as the Waif and plaintiffully asked me what was wrong with her. When I responded that she may have Borderline Personality Disorder and brought some information, the inpatient psychiatrist was irrate with me saying that the patient was not in any condition to understand the information and recommended that the patient's care be transferred to another therapist upon her discharge. Over the next few years the patient's condition continued to deteriorate with more hospitalizations, and I continue to wonder if things could have stabilized and maybe even improved, if she had been given and helped to process the information.
This is post # 13 in a series based on Dr. Christine Lawson's book, Understanding The Borderline Mother.