Sunday, December 15, 2013

Reflections from my Abnormal Psychology course

There are many factors which may contribute to a higher frequency of Borderline Personality Disorder in women than men.  As per the textbook, and DSM-IV-TR, patients must exhibit 5 or more of the following characteristics:

Frantic efforts to avoid real or imagined abandonment.
A pattern of unstable and intense interpersonal relationships characterized by alternating between
        extremes of idealization and devaluation.
Identity disturbance.
Impulsivity in areas that are potentially self damaging.
Recurrent suicidal behavior, gestures or threats.
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger.
Transient, stress-related paranoid thinking or severe dissociative symptoms.

I think women are more prone to exhibiting these characteristics because women’s identities change more than men’s do.  They change their last name, their bodies change to produce babies, their babies change their lifestyle habits; it’s an overwhelming amount of change to deal with.  Considering the added pressures of working outside the home, women are stressed in ways that they have never biologically or emotionally been before.  Then, add the fact that they’re an adult (as in the case of Robin) and they “should” have their emotions in check, and they “should” be able to cope; it’s all very overwhelming.  This in turn, makes women more susceptible to disassociative behaviors, and an exaggerated inability to deal with their emotions, leading them to act out in inappropriate ways.

Furthermore, in the West, we have spiritual poverty, which may be worse than poverty in the traditional sense.  People do not believe in God, do not pray.  People are selfish with their own needs and desires, and do not care for each other.  You have the poverty of people who are dissatisfied with what they have, who do not know how to suffer, who give in to despair.  This poverty of heart is often more difficult to relieve and to defeat.

Scientifically, BPD is difficult to treat because the causes are not well understood.  They also share signs and symptoms of other personality disorders, mood disorders and PTSD.  As per the text on page 211, little research has been conducted on the development and evaluation of treatments for BPD.  Many people have responded well to medication, while others often have problems with drug abuse, compliance with treatment and suicide attempts.  All of these factors complicate efforts to provide safe and successful drug treatments.

While I am not a therapist (and yet perhaps this is common practice), I thought it was unusual that the clinical psychologist agreed to accept Robin into therapy as long as she committed to work toward behavioral change and stay in treatment for at least 1 year, and also included the stipulation that Robin could not attempt to commit suicide.  How could a patient with mental illness agree not to commit suicide; especially one with characteristic “impulsive behaviors” and one with a history of abuse?  Before I read the outcome of the hospitalization pattern, I thought it was strange that the patient had so much say over whether or not she could be hospitalized, since the text stated she manipulated every person that came into interaction with her (thereby holding them hostage, page 204).

I am further humbled by how important my job as a teacher is, because I realize now more than ever, how important it is for children to get an equitable, respectful educational experience. Children must learn to be resilient, confident and self-sufficient.  They must feel loved, supported and receive constructive feedback instead of criticism in their formative years.

As per this case study, it is almost impossible for mental health professionals to undo the years of damage committed in adolescence.

Barlow, David H. & Brown, David H. (2011). Casebook in Abnormal Psychology. Belmont, CA: Wadsworth.

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