Meeting the Clinical Challenges of Managing Borderline Personality Disorder
Individuals diagnosed with borderline personality disorder (BPD) are high utilizers of mental health treatment and comprise a large percentage of both inpatient and outpatient psychiatric populations. Not only do they exhibit extreme interpersonal sensitivity and are quick to feel invalidated, rejected, and abandoned, they also present clinically with very challenging symptoms that have contributed to a stigmatization of the BPD diagnosis and the misconception that BPD is not treatable. Recently developed BPD-specific evidence-based psychotherapies incorporating theoretical and technical modifications to “treatment as usual” contribute to the destigmatization of the BPD diagnosis and to increased effectiveness in clinical management of the disorder. This chapter reviews the conceptualizations and interventions that facilitate the capacity for mental health providers to maintain an empathic therapeutic stance toward and positive engagement with BPD patients in order to keep patients engaged with and making progress toward their goals in treatment.