Application of Transference Focused Psychotherapy in Borderline Personality Disorders

Borderline Personality Disorder (BPD) is a condition that is currently commonly found in daily psychiatric practice, and causes serious psychiatric disorders because it has an impact on the emergence of various other comorbid psychiatric disorders. The management of BPD is a challenge, because it is quite difficult and complex. Psychotherapy is an effective first-line therapy for BPD. Transference Focused Psychotherapy (TFP) is psychodynamic based psychotherapy that is specifically designed for BPD and is considered effective based on the specific psychopathology of BPD, namely the lack of identity integration. TFP focuses on the relationship between patient and therapist in sessions which have the aim of facilitating better behavioral control and increasing reflection and influencing regulation so as to produce identity integration that leads to a more coherent identity, better regulatory abilities, less self-destructive behavior. forming a more balanced and constant relationship, and increasing overall functioning.Keywords : Borderline Personality Disorder, Psychodynamic Psychotherapy, Transference Focused Psychotherapy.

Missed appointments in mental health care clinics: A retrospective study of patients’ profile

Background: Missed appointments (no-shows) are a problem and common in outpatient clinics especially in psychiatric setting.Objective: This study aimed to describe the extent of no-shows in a regular psychiatric outpatient clinic, and to assess associations of missed appointments with patients’ demographic and clinical characteristics and types of services provided.Methods: Data collection from a hospital psychiatric clinic charts was conducted from administrative years 2017-18 and 2018-19, using descriptive analyses.Results: In the administrative year of 2017-18, the no-show rate was 9.5%, adding 10.7% for cancellations, for a total of 20.2%. In 2016-17, rates were 9.7%, with 17.3% cancellations, for a total of 27%. Rates varied from clinical groups (2.5% for borderline personality disorders patients to 30% for young psychotic patients) and by professionals (psychiatrists 5.6%, psychotherapists 23.3%) and for crisis services 21.9%.Conclusions: No-show numbers are comparable to other clinical sites but remain a challenge in delivering seamless and efficient services. A qualitative study will be conducted as a second phase to examine root causes and provide opportunities for service improvement.

Borderline personality disorders: from the developmental theory of the "self" and mentalizing to "systems"

In the last fifty years the thinking around borderline personality disorder (BPD) shifted from an intra-psychic to a psychoanalytically oriented relational model. The latter described the difficulties associated with this presentation as arising from a disorganisation of the "self" structure in the context of an early caregiving relationship. The concept of inaccurate, or inconsistent "social biofeedback parental affect mirroring" has been pivotal to explain the characteristic failure to mentalize and the interpersonal difficulties associated with a diagnosis of BPD. Nevertheless, far from being the result of a sole linear relationship, these difficulties appear linked to communicative and emotional feedback loops that are reminiscent of cybernetic principles. Furthermore, recent claims have suggested that the communication feedback loops characteristic of the carer–child attachment style represent nothing less that the communication styles of the wider social environment in which the dyad is located. These claims have recently prompted a further shift from mentalizing to epistemic trust and epistemic vigilance, hence departing from a relational model towards a more systemic one. The difficulties associated with BPD are now suggested to be linked to a disorder of social learning, impacted by the rigid nature of the person's information-processing systems. This article reviews this journey.

Protecting Patients with Borderline Personality Disorders from the COVID-19 Epidemic

This paper describes qualitatively how the author has assisted a patient with psychological disorders, specifically borderline personality disorder (BPD), during this COVID-19 epidemic.