We have seen from other articles I have published on this site that if we suffered significant and protracted childhood trauma we are, as adults, at increased risk of developing borderline personality disorder (BPD).
Many specialists in the field are of the view that of all psychiatric conditions, BPD causes its sufferers the greatest amount of mental pain and anguish – indeed, this is borne out by the generally accepted statistic that approximately 1 in 10 BPD sufferers will eventually kill themselves.
It is particularly tragic, therefore, that it seems that there still exists a great deal of prejudice towards BPD sufferers. And I don’t just mean amongst lay-people who lack understanding of, and education about, the condition, but also amongst those who should know better: namely those who work within the medical profession itself and are responsible for their care and safety.
This unfortunate state of affairs is exacerbated further when one considers that many BPD sufferers have been demonized throughout their lives (including, often, by one or both of their parents) and have come to internalize such demonization, seeing themselves as intrinsically and irredeemably bad’ ; so to meet with similar disparaging attitudes amongst those to whom one turns, often in absolute desperation, for support can be devastating and can potentially tip BPD sufferers over the precipice (most BPD sufferers are perpetually living their lives on the edge of said precipice most, or all, of the time).
RESEARCH PROVIDING EVIDENCE OF STIGMATIZATION OF BPD SUFFERERS WITHIN THE MEDICAL PROFESSION :
STUDY 1 :
Researchers (Black et al.) surveyed 706 clinicians who were responsible for treating BPD patients and found that a large minority expressed a preference not to work with such patients.
STUDY 2 :
An Italian study (Lanfredi et al.) investigated caring attitudes towards BPD sufferers amongst 860 mental health professionals (these included social workers, educators working in social health, nurses, psychiatrists and psychologists). It was found that :
- nurses and social workers scored significantly lower on caring attitudes towards BPD sufferers than psychologists, psychiatrists and social health educators.
- those mental health professionals who had more years experience in mental health and those who had had training in working with BPD patients, overall, scored higher in terms of their caring attitudes towards BPD sufferers compared to those with fewer years of experience / no training in working with BPD sufferers.
The researchers who conducted the above study concluded that training in working with BPD sufferers should be targeted at those clinicians who are less experienced and professional groups for whom such training is less accessible.
STUDY 3 :
A study carried out by Imbeau et al., looked at the attitude of General Physicians and Family Medicine Residents towards patients with a BPD diagnosis.
In total, the study involved 35 General Physicians and 40 Family Medicine Residents. Their attitudes towards their BPD patients was measured using the ATTITUDES TOWARD PEOPLE WITH BPD SCALE (ABPDS; Bouchard, 2001).
This scale is divided into 2 subcategories:
SUBSCALE ONE: COMFORT WHEN INTERACTING WITH SOMEONE WHO HAS BPD.
SUBSCALE TWO: POSITIVE PERCEPTIONS ABOUT BPD.
It was found that the attitudes of General Physicians towards people with BPD were similar to the attitudes of mental health professionals towards people with BPD.
However, it was also found that Family Medicine Residents’ attitudes towards people with BPD were less positive than the attitudes displayed by General Physicians and mental health professionals.
Furthermore, and reinforcing the findings of Lanfredi et al’s study, it was found that less experienced clinicians had less positive attitudes towards BPD sufferers than their more experienced colleagues.
This also serves to emphasize the conclusion drawn from Lanfredi et al’s study, namely that training of clinicians dealing with people with BPD needs to be a key focus to help ensure these highly vulnerable and anguished patients receive the treatment they deserve.
STUDY 4 :
A Spanish study (Castell) also found negative attitudes within the medical profession and, like the studies cited above, also stressed the importance of training such mental health professionals so that they gain a better understanding of the causes of, nature of, and treatment for borderline personality disorder.
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David Hosier BSc Hons; MSc; PGDE(FAHE).