Re: OK, but just one last thing....

Rob - I am definitely a newbie to this thread, but certainly am no newcomer to personality disorders that crop up in behavioral medicine. My tentative diagnostic hypothesis about this client was the same as yours. Moreover, I agree completely with you about (non)utility of DSMIV personality diagnoses for providing any kind of treatment direction. My observation has been that we use those codes when we are trying to tell a third party payor that this is a difficult case and will take a long time. And even this is not appropriate or helpful.
The interchange between you and Paul I think is an important one because it highlights the difficulty of dealing with personality disorders/psychopathology as lifestyle/problem in living/draft choice to be named later in the context of Behavioral Medicine treatment. We are supposed to symptom focussed and time limited, but with this patient, what is the symptom? I think this discussion could be valuable to a broader audience.
BTW, my experience with telling patients they have a personality disorder has been similar to telling patients they have body odor: sometimes they get angry, sometimes they begin bathing.
jbm

Replies:

Re: What is the symptom ?, by , 7/8/99 Re: What is the symptom ?, by John Martin, 7/8/99 Re: What is the symptom ?, by Jim Spira, 7/16/99 Re: What is the symptom ?, by , 06/22/02 Borderline? Spectrum?, by Paul Salkovskis, 7/8/99 Re: Borderline? Spectrum?, by John Martin, 7/8/99 NOW I begin to agree., by Paul Salkovskis, 7/9/99

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