An exploration of clinicians' experiences in the diagnosis and management of patients with borderline personality disorder [patients] at Valkenberg hospital in the Western Cape region
Disorders of personality are conceptualized along a continuum of severity. Among all diagnosed with a cluster B personality disorder, patients with Borderline Personality Disorder illness are believed to experience the greatest suffering. Always in a state of crisis, these patients are so name by different writers because they were believed to stand between a neurotic and psychotic personality organization. This complex diagnostic picture together with the illness's tendency to co-exist with some of Axis I psychiatric disorders has made the illness to be perceived as both difficult to diagnose and manage. Previous research indicates that many professionals are turned off by working with people with this illness because it draws on many negative feelings from the clinician. This study sought to explore factors which assist clinicians in making the BPD diagnosis. It focuses at diagnostic processes utilized other than the DSM-IV -TR. Explanatory theories are also put forward in an effort to try and understand some of the issues experienced by the individual in the development of the illness. Participants' attitudes held towards these patients are also examined to see whether these have shifted. An understanding of these factors and recommendations are offered at the end. Semi-structured interviews were conducted with seven white clinicians from Valkenberg hospital in the Western Cape region. The research design was qualitative and a phenomenological framework was used to inform the study. The interviews were taped, transcribed and typed. The data was then analysed according to broad themes emerging from the interviews. A number of different factors impacted on the decision regarding in both making the diagnosis and management of BPD illness. These factors were discussed according to the following broad themes: Diagnostic challenges; Demographic patterns in BPD diagnosis; Management issues.
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