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Running head: MENTAL DISORDERS 1

MENTAL DISORDERS 2

Borderline Personality Disorder

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Personality disorder refers to the manner of thinking, behaving, and feeling, which deviates from the culture's expectations. It is associated with causing problems functioning and causes distress. Similarly, it lasts over time. There is various type of personality disorders; however, this report focuses on borderline personality disorder. A borderline personality disorder is identified as a complex and challenging illness, which often occurs in the context of relationships. Consequently, borderline personality disorder creates havoc both to the individual with the disorder and the loved ones.

1. Explain the controversy that surrounds your selected disorder.

A borderline personality disorder is recognized to have historically been met with widespread controversy (Rao, 2019). It is associated with many reasons for confusion; this is because even though Borderline personality disorder has nine possible symptoms, it may present itself in over 200 different ways. Additionally, the heterogeneity of the disorder is further worsened by its existence with other conditions. This means borderline personality disorder overlaps with other disorders, especially when it has a high co-occurrence rate, such as eating disorders, bipolar disorders, depression, and anxiety disorders. The controversy of borderline personality disorder is further compounded by the fact that borderline personality disorder is often missed or ignored by assessing another diagnosis instead.

2. Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.

The overlap of borderline personality disorder with other disorders, such as bipolar, and the high prevalence of comorbidities leads to practitioners' diagnostic dilemmas (Debbané, 2018). For example, bipolar disorder and borderline personality disorder are associated with unstable relationships, considerable risks of homicide, and inappropriate anger (Bayes & Parker, 2020). However, it is worth noting that most symptoms are typical in borderline personality disorder, for example, a stronger connection to a childhood history of abuse and self-mutilation.

Similarly, symptoms such as insecure attachments associated with an intense fear of abandonment mainly reflect borderline personality disorder, and they are not evident in bipolar disorder. Additionally, patients with borderline personality disorder show a higher level of acute suicidal threats, hostility, and impulsivity than an individual with bipolar disorder (Campbell et al., 2020). Consequently, for the practitioner to arrive at a primary diagnosis, they should carefully portray the nature of suicidal and non-suicidal attachments and the time course of mood symptoms. A practitioner can use a higher level of hostility and chronic fears of abandonment, typically distinguishing borderline personality disorder symptoms from bipolar disorder.

3. Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.

Successful therapy requires that the borderline personality disorder patient honestly shares their experience and behaviors. However, sharing with a stranger, a therapist included, can be a challenging task. Consequently, the therapist needs to earn the patient's trust to maintain a positive therapeutic relationship (GoodTherapy Editor Team, 2019). One way to make the borderline personality disorder patient feel more comfortable in therapy is by never passing judgment. Although, as a therapist, you may strive to remain non-judgmental, the patient can pick on the slightest hint of judgment. Therefore, a therapist should avoid giving advice that is outside the scope of practice or has a sense of condemnation. Additionally, a therapeutic relationship can be maintained by talking about what the patient wants from the therapy; this is because the patient's goal for treatment may be different from what you, as a therapist, might assume or think they want. Hence, it is important to talk to the patient about what they want to get from therapy.

4. Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.

Surprisingly, the treatment for borderline personality disorder entails managing the complexity and maintaining a strong sense of purpose necessary to prevent adverse results where possible, improve the quality of life, and enhance functioning (Ringrose, 2018). There are various ethical issues that many psychologists face while treating borderline personality disorder. For example, it is questionable what comprises an acceptable level of competence to treat borderline personality disorder. There are no adequate specific guidelines that demonstrate a sufficient level of training and education. The guidelines do not answer whether it is necessary to perform a particular action. Similarly, the guidelines do not specify the competence by nature and extent of training of the psychologist in treating this disorder.

Often, a borderline personality disorder can cause an individual to get into trouble with the law. Consequently, it is important to understand the legal issues and their impact on identifying potential problem areas (Salters-Pedneault, n.d.). For example, one can face the legal trouble of impulse control. An individual with borderline personality disorder struggles with taking action without thinking about the consequences. Similarly, they often engage in behaviors when they are angry or upset. Consequently, this refers to impulse behavior, which can potentially create legal problems. Examples of impulse behavior, which are illegal, include starting fights and reckless driving; this is a prevalent issue since many persons with borderline personality disorder feel emotions intensively and have severe reactions.

References

Bayes, A. J., & Parker, G. B. (2020). Differentiating borderline personality disorder (BPD) from bipolar disorder: diagnostic efficiency of DSM BPD criteria. Acta Psychiatrica Scandinavica, 141(2), 142–148. https://doi.org/10.1111/acps.13133

Campbell, K., Clarke, K.-A., Massey, D., & Lakeman, R. (2020). Borderline Personality Disorder: To diagnose or not to diagnose? That is the question. International Journal of Mental Health Nursing, 29(5), 972–981. https://doi.org/10.1111/inm.12737

Debbané, M. (2018). Treating borderline personality disorder with oxytocin: An enthusiastic note of caution. Commentary to Servan et al. The effect of oxytocin in borderline personality disorder. In L’Encéphale (Vol. 44, Issue 1, pp. 83–84). https://doi.org/10.1016/j.encep.2017.12.003

GoodTherapy Editor Team. (2019, July 10). 10 ways therapists can strengthen the therapeutic relationship. https://www.goodtherapy.org/for-professionals/marketing/customer-experience/article/10-ways-therapists-can-strengthen-the-therapeutic-relationship

Rao, S. (2019). Borderline personality disorder – a misunderstood disorder. In Sri Lanka Journal of Psychiatry (Vol. 10, Issue 2, p. 1). https://doi.org/10.4038/sljpsyc.v10i2.8217

Ringrose, J. L. (2018). Considerations for psychotherapy. In Understanding and Treating Dissociative Identity Disorder (or Multiple Personality Disorder) (pp. 63–82). https://doi.org/10.4324/9780429484483-6

Salters-Pedneault, K. (n.d.). Legal issues and borderline personality disorder. Retrieved July 16, 2021, from https://www.verywellmind.com/bpd-and-the-law-legal-issues-and-bpd-425356