At 12:49 pm +1000 28/4/06, Dr Hugh Nelson wrote:
This girl would be helped a lot by a psychologist good at trauma
counselling, especially one that uses EMDR.
EMDR is useful for PTSD.
EMDR is not good enough for borderline personality disorder.
Dialectic Behaviour Therapy has good research evidence of outcomes
for borderlines. DBT "by the book" is a large team undertaking.
Russel Meares "self psychology" also has a good research basis for
treating DBT.
I have been told by a psychotherapist psychiatrist that 80% of
psychiatrists have a heavy pharmaceutical bent and are not in to
therapy. The ones that do are fully booked with book closed or nearly
so. My recent experience fits with that observation.
If you have a patient who needs therapy, choose your shrink
wisely.... Otherwise a good GP can do at least as well with these
patients.
When they have bounced around the system for 20-40 years, the system
has a problem.
Ian.
Elizabeth Dodd wrote:
On Fri, 28 Apr 2006 06:18, Ian Cheong wrote:
"Borderline" patients are a long-term project
that can be helped towards cure. I have a couple
of them who have eventually been relabelled
correctly as "dissociative" rather than
"borderline" and are moving towards cure after a
long trail of different psychiatrists over
decades who didn't manage to help them. It seems
they often fall over at "...that was a long time
ago...get over it...."
I was having a really interesting talk with one yesterday. Her education
didn't get far enough for her to understand much of the term "borderline
personality disorder" but i've told her it's because she doesn't fit into any
of the other categories (and I had to pick a label for 'the computer')
Interesting talk, because when she was a troubled teenager from 1982 on, lots
of 'helping people' told her that they knew what was wrong ' her father had
interfered with her'. No one asked what was true or false - she had witnessed
her alcoholic father nearly kill her mother by strangulation. I ran late
yesterday, and made her promise to make a double appointment and tell me more
of the story next week.
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Dr Ian R Cheong, BMedSc, FRACGP, GradDipCompSc, MBA(Exec)
Health Informatics Consultant, Brisbane, Australia
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