Professional Forum
Welcome to our interactive e-mail forum for providers of mental health and other services for older adults.
E-mail us questions on aging, mental health, or any other related topics. Questions will be directed to a mental health expert in the Positive Aging Resource Center national network of consultants. Questions and answers will be posted online under the Professional Forum.
Submit questions here: ndowning@partners.org.
Question: “Is it ever appropriate to talk with my clients about my own experience with depression?”
Answer: That depends on your beliefs about how the therapeutic process works and about your role as a counselor in that process. On one hand, it is hard to totally separate one’s personal life, upbringing, attitudes, feelings, beliefs, and experience from one’s therapeutic work. On the other hand, ask yourself whether your “wounds” are healed or resolved enough to become a gift to others. Most models for treating mood disorders do not require therapists to explicitly reveal or share a personal experience with a condition in order to treat it.
Question: “What’s the best way to describe a borderline personality disorder to the family members of an older adult who has this disorder?
Answer: A borderline personality disorder (BPD) is a debilitating illness. People with the behavioral and emotional characteristics that lead to this diagnosis usually have suffered greatly throughout their lives and have likely caused many problems for their family members. They tend to have very poor relationships and difficulties in the role of spouse or parent. Other people tend to find them very aversive due to their chronic emotional dysregulation and poor empathy skills. The children of people who meet criteria for BPD often experience emotional pain and invalidation throughout their childhood, especially if another adult is not available to provide emotional comfort and serve as an effective role model.
Individuals with BPD are highly sensitive to rejection, and they react with anger and distress to such mild separations as a vacation, a business trip, or a sudden change in plans. These fears of abandonment appear to be related to difficulties feeling emotionally connected to important persons when they are physically absent; the individual with BPD feels lost and perhaps worthless. Suicide threats and attempts may occur along with anger at perceived abandonment and disappointments.
Patients must have a good psychiatric evaluation by a professional who specializes in personality disorders before treatment begins. This is worthwhile because the course of the patient's treatment may be determined by an initial evaluation. By the time a borderline personality disorder is diagnosed, so much stress has been generated in the family that everyone is affected. Thus, the entire family should seek support services.
** Answers will be posted in a timely fashion. PARC reserves the right to edit questions for length and content. This forum is for educational purposes only. All information presented on this website is intended for general knowledge only and is not a substitute for a medical or professional consultation. Inquiries directed to PARC consultants or staff are not considered to be formal medical consultations, and any response by PARC consultants or staff to such inquiries is not considered to be formal medical advice.
