Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

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Introduction All frontline workers will encounter people who might be seen to have a personality disorder. Someone’s personality is their characteristic patterns of thinking, feeling and behaving that remain fairly consistent across situations and over time. ‘Personality disorder’ is the term used within mental health services to describe longstanding difficulties in how an individual thinks and feels about themselves and others, and consequently how they behave in relation to other people.
INTRODUCTION THE PURPOSE OF THIS GUIDE IS: • To help people to know more and to understand more about personality disorder, and how this impacts on individuals who may attract this diagnosis, and the staff, teams and organisations that work with them. • To invite people to think about their own attitudes to working with people with personality disorder. • To provide some information about services that might be available, how to access help for people with personality disorders, and what can be expected from services. • To offer guidance on helpful and unhelpful ways of responding to people with personality disorders. Sometimes it is our own reaction to a service user 1 that alerts us to the fact that this person struggles with relationships. We may find ourselves feeling uncharacteristically frustrated with someone, or eager to help and ‘rescue’ them from their difficulties, or feeling we have to tip toe around them for fear of provoking them. Sometimes these reactions are to do with our own issues, but sometimes it signals that this service user has personality difficulties and will need the worker to be particularly careful and thoughtful in their approach. <strong>The</strong>re are many different ways in which someone can have personality difficulties, or a personality disorder. <strong>The</strong>se are three examples of people who have personality difficulties which interfere with their everyday life: 2 Jack often reads hidden meanings into harmless remarks and is quick to feel injured or slighted and then reacts in an angry way. His family feel they have to tread carefully around him. His partner experiences him as suspicious and inclined to be jealous; he has accused her of having affairs. If he feels he has been got at or betrayed by friends he harbours grudges and will not forgive and forget, so over the years he has lost friends and become increasingly isolated. Kelly manages to hold down a job as a nursery nurse, but she struggles with mood swings, sometimes feeling OK, but often overwhelmed by anger or feeling depressed and worthless. Her relationships with partners start well but seem to ‘crash’ within a few weeks; she is very sensitive to feeling rejected or abandoned and partners can experience her as too demanding. When she feels hurt or rejected she can get in a rage and she sometimes lashes out at others, but she is more likely 1 Throughout this guide the term ‘service user’ will be used to refer to people who might be given this diagnosis and who have accessed help from services. We have chosen to use this in preference to other terms in use to denote people in receipt of services, such as ‘patient’, ‘client’ or ‘customer’. We recognise that the term ‘service user’ is not ideal as some people feel it devalues the many aspects of individuals’ lives beyond their engagement with services. We use it here for ease of understanding but hold in mind these reservations. 2 When examples are given, these are not real people, but are fictitious examples based on people we have known. 5
Page 1 and 2: Working effectively to support peop
Page 3 and 4: Contents Foreword .................
Page 5: Executive summary It’s not person
Page 9 and 10: WORKING TOGETHER Professionals have
Page 11 and 12: BACKGROUND Each person’s personal
Page 13 and 14: BACKGROUND • People with personal
Page 15 and 16: BACKGROUND taken overdoses is stock
Page 17 and 18: BACKGROUND How do we describe and u
Page 19 and 20: BACKGROUND 1) Openness (seeking out
Page 21 and 22: BACKGROUND “Music has got me thro
Page 23 and 24: LEARNING POINTS FROM CHAPTER 1 —
Page 25 and 26: BACKGROUND There is no underlying
Page 27 and 28: BACKGROUND The notion of treatabili
Page 29 and 30: BACKGROUND For many years, because
Page 31 and 32: Learning points from Chapter 2 —
Page 33 and 34: BACKGROUND Most professionals agree
Page 35 and 36: BACKGROUND soothing, responsive car
Page 37 and 38: BACKGROUND THE THEORY OF MENTALIZAT
Page 41 and 42: PRACTICAL GUIDANCE RECEIVING GOOD C
Page 43 and 44: PRACTICAL GUIDANCE What might get i
Page 45 and 46: PRACTICAL GUIDANCE THERE ARE MANY R
Page 47 and 48: PRACTICAL GUIDANCE HELPFUL THINGS T
Page 51 and 52: PRACTICAL GUIDANCE Here are some ex
Page 53 and 54: PRACTICAL GUIDANCE Some teams will
Page 55 and 56: PRACTICAL GUIDANCE Specific psychol
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PRACTICAL GUIDANCE borderline and a
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Learning points from Chapter 5 —
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PRACTICAL GUIDANCE There are many d
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PRACTICAL GUIDANCE It is extremely
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PRACTICAL GUIDANCE 6) ISSUES OF POW
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PRACTICAL GUIDANCE We all know that
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PRACTICAL GUIDANCE Common defences
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PRACTICAL GUIDANCE It is possible t
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PRACTICAL GUIDANCE ORGANISATIONAL V
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therapist and client is a collabora
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Appendix 2: References and resource
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SELF HARM: National Self Harm netwo
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