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Borderline Professional Disorder

Borderline Professional Disorder by Dr James Johnston  

 

The yellow line signifies cowardice, a watershed or an arête; the sharp ridge at the mountain top, either side of which one may slip and fall to one’s death.

 

The line of the borderline is a border which is always crossed as a boundary in this country of the mind is there to be blurred or broken.

 

I have come to think of the professional who chooses to engage with the borderline patient as having chosen to traverse a tightrope. (See image 6).

 

 

Borderline Professional Disorder

   
Borderline Professional Disorder by Dr James Johnston  

 

This shocking bloody mess conveys the experience of entering into a world where invariably there will be blood on the carpet, literally that of the patient and symbolically that of the professional.

 

 

 

 

 

 

 

 

The Do Do Bird

 

   
Borderline Professional Disorder by Dr James Johnston  

 

The psychotherapist’s mantra is ‘don’t just do something, sit there’. The demand for action in the world of the borderline is like a chaotic choreographer who uses harm against their body and the threat of death to move others to do. Borderline activity is like an unconscious manic maelstrom at the still centre of which is the patient.

 

 

 

 

 

 

Dead as a Dodo

 

   
Borderline Professional Disorder by Dr James Johnston  

 

The Do Do Bird became extinct because it had no space to think. The emotional demand of the entitled, anxiety provoking patient who threatens death is one which can lead professionals to stop thinking, mirroring the patient’s replacement of thought with doing. There is an infinite imperative; no one is indispensible.

 

 

 

 

 

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Updated: 31 January 2011


© 2011 Royal College of Psychiatrists