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Published on: March 8, 2018
A Psychodynamic Approach to Co-occurring Borderline Personality and Substance Use Disorders in the Emergency
Bernadine H Han1, Giselle Appel1, Jonathan D Avery1
1Columbia University Center for Psychoanalytic Training and Research, Columbia University Medical Center, New York City (Han, Hersh); Department of Psychiatry, Weill Cornell Medical College, New York City (Han, Appel, Avery).
Abstract:
Patients with co-occurring substance use disorders and borderline personality disorder have high rates of morbidity, mortality, and utilization of medical services. Their acute symptoms present complex challenges to clinical staff in the medical emergency department related to both logistics and management of countertransference. This article examines patterns in countertransference and proposes application of psychodynamically informed principles and strategies to facilitate safety and enhance communication during fraught clinical encounters.
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