Can Negative Attitudes toward Patients with Borderline Personality Disorder Be Changed?
In a recent study Registered Mental Health Nurses (RMNs) expressed less social rejection towards patients with a diagnosis of schizophrenia and perceived them to be less dangerous than patients with a BPD label. Staff were least optimistic about patients with a BPD diagnosis and were more negative about their experience of working with this group compared to any other patient groups.
It is only fair to say that many nurses and clinicians express a desire to gain knowledge and explore ways of working effectively with BPD clients yet often are left feeling powerless to help. It is also of concern to the profession that one of the problems confronting people with BPD is the negative attitudes of those staff that care for them.
I once asked a nurse if he enjoyed his holiday only to be told that he did not answer personal questions coming from people with “my diagnosis”
There is no doubt that further research is necessary to identify appropriate service frameworks and clinical interventions that assist in more effective clinical management of clients of BPD. It is so very important that the Borderline and the key worker develop a rapport and trust and that a firm foundation in which both parties feel valued.
Using a treatment contract
Personally, I found a treatment contract of great use. It made me feel safe and was a reassuring indicator of what I could and could not expect from my therapist.
‘A treatment contract involves formalising the usually implicit agreement which exists between patient and doctor in a straightforward clinical transaction. If it is established early, before basic mistrust and prior insecure or disorganised attachment patterns are reinforced by the current relationship and interaction, it can serve to anchor an agreement to achieve relevant goals by minimising the influence of destructive or distracting personality ‘clashes’ between patient and doctor’
This last passage is a quote from a book written by my psychotherapist. I was lucky enough to have the best which is possibly why I am alive today. I am so very grateful to the man and although one of his favourite lines was
“I am not your father!”
And I am in no doubt of our proper relationship, I absolutely adore him!
borderline personality disorder 