Examples of perceived behaviour of people with BPD50 | Possible explanations for this behaviour | Possible solutions for the doctor |
High use of healthcare | High burden of psychiatric and physical comorbidities, coupled with health anxiety and fear of abandonment | Allowing enough time during the consultation to make the patient feel understood Avoiding ‘bouncing’ patients between specialties where possible |
Apparent intentional sabotage of care | Part of self-destructive behaviour due to low self-worth Fear of abandonment by health professionals | Maintaining an open and validating approach Organising follow-up |
Difficulty establishing trust | Histories of being repeatedly let down or taken advantage of in the past | Working towards a collaborative, transparent approach with careful explanations Sticking to appointment times and agreements Organising follow-up |
Misunderstandings and angry reactions | Negative interpretative bias to ambiguous faces in people with BPD | A genuinely compassionate approach from the physician will often instil greater patient confidence |
‘Splitting’ in clinical teams | Emotional dysregulation in patients can provoke strong reactions in clinicians which can become polarised | Recognising the pattern and using it informatively Effective teamwork and adequate supervision |
BPD, borderline personality disorder.