Nursing Care Plan for Borderline Personality Disorder

Management of Borderline Personality Disorder
1. Definition of Borderline Personality Disorder

Borderline Personality is a psychological disorder that occurs due to not labile mood of the patient followed by a bout of depression, anxiety, or anger, which is very frequent and sometimes does not make sense. More details Borderline personality disorder is a personality disorder in relationships with other people, to know their own feelings, and failures in the control of emotions and behavior it causes. The most prominent problem in patients with personality disorders is the encouragement of suicidal impulses or behaviors to harm themselves.

Forms such as mood instability, lack of clear thinking, instability in maintaining interpersonal relationships, self-image, emotions and behavior is a real disorder in this personality disorders. As a result of the greatest of shape this behavior is its impact on the social environment of the patient.

Personality disorder is referred to as a personality disorder threshold (Borederline) due to be among the border between neourotic disorder and schizophrenia. This disorder is common in adolescence or early adulthood and occurs mostly in women.


2. Explaining Theories  of Borderline Personality Disorder

The theory is able to explain the growth of this Borderline personality disorder is a Theory of Psychoanalysis. According to the psychoanalytic view of this impaired condition due to the lack of a relationship that is created in his childhood with
guardians. Caregiver actions that make people dependent on the beginning and then at the start off of the caregiver resulting in the patient is less able to learn his views on caregivers and others.

As a result, the patient is less developed in understanding themselves and others. The development process is what is wrong according to the psychoanalysis argues that this borderline personality disorder symptoms. Patients were hampered progress toward its views of themselves and others become incapacitated and hesitation in perceiving themselves and others.
He could argue everything on destiny right or wrong, and even doubts about his views.


3. Incidence Causes of Borderline Personality Disorder

As has been stated above that the psychoanalytic theories to explain the occurrence of this Borderline personality disorder, as a result of which in the natural life of the patient in the past. To more clearly as follows:

1). The violence in childhood, rejection and separate the real parents. Many studies show that the relationship of child abuse, especially sexual abuse and violence will foster the development of children's personality later became BPD. Patients with borderline personality disorder experiencing verbal abuse, emotional, physical and sexual abuse during childhood development. In girls who were separated from biological parents and foster parents have withheld by the risk of violence and sexual abuse more than boys, but the other two have potential violence. Both have links tighty emergence of personality disorders on subsequent development phase.

2). Task Failure Factor In Progress
Another factor is the emergence of borderline personality disorder is not only caused by the interference spectrum of trauma alone, the study "Kernberg" mentions that the emergence of BPD is caused by a failure in the developmental tasks of childhood. Failure is a failure to recognize and differentiate the child in the child with another person who subsequently developed other forms of psychosis in children.
Parental education at home also affects the formation of BPD, such as negative interactions between parent-child, lack of empathy, and greater criticism evidenced in children than awards.

3). Genetic factors
Some literature states that treatments associated with BPD will affect the genes that would affect the child's personality, but genetic factors being investigated further.
Effect of serotonin associated with genetic allegedly also influential.

4). The imbalance of neurotransmitters
The imbalance of neurotransmitters such as serotonin, norepinephrine and acetylcholine (an effect on the type of emotion and mood); GABA, (stabilizers mood changes), the function of the amygdala; influence the behavior of BPD patients in response to a stressor that appears. Impulsive behavior and aggressiveness is caused by an imbalance of serotonin and parts of the prefrontal cortex.


4. Treatment or Therapy Against of Borderline Personality Disorder

1). Dialectical behavioral therapy
Was first introduced by Marsha Linehan in the 1990s to intervene in patients who wish to commit suicide, dialectical behavioral therapy (DBT) therapy in the treatment of BPD is based on the biosocial theory that emphasizes private functions in regulating emotions in accordance with environmental experiences.
DBT is derived from various forms of congnitive-behavioral therapy but in DBT emphasis on giving and negotiations between the therapist and the client; between the rational and the emotional, acceptance and change. The target is to achieve the adjustment between the various problems being faced by the client with the right decision. Other things that the client obtained in this therapy are; concentration, the relationship
interpersonal (such as the desire assertive and social skills), coping with and adapting to the distress, identifying and appropriately regulate emotional reactions.

2). Schema therapy
Schema therapy is an approach based on cognitive-behavioral and gestalt. The focus is on the emotional aspects of therapy, personality and how individuals react to the environment. In this treatment focuses on the relationship between therapist and client (mentoring; reparenting), daily life outside of therapy clients, and the experience of childhood trauma.

3). Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a type of therapy that is very widely used for treatment of mental disorders, but the healing disorder BPD is considered less effective therapy. Difficulties encountered when developing interpersonal relationships in conjunction with the treatment given, therefore, CBT also adopted schema therapy.

4). Family therapy
Family therapy is helpful for reducing conflict and stress can worsen the condition of an individual's mental with BPD. Family therapy training family members appreciate the individual BPD, improve communication and problem solving together and mutually
support between spouses.

5). Transference-focused psychotherapy
Transference-focused psychotherapy (TFP) is a form of therapy developed by the psychoanalyst Otto Kernberg. Unlike psychoanalysis is considered outdated, the TFP therapists play an active role together in the client premises each treatment session.
The therapist tried to explore and clarify aspects of friendship according to the client's needs.

6). Mentalization-based treatment
Mentalization-based therapy treatment (MBT) is a form of re-regulation has been deemed mentally disturbed after experiencing various problems in childhood. The focus in this therapy is to develop independently the patient to arrange a way of thinking based on psychodynamic theories. In this therapy the patient does not spend his time labored so long in the hospital, medical drug use reduction, and eliminate the negative desires such as the desire to commit suicide.
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