TITLE:
Integrative therapy for personality disorders: Experiences in developing integrative approaches for treatment-refractory personality-disordered clients
AUTHORS:
Nazir Hussain
KEYWORDS:
Personality Disorder; Mental Health Issues; Integrative Therapy; Treatment Refractory; Borderline Personality Disorder; Suicidal Behaviour; Safety Seeking Behaviours; Emotional Dysregulation
JOURNAL NAME:
Health,
Vol.5 No.5,
May
27,
2013
ABSTRACT: Personality Disordered (herein referred to as PD) clients are challenging to statutory
mental healthcare programmes. They can be difficult to diagnose: their
disorders can be obscured by second-order problems such as anxiety and depression,
caused by PD cognitive processes. Treatment-as-usual (the predominant model of
psychiatric intervention) for PD clients in crisis tends to focus on these
second-order presentations, but provide no means of identifying underlying
PD. The purpose of this paper is to
describe how heuristic methods of diagnosis can be used to reframe the client’s
distress in the context of personality disorders (according to DSM-IV criteria),
and how subsequent application of integrative therapies can break their cycle of recidivism. Method: Two
case studies of treatment-refractory individuals
with cyclical patterns of crisis-point service engagement for self-harm or psychotic depression
where heuristic/ integrative therapies were used. Results: The use of integrative therapies in the case studies presented
resulted in a marked change in recidivism and quality of life for each
client, as measured by a significant reduction in presentation of symptoms
and hypervigilance. Discussion: By understanding the maladaptive cognitive-behavioural
processes of PD clients, they can be modified to reduce the client’s self-defeating
behavioural patterns, breaking the cycle of recidivism. However, a new
diagnostic strategy must first be formulated that looks at the clients past use of mental health services to detect underlying PD.