Why Do So Many Therapists Refuse To Treat People With BPD?

Why Do So Many Therapists Refuse To Treat People With BPD?

Borderline Personality Disorder (BPD) is often regarded as one of the most challenging diagnoses within the mental health field. Many therapists, taught during their education and training about the complexities and potential risks associated with treating BPD, hesitate to take on such clients. The reasons behind this reluctance are multifaceted, encompassing the disorder’s reputation for intense emotional dysregulation, unstable relationships, and the potential legal implications that some believe accompany treating individuals with BPD.

However, contrary to the prevalent narrative, some therapists, like the one sharing their experience here, find working with BPD not only manageable but deeply rewarding. This therapist’s journey offers valuable insights into why some professionals shy away from BPD cases and what can change this dynamic.

The Stereotypical Challenges of BPD

From the onset, therapists are introduced to BPD as a diagnosis fraught with difficulties. The portrayal often includes a spectrum of destructive behaviours, emotional volatility, poor boundaries, unpredictability, and even suicidal threats. Additionally, there’s an anecdotal belief that clients with BPD are more likely to sue their therapists, further augmenting the perceived risk involved in treating these individuals.

A Different Experience

Contrary to these daunting portrayals, the therapist recounts a personal journey of discovering the fulfilment in working with clients diagnosed with BPD. For them, therapy sessions with BPD clients were engaging, rewarding, and devoid of the anticipated problems. The key to this success, as highlighted, lies in several factors.

Court-Mandated Therapy: A Unique Context

One significant aspect was the context of court-mandated therapy. The clients weren’t seeking treatment out of a voluntary desire for emotional healing but as an alternative to incarceration. This scenario unexpectedly led to a high level of motivation among clients with BPD, who were eager to alleviate their emotional suffering and genuinely engaged in the therapeutic process.

Why Do So Many Therapists Refuse To Treat People With BPD?

Therapeutic Approach and Temperament

The therapist emphasises the importance of their approach and temperament in navigating the challenges commonly associated with BPD. A laid-back attitude and comfort with intense emotions allowed for a therapeutic environment where emotional outbursts were not alarming but understood as part of the healing process. This disposition, along with a clear understanding of the disorder and not taking clients’ behaviours personally, facilitated effective therapy.

Personal Experience and Specialisation

Another theory posited is the influence of therapists’ personal experiences with BPD, suggesting that those with close encounters with BPD in their personal lives might find it triggering and, therefore, challenging to maintain professional patience. Additionally, the vast landscape of mental health disorders encourages therapists to specialise, leading some to avoid BPD due to a lack of qualification or preference for other areas of focus.

The reluctance of many therapists to treat individuals with BPD is rooted in a mix of educational background, personal temperament, and professional specialisation. However, as demonstrated by this therapist’s account, understanding, patience, and the right approach can transform the treatment of BPD from a daunting challenge into a rewarding experience. This narrative not only sheds light on the complexities of mental health treatment but also underscores the importance of personal growth and adaptability within the therapeutic profession.

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