How to lose your clinical balance, while holding on to your therapeutic bearings, and other ideas on working therapeutically with a ‘treatment resistant’ client diagnosed with Borderline Personality Disorder

Abstract

AbstractThis article describes a clinical case where an Advanced Brief Strategic Therapy Model (Gibson and Boardman, ; Gibson et al., ; Nardone and Watzlawick, ) was used with a woman presenting with presumed Borderline Personality Disorder (BPD). In the world of therapy, the process of change can often be hard to predict at the best of times and extremely unpredictable during the worst. It can be difficult for the curious therapist to know how and what to look for as indicators of change when the larger picture may appear to remain unchanged in a client's life. I am curious about those therapy cases which present with great difficulties attached to them and which often drain much of our energy, vim and vigour as psychotherapists with often little apparent return on the investment we make. That is, if we measure that return in terms of reported change by the client, as opposed to privileging therapeutic disposition.Practitioner points This article explores how an Advanced Brief Strategic Therapy Model was used with a client diagnosed with Borderline Personality Disorder I critique the often misunderstood idea of embodied cybernetics as an interpretation of the therapeutic process Drawing on clinical practice, I describe some of the challenges in working with a client who often dispensed with rationality and employed non‐ordinary logic in her modus operandi