Borderline Personality Disorder Case Conceptualization

Borderline Personality Disorder Case Conceptualization
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Case Conceptualization
Background
Stella is a 28-year old Caucasian female who checked in at the outpatient clinic after a string of failed relationships and chronic depression symptoms. Stella was raised in Albuquerque, New Mexico, but moved to New York after securing a placement at the City University of New York. She has been living by herself ever since and rarely visits her kin back home. The patient has had five long-term relationships since her college years, but they have always ended tragically, with most boyfriends terming her as “controlling,” “manipulative,” “psychotic,” and “violent.” Stella admits to having a closer relationship with her younger brother and cousins than with either of her parents. Her parents divorced when she was 13 years old, and she has not seen either of them in four years. However, Stella admits to having a few close friends and that they support each other.
Stella reported having bipolar disorder symptoms and that her irritability started while she was still in middle school. The patient stated that she has difficulty adjusting to new people or situations and that her parents assumed that she would eventually grow out of her “childish behavior.” However, her tendency to quickly get upset and have tantrums intensified in her teenage years. She was very dependent on her father, who was often away from home (working in California), and that she suffered separation anxiety every time he left for work. As her inability to control her mood swings increased, so did her tendency to engage in impulsive behaviors such as running away from home or yelling at her teachers in school. Stella had very few friends in high school, but her friendships would always end in conflict, something her mother scolded her for. She talked about feeling isolated, bored, and incapable of sustaining any meaningful relationship for longer than three months. Before leaving for college, her life had started spiraling out of control, and her emotional instability became more uncontrollable.
She would fight with her mother incessantly over little things and experience intense depression with suicidal thoughts. However, she found a way to distance herself from college and preferred short-term relationships to long-term ones. Along the way, she managed to have several serious love interests who would put up with her behavior for several months before ending the relationship. Although she is a hard worker, the patient stated that her manipulative, impulsive, and antisocial tendencies had cost her several jobs owing to explosive disagreements with coworkers and supervisors. Stella has attempted suicide several times, but all have been unsuccessful until recently when her roommate found her in the act of slashing her wrists with her hair clippers. Her friend then decided that it was time to find help and advised her to see a psychiatrist in the area.
Session Overview
The clinician first evaluated the patient to determine if an inpatient or outpatient treatment approach would help counter Stella’s...