DSM Criteria for Borderline Personality Disorder
Borderline Personality Disorder (BPD) is associated with some Diagnostic and Statistical Manual (DSM) criteria by which its diagnosis is based. The list of DSM criteria for BPD is outlined below.
- Delirious efforts aimed at avoiding existent or imagined abandonment (Freeman et al., 2005). The symptom that is related with this particular criterion is the regular fear of being abandoned by loved ones alongside frenetic endeavors to fight family neglect.
- A configuration of unsteady and acute relational associations characterized by oscillations between opposites of idealization and contraries of devaluation (Freeman et al., 2005). A prodrome that indicates BPD manifestation is the action of regarding close relations as being impeccable than they actually are and the feeling suddenly changes to intense rage towards the person.
- Identity disturbance: noticeably and endlessly unsteady introspection (Freeman et al., 2005). In this particular case, having a wobbly image of one’s abilities and competencies mark a person’s life and resulting to low self-esteem.
- Recklessness in at least two areas that might be potentially self-harming for instance spending and reckless driving (Freeman et al., 2005). Symptoms that are quite noticeable are, over speeding and being spendthrift.
- Cyclical suicidal conducts, indications, or threats or self-mutilating actions (Freeman et al., 2005). Periodically, a BPD convalescent may encounter higher likelihoods of resorting to suicidal actions, though most of them the episodes are unpredictable.
- Emotional instability as a result of marked reactivity of mood (Freeman et al., 2005). BPD valetudinarians undergo interludes of shifting moods consisting of consternation, dejection, and intense anhedonia.
- The patient might have incurable feelings of emptiness or hollowness (Freeman et al., 2005). Most commonly, the BPD patients might experience a life without sense of direction or meaning.
- Improper extreme rage or difficulty managing anger by a BPD patient (Freeman et al., 2005). Those with BPD frequently evince unreasonable displays of anger that are not only unsuitable but are also intense.
- Transitory, stress-related beliefs about potential danger or acute disconnection symptoms (Freeman et al., 2005). Short-lasting feelings of disengagement and feelings of not being part of a group characterizes the symptoms of BPD.
Treatment Model
My treatment model for Linda would be Dialectical Behavioral Therapy (DBT). This remedy paradigm is a new approach for BDT that draws immensely from cognitive-behavioral suppositions. The pioneer of this particular treatment design was Marsha Linehan who was interested in the study of parasuicidal behaviors (Freeman et al., 2005). Essentially, DBT works to help clients find their purpose in life, discover intrinsic wisdom in personal actions, accept themselves completely and try to make their lives better. Undoubtedly, DBT is the best method of treatment of BDT because it is a model that is firmly based on cognitive-behavioral techniques.
Essential Clinical Skills
I would employ all the relevant clinical skills to ensure Linda attains the best results the therapy can offer. Majorly, I will apply adaptive skills, which can assist me to view Linda as doing her best to cope up with life. Moreover, the team support skills can enable the fellow consultants help me normalize anti DBT conceptualizations I might have (Freeman et al., 2005). Further, I need to be flexible because this will enable me find the best balance between a steady focus and empathetic pliability.
Therapeutic Goals
In Linda’s diagnosis, my treatment would be focused on two therapeutic goals. Firstly, I will allign Linda to DBT and to help her make commitment to this type of treatment. The goal is important before it is proper to prepare her both psychologically and physically for the therapy. Lastly, I will aim at boosting Linda’s distress forbearance and emotional adjustment. Accordingly, the two objectives of therapy will eradicate destructive behaviors of shopping, impulsive sex and angry-lashing as Linda’s copying mechanisms.
Assessment Tools for Linda’s Case
I would gather further information about Linda’s impulsive behavior through an interview. In fact I will prepare a checklist to enable Linda recognize the extent to which she is affected by the BPD’s symptoms. The specific assessment tool that I would use would be the Dissociative Experiences Scale (DES) (Bernstein & Putnam, 1988, as cited in Freeman et al., 2005). The rationale for choosing this assessment tool would be to determine if Linda is highly dissociative. Consequently, scores higher than 25 on DES scale would call for further assessment of dissociation or clinical interview.
Conceptualization of Linda’s Personality and Cognitions
Linda is probably lonely and melancholic and demented why her relationships have failed. She might think that there is no good person around her and fail to recognize how her lack of interpersonal skills and emotional imbalance contributes to her relationship problems. The paranoia she is suffering from makes her feel unhappy and emotionally detached, and that is why she uses impulsive behavior to soothe herself (Freeman et al., 2005). Accordingly, Linda has come to believe that something is wrong with her and she is essentially bad in some way.
The Biblical Perspective
The treatment of BPD can be based on Apostle Paul’s teaching about love. In Corinthians 13:1-13 (King James Bible, 1769/2017), Christians are taught of attributes of agape love. Mostly important, love is known not to have things in its own way, as it resentful. In Linda’s case, she might think that the overwhelming thoughts of failure and worthlessness are God’s points of view yet those are manifestations of a disorder. Linda’s quick shift to victimhood does not help as she needs to remind herself of God’s love. The important part of agape love is trusting God with all one’s needs and not demanding that others give what only Christ can (King James Bible, 1769/2017, Philippians 4:19). Clearly, understanding of God’s love and His expectation upon human life helps in alleviating parasuicidal thoughts.
References
Freeman, A., Martin, D., & Stone, M. (Eds.). (2005). Comparative treatments for borderline personality disorder. Springer Publishing Company.
King James Bible. (2017). King James Bible online. (Original work published 1769).