Being Driven Mad: Towards Understanding Borderline and Other Disturbed States of Mind Through the Use of the Counter‐transference

Evans, Marcus

doi:10.1080/02668730701535578

Cited by 14 publications

(7 citation statements)

References 8 publications

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“…However, the postulated causal attributions are still to be established. While these possibilities would be in line with our data, our study lends no support to the assumption that these patients feel pride in their scars or want to be admired for them [24, 25]. …”

Section: Discussioncontrasting

confidence: 53%

“…These might be some of the reasons why many self-injurers have negative emotions towards their scars and often state that they harm the arms or legs “because the wounds can be hidden under clothing” [23]. However, it has also been speculated that some patients “feel a smug pride in [their own] scars” [24] and show them off “like soldiers who wear medals and need to be admired for their bravery in battle” [25]. Trauma research further fosters the concept that the memories related to a specific scar can impact the evaluation of that scar.…”

Section: Introductionmentioning

confidence: 99%

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Body self-evaluation and physical scars in patients with borderline personality disorder: an observational study

Kleindienst

Priebe

Borgmann

et al. 2014

Bord Personal Disord Emot Dysregul

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BackgroundData from general psychology suggest that body self-evaluation is linked to self-esteem and social emotions. Although these emotions are fragile in individuals with borderline personality disorder (BPD), body self-evaluation is clearly understudied in BPD research.MethodsA total of 200 women took part in the study: 80 female BPD patients, and 47 healthy and 73 clinical controls including post-traumatic stress disorder (PTSD) after childhood sexual abuse (CSA). Diagnoses were established through standardised interviews conducted by experienced psychologists. The participants used the Survey of Body Areas to indicate which areas of their own bodies they liked or disliked and to mark the locations of physical scars.ResultsCompared to healthy controls, both BPD patients and patients with PTSD after CSA had a predominantly negative body self-evaluation (Cohen’s d = 1.42 and 1.38, respectively). As indicated by multilevel analyses, scars were related to a negative evaluation of the affected areas in BPD patients, but not in the control groups. Subgroup analyses revealed that the negative body self-evaluation applies to both BPD patients with and without PTSD or reported CSA.ConclusionsBPD patients show a negative body self-evaluation which is associated with the presence of scars but not with CSA.

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Section: Discussioncontrasting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Body self-evaluation and physical scars in patients with borderline personality disorder: an observational study

Kleindienst

Priebe

Borgmann

et al. 2014

Bord Personal Disord Emot Dysregul

View full text Add to dashboard Cite

show abstract

“…This supports Krawitz (2004) and Treloar & Lewis's (2008) research into the effect of training nurses to work with this client group, both projects identified empathy as the ‘active ingredient’ in positive change. Although staff values cannot be implanted into a service there are mechanisms such as training (Treloar & Lewis 2008), a shared vision of treatment (Bergman & Eckerdal 2000) and adequate supervision (Evans 2007) that can support their development.…”

Section: Resultsmentioning

confidence: 99%

Borderline personality disorder: clinicians' accounts of good practice

Bowen

2012

Psychiatric Ment Health Nurs

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People with a diagnosis of borderline personality disorder are relatively high users of inpatient and community services. There is concern, however, that mental health nurses feel negative about working with this group of people, are often socially distancing and feel under-skilled. The purpose of this research was to explore the experiences of good practice among mental health professionals working in a service that provided specialist treatment for this group of service users. The research was undertaken through semi-structured interviews and identified four key themes: shared decision making, social roles, peer support and open communication. These themes are discussed in the context of research in this field, the need for recovery-focused services, and through drawing on the Winnicotian notions of disillusionment and mirroring as key developmental processes.

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“…Clinical supervision and opportunities for reflective practice are essential for good psychological care of both patients and staff alike (Evans, 2007). The psychoanalytic model is particularly valuable as it provides a model for thinking about the internal world of the patient as well as an understanding of unconscious communication and the relationship between the transference and countertransference.…”

Section: Discussionmentioning

confidence: 99%

Pinned against the ropes: Understanding anti-social personality-disordered patients through use of the counter-transference

Evans

2011

Psychoanalytic Psychotherapy

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This paper focuses on difficulties in the treatment and care of patients with a diagnosis of psychopathic, or anti-social personality disorder as it is usually referred to today. The current psychiatric diagnostic systems (ICD-10 and DSM-IV) are primarily categorical and theoretical. Diagnosis is arrived at by assessing the presence or absence of symptoms and behaviours. These diagnostic systems do not take any account of the individual's development or personality structure and consequently there is no dimension for describing links between different diagnoses. This means that these patients are often thought to be either suffering from paranoid schizophrenia or anti-social personality disorder or a dual diagnosis depending on the phase of their illness. The current diagnostic system does not recognize the underlying personality structures that link the diagnosis and cycles of the illness together. However DSM-V, which is coming out next year, will take a more dimensional approach, and as such will be more compatible with a psychoanalytic understanding of mental disorder.\ud \ud In this paper the author draws upon literature in this area and suggests that this dichotomy between the psychotic and the anti-social may be too simple and argues that if we can understand that psychotic processes may well also underlie the personality disorders, we may reach a better understanding of what takes place in these settings and how staff are affected by the patients. In order to function effectively, staff need regular, on-going supervision. These arguments will be illustrated with clinical examples taken from supervision groups and consultations in forensic and mental health settings.\ud \u

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Being Driven Mad: Towards Understanding Borderline and Other Disturbed States of Mind Through the Use of the Counter‐transference

Cited by 14 publications

References 8 publications

Body self-evaluation and physical scars in patients with borderline personality disorder: an observational study

Body self-evaluation and physical scars in patients with borderline personality disorder: an observational study

Borderline personality disorder: clinicians' accounts of good practice

Pinned against the ropes: Understanding anti-social personality-disordered patients through use of the counter-transference

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