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Variables of poor prognosis in BPD

Numerous researches on BPD are ongoing worldwide probably because of large number of cases diagnosed. And also because borderline individuals are likely to make frequent suicidal gestures, more research & treatment has been carried out with BPD than other personality disorders. Most of the theories about its cause focus on a disturbed early relationship between a preborderline child & his/her parents. Some focus on attachment experience in early childhood, while others point to parents who fail to provide adequate attention to child's own feelings. Some theories focus on parental abuse in adolescence, as well as on divorce, alcoholism & other stressors. Perhaps BPD is associated with some genetic vulnerability.

One group of researchers has suggested that the difficulties borderline individuals have in regulating their lives may be due to disruption in the functioning of certain neural circuits.

SPLITTING is Otto Kernberg's theoretical explanation of the tempestuosness & extreme changeability that can be seen in the borderline person's relationships to others. He defined splitting as failure to integrate the positive & negative experiences that occur between the individual & other people. Intolerance of being alone is a frequently observed core problem of BPD. There is no firm answer as to why this is so.

Various therapeutic approaches deal with these core issues in different ways. Psychodynamic therapists believe that most patients can best be treated in intensive face to face psychotherapy sessions at least 3 times a week over a period of several years. According to one school of thought, those with this disorder seek therapy because if their desire for relief, but they then unconsciously avoid, evade or undermine therapeutic programs. Cognitive therapists focus on patient's limitation in 3 areas, cognitive distortion, automatic thoughts & unrealistic assumptions. CBT thus concentrates on identifying & changing cognition so as to permit better reality testing. Behavior therapists try to teach better social skills to cope with stress.

#bpd #borderlinepersonalitydisorder #cbt #bt #mentalhealth #abnormalpsychology

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