Living with personality disorder and seeking mental health treatment: patients and family members reflect on their experiences

Abstract

Background: Despite effective treatments for personality disorders being developed, consumers and carers often report negative experiences of mental health services, including challenges accessing these treatments. Methods: This qualitative study used separate focus groups to compare the unique perspectives of consumer and carers, and to investigate how to improve services for individuals with personality disorders. Reflexive thematic analysis was used to analyze the data. Results: Both consumers and carers (N = 15) discussed the value of providing appropriate information to consumers when they are diagnosed with personality disorder. Consumers and carers described the importance of creating a safe environment for consumers when they present to the emergency department. Both groups discussed experiencing positive and negative treatment from mental health professionals, and suggested that professionals should be trained to understand personality disorder. Limited accessibility and quality of services, and offering peer support to consumers were also described by consumers and carers. Consumers and carers also had perspectives which were unique to their group. Consumers identified the importance of psychological treatment, having a strong therapeutic relationship with a mental health professional, and the benefit of long term psychotherapy with the same professional. Broadening the scope of psychotherapies including creative, animal-assisted, and physical therapies was recommended by consumers. Carers described the importance of assessing for personality disorder and intervening early. Involvement in the assessment, diagnosis, and intervention process was important to carers. The desire to be recognized and supported by mental health professionals was discussed by carers. Conclusions: This research contributes to the concern that consumers with personality disorder and their carers experience stigma and low quality care within mental health services. In line with these findings, we recommend guidelines for health professionals who work with consumers with personality disorder.

It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism

“…Not rarely treatment courses of narcissistic patients end with unpleasant surprises and sudden dropouts, fights, or an inability to end the treatment and separate from the therapist (8). Overall, our findings extend recent studies showing the interpersonal burden pathological narcissism places on relationships, both in daily life (92) and in clinical settings (93). These challenging interpersonal patterns are visible in treatment complications like drop-outs (4), the need for tact and sensitivity and therapist's adaptiveness when dealing with problematic relationship patterns (94), underlying shame (95) and the need for the therapist to turn to both fragile vulnerable aspects and provocative grandiose aspects of pathological narcissism (96).…”

Experiences of crisis care among service users with complex emotional needs or a diagnosis of 'personality disorder', and other stakeholders: systematic review and meta-synthesis of the qualitative literature

“…Of the included studies, three were conducted in the UK, 9,21,22 two were from Canada, 6,23 one study each was conducted in Australia, 24 the USA, 3 Sweden, 25 Ireland, 26 and The Netherlands, 10 and one study was conducted across Australia and New Zealand. 27 Sample sizes ranged from six to 500 participants (the study that used 500 participants performed content analysis 3 ).…”

“…Two papers focused on family carers. 21,24 Six papers provided information on the gender of participants, 6,9,21–23,26 and only two reported ethnicity. 9,22 Of the papers that did report ethnic background, the majority of participants identified as White.…”

The Lived Experiences of Family Members of a Sibling with Borderline Personality Disorder in South Africa: A Qualitative Study

“…[8,9,10,11] Barr et al [12] also examined family members' or carers' experiences supporting someone with a personality disorder. The authors [12] reported that carers described the importance of early assessment and intervention for personality disorders. In support, Greer and Cohen's [13] research focused on the partners of individuals with BPD, who experienced emotional challenges, dual roles as both a romantic partner and parental/therapeutic gure, and a lack of control.…”

“…[8] Family caregivers of people diagnosed with BPD's experiences have been studied by Hoffman, Fruzzetti and Buteau, [9] Buteau, Dawkins and Hoffman, [10] Lawn and McMahon, [11] and Kay et al [8] Various challenges, such as negative feelings towards their relatives, social humiliation, nancial strain, marital discord, caregiver and nancial burden, grief, and isolation, were some of the similarities in these studies. [8,9,10,11] Barr et al [12] also examined family members' or carers' experiences supporting someone with a personality disorder. The authors [12] reported that carers described the importance of early assessment and intervention for personality disorders.…”