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Old May 24, 2012, 05:03 PM
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athena2011 athena2011 is offline
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Member Since: Dec 2011
Location: In another dimension...
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Here is an excerpt from the article in 'Psychiatric Times':

Empirically validated treatments have demonstrated how therapies need to be specifically tailored for successful treatment of BPD. The first of these, dialectical behavioral therapy (DBT) was developed only after it was realized that patients with BPD resisted a traditional behavioral approach. DBT incorporated techniques of validation and the concept of acceptance to a cognitive-behavioral framework. Similarly, schema-focused therapy was developed for personality-disordered patients who were “nonresponders” to—or “relapsers” from—standard cognitive-behavioral therapy. Several of these approaches explicitly address the borderline patient’s typical treatment-interfering behaviors so that his or her responses are not personalized or overreactive.

Originally, the concept of treatment resistance was defined in psychoanalytical terms. Freud described the phenomenon of resistance broadly as “whatever interrupts the progress of analytic work.” The term “resistance” often referred to defenses or aspects of character structure that were obstacles to therapists. Currently, treatment resistance often refers to psychiatric symptoms that do not respond to otherwise effective treatments. The most widely recognizable use of this modern meaning of resistance is treatment-resistant depression, which describes a form of depression that does not remit despite reasonable and extensive (usually psychopharmacological) treatment. Both psychological resistance to treatment and the resistance of symptoms to respond as expected refer to a variety of phenomena that can render generally effective treatments ineffective.
BPD is associated with both forms of resistance, and these underlying sources may overlap. Particular forms of defenses exhibited by patients with BPD can constitute therapeutic resistance. However, when BPD coexists with mood disorders, those disorders often fail to respond to treatments as well as expected.


This about a quarter of the article. I can paste more or if anybody's interested, you can sign up for a free subscription to Psychiatric Times (which I highly recommend if you are into self-help) and search for the article. Case studies are presented which I find particularly helpful but it's kind of hard to start in the middle of the article.
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