Personality disorders and the self-fulfilling prophecy – why staff attitudes really matter

Some great observations and research here.

Dan Warrender's Mental Health Blogma

The room sighs as yet another person diagnosed with a personality disorder is admitted to the busy hospital ward, as a health service with limited resources and a skeleton staff (yet ever increasing expectations from an insatiable society) wheezes through another day. Unbeknownst to the staff team however, their sigh has already set the tone for what is to follow. The expectations are often of a ‘difficult’ patient, perhaps influenced by the memory of previous challenging experiences, or the unwelcome diagnostic baggage and stigma which accompanies people with these controversial labels. Negative attitudes have commonly seen people described as manipulative and attention seeking, with emotional dysregulation and impulsivity often unhelpfully dismissed as “just behaviour”. There is no doubt that working with people with diagnoses of personality disorders in significant distress can be extremely challenging, with self-harm and suicidality a common and understandable precursor to staff distress, as they undertake the…

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