Читать книгу Dynamic Consultations with Psychiatrists - Jason Maratos - Страница 32

Ms. B was given the diagnosis of Borderline Personality Disorder, adjustment disorder, and cannabis misuse with the possibility that she may have been suffering from a depressive episode. She was treated with antidepressant medication and counseling, which was focused on her relationship difficulties and her maladaptive coping techniques as well as anger management. She was offered a short stay (1 week) at the psychiatric hospital.

Ms. B settled well and was cooperative throughout the admission. She had no overt or pervasive depressive symptoms. She had no craving for substances or alcohol. She could sleep well without hypnotics. She was quite attentive and constructive when talking about relationship problems. She had no intention of giving up her boyfriend even though he appeared to be suspicious and unfaithful. She kept daily phone contact with her boyfriend. When her boyfriend visited her in the hospital (once), she mentioned that he cried in front of her. Ms. B said she missed the ward “a bit” at the time of discharge. She considered the hospital a safe and secure place. Ms. B also respected the staff and her doctor and asked to be followed‐up in the public sector.

It was felt that the following factors were playing a part in her condition: a strong family history of depression; mother committed suicide; insecure attachment to parents; lack of care, love, and emotional expression from father and stepmother; lack of discipline from maternal grandmother who often satisfied her demands, irrespective of whether they were thought to be reasonable. There was a history of being betrayed by peers in primary school, which may have further intensified her feeling of insecurity. Repeated self‐harm behaviors and suicidal threat as a kind of manipulation to induce the boyfriend's guilt whenever Ms. B considered the relationship unstable, which contributed to a vicious circle.