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2018-09-24

personality disorders – the king discipline of psychiatry?

I worked for many years in psychiatry. Directly after the training I started to work on a ward for patients with Borderline personality disorders. Later, I led a Station for young adults with personality and trauma disorders. From this time I remember very well a phone call from a colleague who wanted to apply with me and the phone call with the sentence began: “So, I thought I try now again in the king discipline of personality disorders.” My first thought: How is he? My second: Could there be something to it? Before I give the answer, but it is a small digression in the structure of the psychiatry helpful.

Thus, the psychiatric hospitals are organized

As in the field of somatics, and today’s psychiatry in different subject areas is divided. At least the larger psychiatric hospitals to organise themselves so. In the Asklepios clinic North, there are six different departments, each called a “clinic for…”. These include:

• Clinic of acute psychiatry and psychosis

• Clinic for forensics

• Clinic for dependence diseases

• Clinic for affective disorders

• Clinic for geriatric psychiatry and the

• Clinic for personality and trauma disorders.

A superficial classification of the patients

Depending on the reason a Patient of the clinic will be allocated. That sounds first of all, think to the drawer and the little individually. Because it is not a Person that would be suffering from depression, and actually, in the clinic for affective disorders treated can also have an addiction problem? The is definitely. It is directed in the case of several mental problems the most acute, so what makes the most and biggest problems.

The special feature of the clinic for personality and trauma disorders

In the clinic for personality and trauma disorders, there is a colorful mix of people. One reason is that problems in behavior, in relationships and with yourself turn out to be often as symptoms of a personality disorder. Often, these problems are very acute and often lead to suicidal thoughts and -attempts – the most common reason for in-patient admissions in the psychiatric ward. At the same time disorder arise as a part of the personality further of behaviour and Experience such as depression, eating disorders or dependence disorders. A good Overview of the common clinical pictures in psychiatry here on the pages of the clinic for personality and trauma disorders.

Personality disorders are curable?

There was a time in which personality disorders were not curable. This opinion is thankfully history. But it remains a complicated disease, the patients suffer from. A therapeutic way in early Childhood as the date of origin is necessary, and that hurts. At that time, the seeds of the personality disorder was sown by emotional Stress, the symptoms pointed only in the puberty. The for healthy people hardly imaginable pain, Fears, anger, and Overwork are created to endure over the years, unconscious patterns of behavior that characterize the relationship behaviors. The relationships between patients and caregivers are affected.

Cleavage as a burden for the Patient-care relationship

One of these behavior patterns loaded on the interpersonal relationships of patients with personality disorders: the division. This pattern of behavior has its origin in early Childhood: a child emotionally and/or existentially threatening experience, with respect of persons. The child at this time but subject to the respect of persons, and must withstand the threatening experience. A strategy: The perception of Negative is cleaved and displaced. The positive sides of the injurious persons are idealized. So the world is divided in black and white. This ensures the Survival of the child, but to the obstacle, if in subsequent relationships in case of conflicts, also black-and-white thinking, and traded is felt.

Challenging behavior Endure together

It comes in all of our lives to everyday conflicts – including a day in the clinic between patients and nurses. Patients with a personality disorder tend to break off the relationship, and if they refuse to nurse at once, because it’s a daily conflict arouses the Fears of the past. For the patient there is only good or evil people. At this point, both sides need to show a lot of courage, strength and perseverance. The nurse as a professional, first, double, for example, by reaching out again and again on the patient, even if this behavior is actually negative. The patients need to learn the Stand of closeness and conflict with one and the same Person can be so tedious.

The colleague on the phone is meant by this requirement, as he described the work with personality disordered people as the king’s discipline. He has had the courage to accept the challenge.

Photo: Katharina Voss

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