4. BPD

Diagnosis, stigma, and phenomenology

  1. Beth S. Brodsky PhD Associate Clinical Professor of Medical Psychology1 and
  2. Barbara Stanley PhD Professor of Clinical Psychology2

Published Online: 6 MAY 2013

DOI: 10.1002/9781118556603.ch4

The Dialectical Behavior Therapy Primer: How DBT Can Inform Clinical Practice

The Dialectical Behavior Therapy Primer: How DBT Can Inform Clinical Practice

How to Cite

Brodsky, B. S. and Stanley, B. (2013) BPD, in The Dialectical Behavior Therapy Primer: How DBT Can Inform Clinical Practice, John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781118556603.ch4

Author Information

  1. 1

    Department of Psychiatry, Columbia University College of Physicians and Surgeons, Research Scientist New York State Psychiatric Institute, New York, NY, USA

  2. 2

    Department of Psychiatry, Columbia University College of Physicians and Surgeons, Research Scientist New York State Psychiatric Institute, New York, NY, USA

Publication History

  1. Published Online: 6 MAY 2013
  2. Published Print: 15 JUL 2013

ISBN Information

Print ISBN: 9781119968931

Online ISBN: 9781118556603

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Keywords:

  • stigma;
  • borderline personality disorder;
  • phenomenology;
  • suicide ideation;
  • diagnosis

Summary

In this chapter, we review the history as well as the current conceptualizations of the borderline personality disorder (BPD) diagnosis, and the phenomenological experience of having the disorder. It is clear that the nature of the behavior in individuals with BPD is extremely anxiety provoking to clinicians, family members, and those with BPD themselves. Individuals with BPD often present with chronic suicidal ideation, self-harm, and impulsive, self-destructive behaviors. They experience extreme, seemingly unpredictable fluctuations in mood, level of functioning, and interpersonal relatedness. They also have severe interpersonal sensitivity and limitations in interpersonal functioning which manifests in the form of hostile, paranoid behaviors that challenge the patience and compassion of the most caring, well-intentioned clinician. These persistent personality traits often do not respond to traditional forms of psychotherapeutic and psychopharmacological interventions. We propose that the stigma regarding BPD, and misconceptions regarding its treatment resistance, stem from certain reality-based challenges as well as from iatrogenic factors.