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The Royal College of Psychiatrists Improving the lives of people with mental illness

Borderline Professional Disorder


Sections

Borderline Personality Disorder

The do do bird

Dead as a do do

Twin towers

Tightrope between the twin towers

Angel and devil

Torn apart

Misery

The judge

Terror: I

Patient begins to panic before emotional storm

Emotional storm I: things I fear

Terror: II

Professional begins to panic before emtional storm

Emotional storm II: things; fears

Cloud of unknowing bliss

Halo effect

Jacuzzi effect

J'accuse!

Hell effect

Bad feelings

In two minds

Torn apart

 

 

Introduction

The diagnosis Borderline Personality Disorder is likely to evoke associations in mental health professionals of threats of or enactments of self harm, demands for admission to the psychiatric ward (the ‘brick mother’) and above all, frustration and irritation, often borne from a feeling of therapeutic helplessness or inadequacy.


Borderline Professional Disorder by Dr James Johnston

Unconscious enemy

The word borderline conjures a boundary between territories on a map and if one thinks of the mind as a country, the patient who occupies that land cannot find a secure place in which to live. No territorial boundary in the country of the mind will be respected as they search without a map or a compass, randomly roaming in a longing for an idealised place in which they will find freedom from mental pain.

 

The professional who encounters and is drawn into the world of the borderline patient will be invaded, and will be occupied by an unseen unconscious enemy they did not see coming who seeks to colonise the country of their mind.

 

The unconscious experience of becoming part of the borderline experience for the professional is emotionally bloody and messy. Any clarity of purpose or therapeutic strategy will be destroyed in favour of a feral conflict in which rules play no part and primitive instinct, of nature red in tooth and claw, governs the game.

Primitive process

Without knowing quite how and often against their will, the professional is drawn into a level of primitive emotional functioning they may not initially recognise but as they do see who they have become they will witness echoes of formers aspects of themselves which can cause shame, guilt and confusion.

 

This regressive emotional echo in the professional may be of feelings of disgust, retaliation, dread or perhaps excitement and desire but the emotions felt will invariably cause a conflicted wish to conceal what is happening, leading to a mute withdrawal in which silence hides a shameful secret. This is the dangerous professional equivalent of keeping mum.

 

I use the pseudo-diagnostic term Borderline Professional Disorder to describe the professional emotional experience of being disturbed by and mirroring the borderline whose primitive processes resonate in professionals and evoke shame in their being reminded of parts of them selves they sought to forget or undo in their helping roles.

 

The cartoons which follow are based on psychoanalytic ways of thinking about the transference and counter-transference experiences of being with and trying to understand some of what is happening unconsciously that leads to the experience of being disturbed.


 

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Updated: 07 July 2011


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