Psychodynamic formulation in borderline personality disorder: A case study

Psychodynamic case formulation examines how symptoms of the patient appeared and constitutes a useful guideline for clinicians because it examines the level of object relations, ego strength, mental capacity, and core conflict, plans the treatment, and predicts prognosis. Borderline personality disorder (BPD) cases display symptoms characterized by dramatic life history, impulsivity, relationship problems, and unstable moods and behaviors. These unstable and multiple symptoms affect the clinical appearance and treatment response of the disorder. People with BPD build up intense transference and countertransference responses and are often perceived as “difficult patients” by healthcare professionals and nurses who spend the most time with these patients in inpatient services. Therefore, psychodynamic formulation is particularly necessary and useful in BPD cases to understand the patient better and manage the treatment processes. The case presented here reported complaints including mood swings, feelings of emptiness, inability to go to school, bursts of rage, self-injurious behaviors, and suicidal thoughts and attempts. Her expectations from treatment were to control her anger, express herself, be strong in bilateral relationships, and be a normal person. A psychodynamic formulation was done in company with the supervision and the case was diagnosed with BPD. Formulating BPD cases in terms of a psychodynamic perspective may provide more information on thoughts, emotions, and behaviors of the patients. In this study, through the information obtained using psychodynamic interview techniques, impulse, affectivity, mood characteristics, defense mechanisms, selfdom, object relations, and superego of the BPD diagnosed case are discussed. © 2019, Kare Publishing. All rights reserved

An investigation of emotional labor strategies on the basis of empathy among nurses working at intensive care and inpatient units

WOS: 000331837900008Objective: Intensive care nurses produce emotional labor through deep acting by generating empathetic emotional and cognitive reactions during their interactions with patients. On the other hand they produce emotional labor through surface acting whereby they forge empathic behaviors towards patients in the absence of appropriate emotional and cognitive actions. The present study explored emotional labor strategies on the basis of empathy among nurses working at intensive care and in-patient units. Methods: The present study was carried out in a state hospital in Istanbul. The sample of the study consisted of 116 nurses. Emotional Labor Scale, the Empathy Scale and a demographic questionnaire were used to gather data. Results: The hypotheses that as compared with in-patient care nurses, the empathy levels of intensive care nurses would be higher; nurses who have high levels of empathy would show higher levels of deep acting and emotional effort than nurses who have medium or low levels of empathy; nurses who have high levels of empathy would show lower levels of surface acting than nurses who have medium or low levels of empathy; and as compared with in-patient care nurses, intensive care nurses would show higher levels of deep acting and emotional effort and lower levels of surface acting, were not supported by the data. Conclusion: The results have shown that intensive-care nurses do not have higher levels of empathy, and they do not use deep acting and emotional effort more than inpatient clinic nurses. These findings indicate that regardless of the characteristics of the working environment, the nurses show empathy and use emotional labor strategies. More research is needed to understand these findings