UMass Amherst PSYCH 380 - Therapist Issues with Borderline Personality Disorder (4 pages)

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Therapist Issues with Borderline Personality Disorder

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Therapist Issues with Borderline Personality Disorder


We talked about the many things that therapists have to deal with when treating a person with borderline personality disorder.

Lecture number:
Lecture Note
University of Massachusetts Amherst
Psych 380 - Abnormal Psychology
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Psych 380 1nd Edition Lecture 20 Outline of Current Lecture I Therapy Challenges associated with Borderline Personality Disorder Current Lecture I II III IV This Thursday is the final lecture Next Tuesday Final exam Optional classes the week after Thanksgiving Therapy Challenges Borderline Personality Disorder a Initial warning signs i History of abuse ii Problems with previous therapist iii Refuses to give permission to contact previous therapist iv Litigation with previous therapist v History of sex with authority figures b Example Jane i Work related stresses ii Signed the informed consent form 1 Specifies secrecy etc iii Dr Halgin asked for permission to contact her previous therapist and she declined because she was going to sue him iv Dr Halgin is on the MA board for psychologists reviews the actions of psychologists practicing in the state v There are therapists who misbehave vi Options 1 Probation 2 Mandated therapy for themselves 3 Take away license 4 Others vii Although sometimes it is the client and not the therapist Example of a therapist who was sued for sexual assault the client was lying the whole time proved it by asking her about a body mark on the therapist s body that she couldn t identify viii There is a law that therapists cannot have sex with clients that they have had in the previous 2 years 1 Easy for people to lie and wait 2 years and 1 day c Back to Jane i He sees her a second time with no issue ii The third session she comes in practically naked bikini and hammered iii She could barely stand These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute V VI iv She says I m here to do some favors for you When Dr Halgin says he doesn t understand what she means she says We both need to relieve from stress I m going to have sex with you v She had driven to the appointment intoxicated is a danger to herself and society vi She went towards Dr Halgin physically vii This was extremely awkward for Dr Halgin didn t know what to do He couldn t let her leave but he could also get himself in trouble There are no witnesses there and she could sue him he said she said viii When he denies her advances she says Fine if you don t want to fuck me I ll leave ix He decides he has to call either her husband or the police x Because she is a danger to the public he may want her arrested xi After practically wrestling her he gets her keys and calls her husband who comes and picks her up xii After that he calls her and tells her that he can t treat her anymore Later warning signs a Expresses excessive satisfaction best therapist I ve ever had i Splitting 1 Idealization devaluation b Seeks physical contact hug kiss c Brings gifts enraged if they aren t accepted d Tried to take control of the time and place of therapy What to do a Talk to colleagues i Consult and document ii What do you think about your reaction to your patient iii Example before his son was born iv Dr Halgin always felt extremely anxious and uncomfortable when he was with an 18 year old college student who was his patient v It had to do with he himself having a kid vi Thinking will my son have to deal with this in 18 years vii 90 attention to client 10 thinking about self b Adhere to frame i No I can t meet you at ABC for our session c Avoid friendship i I m not your friend I m your therapist ii I ll be friendly at times but I have to tell you things you don t always want to hear d Avoid touching i May be interpreted as sexual ii Touching is violation of boundaries e Let client solve practical problems of life f Hospitalize if necessary i This is the not so fun part of being a therapist ii You essentially take away their rights iii They are in the hospital for 72 hours without release iv You take away their autonomy VII VIII v What if it were me in there How would I feel Video Jesse from the show In Treatment a Previously watched another episode in which he went to therapy with his adoptive mother He had just gotten kicked out of school had gotten in contact with his birth mother b In this episode he shows up at Paul s home late at night Paul is making pancakes with his son c Jesse says he got kicked out of his birth parents home d He was invited there and went early to scope out the house e Saw children using chalk in the driveway was upset by this f Left and got high g Went back to the house later ate nearly all of the oreo cookies they put out said he felt patronized by the fact they put cookies out h He doesn t really remember what they said just noticed that they held hands the whole time he noticed that all signs of their children were hidden except for safety covers on the outlets i When he went to the bathroom he noticed a bar for disabled people remembered a child in a wheel chair earlier j They had washed all of the chalk off the driveway k Paul confronts Jesse for purposefully sabotaging himself so that he can blame things on other people l Jesse leaves very angry from the session Ethical Legal issues a Understand yourself i Dr Halgin talks about the doctoral psychologist program at Umass ii They only accept 4 students each year iii He always asks the applicants what was the most important influence in them wanting to become a psychologist iv Gives example of person who says Karate v Another person recalls when he was 13 and stole his parents car with his friends and ran away They spent a week down there before they were caught vi You need self understanding in order to treat others b Know ethics and standards i Is it ethical to have sexual relationship with former client ii sex violation of power iii 2002 code within 2 years of treatment is considered unethical c Be competent in what you do i Complaints about incompetence didn t solve problem ii Child custody evaluations who should get custody iii One parent is always going to be enraged d Balance business and clinical issues i Collection agencies can lead to clients filing a complaint or spreading the word that the person is a bad therapist ii Better to expect that about 10 won t pay e Confidentiality i HIPAA ii Health insurance Portability Accountability Act f iii Promoted by Senator Kennedy in 1990 s iv It protects people s privacy v Example of alcoholic people found out about it at work via insurance form vi Must have locked filing cabinets in …

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