Re: Personality disorder diagnosis by remote control

You know what? I agree with both of you: I can see the basis for a personality disorder hypothesis AND I know very well the impact of the diagnosis on the patient. Frankly, in my own work, I use personality disorder as a type of shorthand for the complexity and variety of interventions I will need to use to move the patient toward a satisfactory (for him/her) outcome.
Regarding this patient, I suggest that keeping her in the group be considered a treatment success (as much for you as for her). As far as assessment goes, where does the ocean actually meet the shore and how long exactly is the coast line?
If she can last through your group, and if you have others like her in other groups, why not invite them to an "advanced" group? I have found that changes the dynamic substantially, for me and them. Getting them to commit to something regular, like a group, something structured, is a monumental success. I know this is light years from getting her HbA1c down to reasonable levels, but frankly and reasonably, that is simply not an achievable goal without her being able to commit to doing something on a regular basis (read Group).
BTW, this is really tough work and no mistake about it! I almost prefer the medication dependent pain patient if it weren't for the litigation that inevitably crops up.

Replies:

Re: Personality disorder diagnosis by remote control, by Jim Spira, 7/15/99 Re: Personality disorder diagnosis by remote control, by John Martin, 7/16/99 Alexithymia, by Jim Spira, 7/17/99 Re: Alexithymia, by John Martin, 7/17/99 Re: Alexithymia, by , 8/13/99

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