Dangerous and Severe Personality Disorders

[Guest guest]

I came across this book, written by a psychiatric nurse, Len Bowers, which

discusses " the response and role of the psychiatric team " of

personality-disordered patients.

The reviewer writes:

" As Ratey at Yale has noted across time, it is this group of patients that

will most test the persona and skill of any carer, and also at the same time

elicit the most unprofessional behavior from even the most caring

professionals. "

So, even trained, skilled, compassionate professional nurses find it difficult

to handle patients with personality disorder.

The reviewer goes on to describe how the author breaks down the various types of

manipulation tactics those with personality disorder commonly use:

" Bowers puts a lot of emphasis on a synergistic interplay between various poles

of manipulative behavior, from the " instrumental " (objective, conscious, clear

cut goals) to the " interpersonal " (emotional, unconscious, obscure goals) which

define the parameters of manipulation. The hexagon, as he defines it, or rather

the hexagonal model he provides, categorizes manipulative interactions with the

patient as one or many of: Corrupting, bullying and dividing (the instrumental

side), and the other three categories conditioning, capitalizing, conning (the

interpersonal dimension). "

I find this fascinating, that the psychiatric nurses get trained in

understanding and recognizing various types of manipulations, which then helps

them care for their pd patients properly by remaining as objective, detached,

and unaffected by the manipulations as possible.

We KOs are at the other end of the spectrum: we have been conditioned from birth

to *believe* the manipulations and respond to them, even cater to them. We had

no choice in the matter; a child's objectivity is nonexistent as a minor, and

even us adult KOs have to struggle with detachment and objectivity and awareness

when the abusive manipulative tactics are directed at us by our own mother or

father.

Although this book is intended as a sort of textbook for those within the

industry who specialize in nursing pd patients, I think it would make an

informative read for us adult children of pd parents.

The reviewer writes:

" Bowers draws on many works in the general literature, but also heavily on the

results of a survey of 651 nurses who responded to his questionnaire. This all

makes for fascinating but familiar reading. Anyone from the industry would

recognize the emotive and concerned responses from nurses in specialized PD

units, as well as those from general wards, as they ponder their experience of

those whom others consider sad, bad or mad by virtue of their interpersonal,

enduring styles. "

-Annie