Borderlines.......

[PsychRN-Kris]

Borderlines have been some of my most challenging patients to deal with and I find myself practicing a lot of patience and limit setting with them. Anyone have any useful tips for surviving a shift with one or more Borderlines?

[stillpressingon]

Purplekath - dependency unit? Is that like a drug dependency or ...?

[purplekath]

No, these are psychiatric areas...high dependency is the place we nurse those who need to be watched constantly. Very suicidal, high risk to others, high risk of absconding etc. People who are very high acuity.

[Diahni]

Get DBT training. It really works for those unfortunate souls with BPD. Just the attitude adjustment that comes with the training will yield a completely different reaction to you from the patient.

DBT centers around the realization that folks with BPD have had horrific lives for the most part, are truly in emotional pain, and have terrible coping skills. Just treating the patient like they have pain and not like the leper of the unit will open doors for you. The goal is to decrease/stop inappropriate and harmful behavior, train the patient in coping skills, a gain emotional mindfulness.

Hi Soxfan,

Clarification please: do you think DBT training is also good for people working with borderline people (not just the patients?) I understand it's one of the most effective therapies for a lot of disorders. One problem with borderline people is it's always somebody else's fault. I wonder how you can help someone stop blaming everybody besides themselves for their behavior?

Diahni

[SoxfanRN]

Hi Soxfan,

Clarification please: do you think DBT training is also good for people working with borderline people (not just the patients?) I understand it's one of the most effective therapies for a lot of disorders. One problem with borderline people is it's always somebody else's fault. I wonder how you can help someone stop blaming everybody besides themselves for their behavior?

Diahni

A large part of DBT is mindfulness, the dialectics part. Mindfulness uncludes recognition of one's own emotions, behaviors, responses, and responsibilities. The blaming others is addressed.

DBT principles work well for many diagnosis and people. But like any cognitive therapy, there is a lot of time and work involved, and the person must be willing to comply with the program. But the nice part is that once you are trained, you can use bits and pieces to suit your needs without going into an entire DBT program.