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De borderline persoo\nlijkheidsstoornis: emotie, cognities en preoccupaties

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De relatie tussen hulpverleners en cliënten met een borderline persoonlijkheidsstoornis verloopt moeizaam. Wederzijdse frustraties en manipulaties leiden tot minimale therapietrouw en hoge drop-out. Hieraan dragen preoccupaties van cliënten bij, maar ook die van hulpverleners. Dit artikel beschrijft deze preoccupaties, waarbij onder andere uitgegaan wordt van het gedachtegoed van Linehan’s dialectische gedragstherapie. Omdat de preoccupaties van cliënten en hun daaruit voortvloeiende neiging een zwaar emotioneel appèl te doen op hulpverleners juist onderdeel uitmaakt van de stoornis, moeten in eerste instantie de preoccupaties van de hulpverleners veranderen. Om dat te bereiken moeten hulpverleners zich bewust worden van hun attitudes, zich informeren over de stoornis, opnieuw leren kijken en onbevooroordeeld luisteren naar wat de cliënt laat zien. Hulpverleners moeten ‘mindful’ worden.

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    Wies van den Bosch

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Abstract

The relationship between therapists and clients with borderline personality disorder is by definition a difficult one. Mutual frustrations and manipulations result in minimal treatment adherence and a high drop out rate. In part, this is due to clients’ preoccupations, but those of the therapists contribute as well. This article describes these preoccupations in light of the basic assumptions of Linehan’s dialectical behaviour therapy. Because clients’ preoccupations and, consequently, their strong emotional appeal on therapists is part of the disorder, therapists’ preoccupations should change first. To achieve this, therapists must become more aware of their attitudes, become better informed about the disorder and learn again to watch and listen without prejudice. They ought to become ‘mindful’.

Dr. L.M.C. van den Boschis behandelinhoudelijk eindverantwoordelijke van het forensisch psychiatrisch instituut Oldenkotte te Rekken. Daarnaast is zij als dgt-psychotherapeut werkzaam bij de polikliniek van dezelfde instelling. Ze is ook hoofdtrainer en supervisor dialectische gedragstherapie. Correspondentie: Forensisch Psychiatrisch Ziekenhuis Oldenkotte, Kievenneweg 18, 7157 CC Rekken; tel: +31(0)620490230; E-mail: wiesvdbosch@planet.nl.

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van den Bosch, W. De borderline persoo\nlijkheidsstoornis: emotie, cognities en preoccupaties. DITH 25, 77–83 (2005). https://doi.org/10.1007/BF03060379

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