Category Archives: Bpd

Childhood trauma and BPD.

Odd, Quasi-Psychotic And True Psychotic Thinking In BPD Sufferers

A study conducted by Zachirini et al. (2013) investigated the prevalence of disturbed thought in 290 in-patients who had been diagnosed with BPD (borderline personality disorder). The quality of disordered thinking measured in these 290 BPD in-patients was compared to the quality of disordered thinking measured in 72 non-BPD in-  patients who had another (i.e. different) Axis II disorder (BPD is an Axis ii disorder, but the category includes several other personality disorders including paranoid, schizoid, schizotypal, antisocial, histrionic or narcissistic personality disorder).

The types of disordered thought of interest to the researchers in this total of 362 in-patients were divided into three main categories which were as follows :

1) NON-PSYCHOTIC THOUGHT:

This category was broken down into:

  • odd thinking
  • atypical perceptual experiences
  • paranoid thoughts (of a type that fell below the threshold to be considered delusional)

2) QUASI-PSYCHOTIC THOUGHT: delusions and hallucinations that related only to limited aspects of perception/thought, were ephemeral (i.e. of short duration limited to hours or days) and ‘non-bizarre’ (i.e. involving situations which could theoretically and conceivably happen in real life such as fear of others conspiring  and plotting against one, fear that somebody is attempting to poison one or fear one is being covertly followed); such ‘non-bizarre’ delusions most frequently occur due to the BPD sufferer’s misinterpretation of their experiences/perceptions

3) TRUE PSYCHOTIC THOUGHT.

 

RESULTS OF THE STUDY:

It was found that the BPD in-patients had significantly more disordered thought in relation to all three of the above categories, i.e. (1) non-psychotic but odd, atypical and non-delusional paranoid thinking; (2) quasi-psychotic thinking and (3) true psychotic thinking than those non-BPD in-patients who had been diagnosed with other Axis II disorders (see above).

OTHER TYPES OF DISORDERED THINKING FOUND TO EXIST IN THE BPD IN-PATIENTS STUDIED:

The participants in the study were followed up over a sixteen-year period by the researchers and during this time 17 more specific types of thinking/perception problems were examined and it was found that the BPD sufferers, when compared to the individuals who had been diagnosed with other Axis II disorders, also had a significantly increased likelihood (over this sixteen-year period) of suffering from the following eleven of these 17 types of disordered thinking; I list these below:

  • overvalued ideas
  • recurrent illusions
  • undue suspiciousness (e.g. ‘everybody despises me’; ‘everybody wants to destroy me.’).
  • quasi-psychotic hallucinations
  • true-psychotic hallucinations
  • quasi-psychotic delusions
  • derealization
  • depersonalization
  • ideas of reference (e.g. ‘I’m a terrible person’; ‘I’m irreparably damaged, and my condition will never improve, no matter what.’)
  • paranoid ideation
  • magical thinking (the belief that one’s own desires, thoughts and wishes can directly influence the real world e.g. ‘putting a curse’ on somebody or putting pins into a voodoo doll).

However, there is better news: as time went on over the sixteen-year period of study, it was found that symptoms of the above types of disordered thought in BPD sufferers diminished (with the exception of true-psychotic hallucinations).

CONCLUSION:

The researchers concluded that the type and intensity of thought disorder in BPD sufferers could help to distinguish those suffering from the disorder from those suffering from other Axis ll personality disorders such as those mentioned above. It was also pointed out by the authors of the study that, whilst thought/perception disorder tends to diminish over time in those suffering from BPD, such thought disturbance (particularly in relation to non-psychotic thought disorder) can remain a residual problem.

THE VITAL IMPORTANCE OF REDUCING STRESS:

As alluded to above, full-blown psychotic thinking, if it does occur in BPD sufferers, tends to be ephemeral and transient, lasting no more than hours or days. Other research, as one would expect, suggests that if such disordered thinking does occur, in BPD patients, it is usually brought on by stress which provides yet another reason why it is imperative for those recovering from BPD (many do recover or go into remission with therapeutic help such as undergoing dialectical behaviour therapy) keep toxic stress levels down to an absolute minimum.

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David Hosier BSc Hons; MSc; PGDE(FAHE).

Research Into Children Of Mothers Suffering From Borderline Personalty Disorder.

 

 

 

Reviewing previous studies involving children between the ages of 4 years and 18 years, Macfie states that such children of BPD mothers are at increased risk of :

  • experiencing changes in household composition (e.g. due to divorce/BPD parent co-habiting with varying new partners/acquisition of step-parents/acquisition of step-siblings etc.).
  • experiencing excessive changes in school (e.g. due to constant relocations).
  • being removed from the home(e.g. due to being taken into care/being palmed off to relatives/being thrown out of home etc).
  • being exposed to living with a mother who is an alcoholic.
  • being exposed to living with a mother who is a drug addict.
  • being exposed to living with a mother who threatens/attempts/completes suicide.
  • suffering from problems relating to poor powers of concentration/attention, delinquency, inability to control anger/proneness to aggressive outbursts,  anxietydepressionlow self-esteem.

And, reviewing previous studies involving infants, Macfie states that such offspring of BPD mothers are at increased risk of :

  • having mothers who are intrusive and insensitive in their behaviour towards the infant.
  • reduced responsiveness towards the mother, including dazed looks and looking away from the mother.

And, perhaps most worryingly of all, Macfie cites research conducted by Hobson et al., 2005, suggesting that, at the age of 13 months, a staggering 80% of infants of borderline mothers have a disorganized attachment style in relation to their interactions with their mothers.

ROLE REVERSAL:

Macfie suggests that mothers suffering from BPD may use the child to satisfy their own needs (e.g. the need to feel loved) and discourage the infant’s instinct to develop autonomy. This, Macfie suggests, can eventually lead to a kind of role reversal (e.g. parentification /adultification) which, in turn, increases the child’s risk of developing difficulties controlling his/her emotions and behaviours.

REPRESENTATIONS OF SELF AND OTHERS :

Macfie also states that if the child has developed a disorganized attachment style due to frequently being frightened by the BPD mother and/or due to frequently witnessing the mother in a fearful and anxious state, s/he is likely to develop a negative representation of others which may include a marked tendency to view people in general as dangerous, threatening and incompetent, Such a child’s self-representation is also likely to be negative, including seeing himself/herself as unworthy of love and care ; such a negative self-view can then become self-perpetuating.

In short, the child of the BPD mother is in danger of developing a cognitive-negative-triad involving a negative view of the self and others, a negative view of the future and a negative view of the world in general (see SHATTERED ASSUMPTIONS THEORY) together with a set of most unhelpfully distorted core beliefs.

Out of these negative representations of self and others, Macfie reminds us that the individual who holds them may develop various severe problems which include:

INTERVENTIONS:

The author of the study suggests that for ‘at risk’ children (i.e. those who are emotionally vulnerable – due, for example, to temperament, emotional reactivity and impulsivity – and grow up in a stressful environment due to various factors including those referred to above) the following interventions may mitigate the danger of developing full-blown BPD:

 

 

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David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

 

 

Why Trauma Survivors May Find It Hard To Learn From Past Behaviour.

Many of us who have experienced severe and protracted childhood trauma, particularly if we have gone on to be diagnosed with conditions such as complex PTSD or BPD as a result, are frequently liable to ‘act out‘  unbearable inner pain (being unable to express it in healthy ways or even to understand its origin) in ways we later regret and feel ashamed of; indeed, such feelings of shame can be intense and devastating. [Related to this concept is the theory that anger, a frequent component of ‘acting out’, may sometimes operate to soothe emotional pain.]

However, despite such regret and shame, many, too, find themselves trapped in a perpetual cycle of repeating such self-defeating, ‘acting out’ behaviours, often at a very high cost to themselves and those who trigger their trauma-related feelings (e.g. feelings of rejection). In this way, the traumatized individual seems powerless to learn from experience and past mistakes, as if driven by unconscious psychological forces beyond their control (which, without effective therapy, may indeed be the case).

THE ROLE OF FAULTY MEMORY PROCESSING :

Such apparent helplessness to learn from experience is, however, much easier to understand when we consider how the severely traumatized individual’s memory processing abilities may have been negatively affected by his/her traumatic past.

To be more specific, trauma can impair brain and memory function in a variety of different ways, including adversely affecting the functionality of a part of the brain known as the hippocampus (indeed, research has shown that those who experience severe, long-lasting trauma in childhood can develop SHRUNKEN HIPPOCAMPI due to the chronic over-stimulation of the body’s stress hormones which have, in excess concentrations, a toxic effect upon the brain and other bodily organs)

Such impairment of brain and memory function, in turn, leads to DIFFICULTIES IN TRANSFERRING MEMORIES FROM SHORT-TERM STORAGE TO LONG-TERM STORAGE and, furthermore, interferes with the brain’s ability to process and make rational sense of information. Episodic memories (memories of past personal experiences that occurred at a particular time and place) may not be properly processed which prevents a corresponding semantic memory (a form of long-term memory essential for the use and understanding of concepts and language) from being formed, making it hard for the individual to use knowledge (which, in normal circumstances, would have been gleaned from the episodic memory and have made it available to be subjected to rational analysis)) to inform and beneficially adjust future behaviour.

DISSOCIATION:

Studies also show that memory function is impaired due to the tendency of traumatized individuals, especially those suffering from complex PTSD and BDP, to dissociate when ‘acting out’ as a result of a trauma-related feeling triggered.

Both of the above (i.e.impaired memory processing ability due to organic damage and dissociation) impact on learning ability which, in turn, then, help to explain why traumatized individuals find it hard to learn from experience, particularly in the context of interpersonal conflict that mirrors early-life traumatic experiences and results in dissociated, ‘acting-out’ type behaviour). Furthermore, such individuals may also suffer from depression which is itself known to impair learning, memory and cognitive processing abilities.

Impaired memory, learning and cognitive processing ability, of course, can also interfere with other crucial areas of life, such as academic and occupational performance.

THERAPY:

Therapies that reduce stress and increase emotional resilience can help people who have been affected in this way and there exists some evidence that antidepressants can increase hippocampal volume (N.B. Always consult an appropriately qualified expert before deciding whether or not to take antidepressants).

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma, The Hippocampus, Depression And Neurogenesis.

Childhood Trauma Can Harm Brain And Increase Risk Of Depression. However, The Good News Is The Brain Can Recover. This Article Explains How.

When we are at our most depressed, we may look at (as others perceive it) a beautiful sunset and derive no more pleasure from it than we would from looking at a rubbish dump or ugly building site. In short, nothing can lift our spirits and we feel unvaryingly, utterly desolate. It is as if the part of our brain that once experienced pleasure is now dead and unresponsive, never to be revived.

In fact, the latest research suggests that, indeed, a part of the brain, known as the hippocampus (a structure involved with long-term memory, the formation of new memories, and associating emotions with such memories), is impaired in function and reduced in volume in those suffering from severe, recurrent depression.

The good news, however, is that research also suggests that this brain region’s functioning is NOT irrevecocably impaired due to a specific type of brain neuroplasticity (the ability the brain has to repair and rewire itself) known as NEUROGENESIS (the brain’s ability to generate new neurons).

THE RESEARCH :

The research to which I refer has discovered that, in individuals who are severely depressed and suffer recurrent depressive episodes, the hippocampus has become significantly reduced in size. (We know, too, from numerous other articles that I have published on this site, that those who have suffered severe and chronic childhood trauma and, as a result, have gone on to develop conditions such as borderline personality disorder or complex posttraumatic stress disorder are also liable to have incurred developmental damage to this particular brain region ; and, indeed, sufferers of these conditions frequently also receive a co-morbid diagnosis of clinical depression).

The study involved 8,927 participants of whom 1,728 had received a diagnosis of major depression. This allowed the researchers to compare the brains of the depressed individuals with the brains of the healthy individuals using data that had been obtained using a brain scanning technique technique known as magnetic resonance imaging (MRI).

Of the depressed individuals, 65 per cent had recurrent depression and it was this subset of the depressed individuals who were found to have shrunken hippocampi (those participants who were experiencing their FIRST depressive episode had hippocampi which were of normal size).

IMPLICATIONS OF THE ABOVE FINDINGS :

As the researchers pointed out, these findings suggest that it is the depression which causes the damage to the hippocampus, rather than the other way around and this discovery helps to emphasize how important it is to commence treatment for depression at the earliest possible opportunity, especially in teenagers and young adults whose brains may be more susceptible to physical damage due to their greater plasticity when compared to the brains of adults, in order to prevent such organic damage to the brain from occurring.

Indeed, the researchers. underlining this point, drew attention to the fact that the longer depression goes on, and the more depressive episodes an individual suffers, the greater the reduction in size of that individual’s hippocampus is likely to be.

EFFECT OF DAMAGE DONE TO THE HIPPOCAMPUS :

There now exists an increasing body of evidence that one of the functions of the brain’s HIPPOCAMPUS may be the recognition of novelty and it has been theorized that, because, as we saw above, it may be damaged in depressed individuals, particularly those individuals who have suffered long-standing, recurrent depressive episodes, these people may lose the ability to respond to novelty and this loss then contributes significantly to their depressive state. For instance, it helps explain why they may not respond with pleasure to a beautiful sunset (see opening paragraph) and why they are prone to seeing whatever they do as ‘being the same’, by which is meant everything produces the same feelings of flatness, emptiness, meaninglessness ; in short, a state of anhedonia.

THE GOOD NEWS : EVIDENCE THAT THE DAMAGE INCURRED BY THE HIPPOCAMPUS IS REVERSIBLE :

The good news, however, as has already been alluded to above, is that numerous studies have demonstrated that such damage to the brain is, in fact, reversible ; this is due to a quality that the brain possesses known as neuroplasticity (which I have written extensively about in many other articles that I have already published on this site – e.g. see my article about three ways in which the brain is able to repair itself in relation to the damage it has sustained as a result of childhood trauma).

Indeed, one of the leading researchers involved in the study, Hickie, described how the hippocampus was one of the brain regions within which it is known that cells can rapidly generate new connections between themselves (this process is known as neurogenesis, see above) to replace the connections that were lost during the periods of untreated depression.

WHAT KINDS OF TREATMENT DO THE RESEARCHERS INVOLVED IN THE STUDY SUGGEST?

Hickie further states that there is some evidence that medication (antidepressants) protect, to some degree, the hippocampus from shrinking but also stressed the importance of meaningful social interventions as a form of treatment, pointing out that if, when depressed, we simply sit alone in a room and isolate ourselves, failing to interact socially with others, then this lack of social interaction, in itself, is likely to reduce the size of the hippocampus – a good social support system, then, is an extremely important factor to be considered when deciding how best to treat depression.

Furthermore, Hickie states that there is also evidence that treatment using fish oils can be ‘neuroprotective.’

In the case of young people, Hickie suggests that psychotherapy may often be the first-line treatment offered, rather than medication. (N.B. Always consult an appropriately qualified professional when considering medical treatments).

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Related Research : Hippocampal Volume Reduction In Major Depression.

RESOURCE :

Depression Self-Help | Self Hypnosis Downloads

David Hosier BSc Hons; MSc; PGDE(FAHE).

BPD And Resolving Conflict With Others

If we suffered severe and chronic childhood trauma, particularly if, as a result, we have gone on to develop borderline personality disorder, it is likely that, without appropriate therapy, we frequently find ourselves in heated conflict with others, especially those others to whom we are emotionally attached such as partners or family members.

Indeed, one of the hallmarks symptoms of BPD is the experiencing of difficulties with interpersonal relationships.

We may have relationship problems for a variety of reasons that include :

And, when a relationship ends, sufferers of BPD are liable to take it particularly hard, especially if rejected in such a way as to trigger reminders of childhood rejection (on either a conscious or unconscious level). Indeed, the emotional pain of such rejection can be as excruciating as severe physical pain.

Because of the frequent ‘love-hate’ relationships BPD sufferers are prone to creating, the nature of the conflict between the sufferer and his / her partner tends to be cyclical and the first step is to become aware of the cycle and recognize its futility and destructiveness.

We also need to recognize the damage it is doing to our relationship ; conflict leaves both us and the person with whom we are in conflict feeling bad. Indeed, following outbursts of anger and rage, BPD sufferers tend to experience overwhelming feelings of profound shame. So, in essence, everyone loses and the relationship is undermined (and is likely to collapse altogether in the absence of effective, remedial action being taken).

Once we have become aware of this destructive cycle, we next need to make a definite commitment to trying our best to break it.

Obviously, though, if one has had a long history of getting into high conflict situations with others, the process of change is likely to take time and cannot, of course, be expected to work instantaneously ; one needs to learn and practice new social skills until they, in an ideal situation, become ‘second-nature’ and there will inevitably be setbacks along the way, paricularly when one is under intense stress, is deliberately provoked or is facing rejection.

Of course, each individual will have their own set of personal triggers which put them at high risk of entering into conflict with another so the next step is to try to IDENTIFY SUCH TRIGGERS.

Not letting potential triggers set off undesirable behaviors also entails controlling impulsivity ; you can read my previously published article entitled : Control Impulsive Behavior by clicking here. Also, you may wish to read my articles : Impulse Control : Study Showing Its Vital Importance and Childhood Trauma And The Development Of Impulse Control Disorders.

Once triggers have been identified, the next step is to rehearse in the mind how one will respond in such a way as not to create conflict or in a way that de-escalates any conflict that already exists. Using visualization techniques to aid mental rehearsal of one’s new, positive ways of dealing with situations that would have previously led to conflict can be particularly effective.

In his excellent book : The High Conflict Couple : A Dialectical Behavior Therapy Guide To Finding Peace, Intimacy And Validation (see image below to view on Amazon), Fruzzetti PhD endorses the above techniques and suggests using the acronym SET to help us to remember more constructive ways of dealing with conflict than we may used in the past ; SET stands for utilizing sympathy, empathy and truthfulness.

Assertiveness training can also help to ensure that a gentler approach to dealing with potential conflict does not lead to being taken advantage of.

RESOURCE :

Fruzzetti PhD’s Book :

David Hosier BSc Hons; MSc; PGDE(FAHE).

BPD, The Love-Hate Relationship And Neuroscience

love=hate

We have seen from several other articles that I have published on this site that one of the hallmarks of borderline personality disorder is the tendency of sufferers of this devastating psychiatric condition to flip suddenly from idealizing / feeling love towards individuals and demonizing / feeling hate towards them (which, of course, is a major reason why BPD sufferers also tend to have severe difficulties with their interpersonal relationships). This tendency is sometimes referred to as ‘SPLITTING.’

Intriguingly, a study (Zeki et al.) carried out at University College, London, may help to elucidate this tendency to suddenly ‘switch’ betwen loving and hating the same person from a neurological perspective (i.e. in terms of brain’s physical organization and biological functioning).

THE STUDY :

The study invoved 17 individuals who had their brain scanned under two conditions :

CONDITION 1 : Brain scans were taken whilst the individuals were looking at photos of people they loved.

CONDITION 2 : Brain scans were taken of the same individuals in Condition 1 whilst they were looking at photos of people the claimed to hate.

NERVOUS CIRCUITS IN THE BRAIN :

Researchers found that some of the brain’s nervous / neural circuits involved in generating feelings of hate are ALSO INVOLVED IN GENERATING FEELINGS OF LOVE.

More specifically :

The region of the brain known as the putaman seems to be activated both when an individual is experiencing feelings of love and when s/he is experiencing feelings of hate including disgust, contempt and aggression.

The region of the brain known as the insula also seems to be activated both when an individual is experiencing feelings of love and when s/he is experiencing feelings of hate,

THE CEREBRAL CORTEX :

Furthermore, research findings suggest that regions of the cerebral cortex are deactivated both when an individual is experiencing feelings of love (the regions deactivated when we are experiencing feelings of love are involved in reasoning and judgment) and also when s/he is experiencing feelings of hate.

However, it should also be noted that fewer regions in this part of the brain are deactivated when the person is experiencing feelings of hate.

This finding may help to explain the neurological underpinnings of the origin of the expression that ‘love is blind’ (i.e. when feeling intense love, all reasoning and judgment tends to go out of the window and we are, to put it colloquially, liable to be led irrationally by the heart rather than rationally by the mind).

Furthermore, the fact that fewer regions of this brain region seem to be deactivated when people experience feeling of hate may be a kind of safely mechanism to prevent them from, for example, resorting to excessive, unnecessary and perhaps, ultimately, self-defeating violence in response to these feelings.

Indeed, the author of the study suggests that the cerebral cortex is less deacivated when people feel hate than it is when people feel love because when they feel hate they need to be able to reason effectively so that they can be sufficiently calculating when it comes to exacting revenge! Such calculation, more relevant to our ancient ancestors, may involve judging if a physical fight could potentially be won and what it would be necessary to do in any such fight to win it – alternatively, it might be necessary to judge whether a violent attack on an opponent will backfire as said opponent is of vastly superior physical strength.

One can, perhaps, tentatively infer from this that evolutionary processes have determined that we are less rational in response to feelings of love than we are in response to feelings of hate.

In any event, it seems the fine line between love and hate, and the propensity, especially in the case of BPD sufferers, to flip suddenly between the two has a neurological basis.

RESOURCE :

Increase Your Emotional Intelligence | Self Hypnosis Downloads.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Attitudes Of Medical Professionals Towards BPD Sufferers

childhood-trauma

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 :

Reseachers (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 subcales :

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 was 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 the gain a better understanding of the causes of, nature of, and treatment for borderline personality disorder.

OTHER USEFUL ARTICLES :

You may also wish to read my previously published articles about dialectical behavior therapy, other treatment options for BPD , BPD and psychodynamic therapy and BPD and remission.

eBook :

bpd ebook

Above eBook now available on Amazon for instant download : CLICK HERE.

David Hosier BSc Hons; MSc; PGDE(FAHE).