Running head: Borderline Personality Disorder

ABSTRACT
Borderline personality disorder (BPD) is a mental health disorder that causes substantial emotional unpredictability, and can lead to many other stressful mental and behavioral problems. BPD may cause an individual to have a severely inaccurate self-image and feel worthless and basically damaged. Anger, recklessness and frequent mood swings may push others away, even though the individual may desire to have loving and lasting relationships.

Background History
Borderline personality disorder (BPD), a mental health disorder, affects how you feel about yourself, relate to others and behave. It has a long-term pattern of unstable or stormy emotions. These inner experiences often led to impulsive actions and chaotic relationships. Tendencies include acting impulsively and without thought of the consequences; the mood is unpredictable and impulsive. Emotional outbursts and uncontrollable behavior explosions are problems associated with the disorder (Butcher, et. al, 2013). To types of personality disorder includes impulsive and borderline. Impulsive type is characterized by unpredictability and a lack of impulse control. In addition borderline is characterized by disturbances in self-image, aims, and internal preferences, chronic feelings of emptiness, intense and unstable interpersonal relationships, and by a tendency to self-destructive behavior, including suicide gestures and attempt.
Identifying history
Shirley, comes from a divorced household with three siblings. Her family had little money when she was a child and decided to become a doctor so that she would not have to live in poverty as an adult. Shirley’s first marriage came about after she got pregnant with her first child and it produced two children, a boy and girl. She did not have a good relationship with her mother-in-law as she would not allow her to bond with the children or present them with gifts.
Her first marriage ended when she began a pervious relationship with an old boyfriend. This marriage produced a daughter and also ended soon after in divorce. One month before her second marriage she had an abortion under unclear conditions. Shirley was reported to a Social Services agency for physically and emotionally abusing her children, however no evidence was found and the case was closed.
While pursuing her medical degree she decided to leave the two oldest children with their paternal grandmother and the third child with her father. She allowed her children to live with her during the second year of medical school. Shirley had been granted custody of her daughter from second marriage, but decided to send the child back to live with her father. During her residency training her supervising physician claimed that, after he made a comment criticizing her treatment of colleagues, she became quite hostile, yelling, crying, and accusing him of treating her unfairly. Her behavior became worse during her second residency. She falsified some of her clinical reports and at least one patient refused to return after seeing her. Because of her behavior feedback was withheld.
One physician described her behavior as manipulative, angry, accusatory and loud especially if she was caught in a lie. She also lacks personal commitment, only going through the motions and not truly enjoying the work. Another physician went as far as describing her as a manipulative, guiltless psychopath.
Reason for Referral
Shirley, a woman in her early forties, was referred with a history of a suicide attempt, impulsive, angry outbursts; inability to maintain stability in relationships; affective instability; and physically damaging acts, including physically attacking one young man in which she can an relationship. After a relationship ends her behavior becomes erratic and violent toward the ex-boyfriend. Shirley has stalked her boyfriends on several occasions going as far as