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Published on: January 5, 2018
[Deliberate Renunciation of Coercion in the Case of Persistent Self-Destructive Behavior]
Stefan Tschöke1, Susanne Hund1, Dana Bichescu-Burian1
1Zentrum für Psychiatrie Südwürttemberg, Ravensburg-Weissenau, Klinik für Psychiatrie und Psychotherapie I der Universität Ulm, Ravensburg-Weissenau.
Abstract:
The clinical course of borderline personality disorder with persistent suicidal communication and self-destruction is often characterized by freedom-restricting interventions, long-term hospitalization, and a lack of commitment for disorder-oriented treatment. We present the course of a 31-year-old man who was offered the free choice between disorder-oriented treatment or discharge from in-patient treatment. The clinical decision to offer the choice to the patient was based on the judgment of given capacity of self-determination except for short periods of acute crisis. Deliberate refraining from the use of coercive interventions and demanding responsibility for change from the patient paved the way for psychotherapeutic treatment and the reactivation of his own skills.
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