Deliberate Renunciation of Coercion in the Case of Persistent Self-Destructive Behavior

Psychiatrische Praxis
Stefan TschökeTilman Steinert

Abstract

The clinical course of borderline personality disorder with persistent suicidal communication and self-destruction is often characterized by freedom-restricting interventions, long-term hospitalization, and a lack of commitment for disorder-oriented treatment. We present the course of a 31-year-old man who was offered the free choice between disorder-oriented treatment or discharge from in-patient treatment. The clinical decision to offer the choice to the patient was based on the judgment of given capacity of self-determination except for short periods of acute crisis. Deliberate refraining from the use of coercive interventions and demanding responsibility for change from the patient paved the way for psychotherapeutic treatment and the reactivation of his own skills.

References

Aug 15, 2000·Psychological Review·S E TaylorJ A Updegraff
Jun 2, 2010·Psychiatric Services : a Journal of the American Psychiatric Association·Susanne HörzGarrett Fitzmaurice
Jun 25, 2013·Neuroscience and Biobehavioral Reviews·David V Baldwin
Nov 13, 2014·Der Nervenarzt·UNKNOWN Deutsche Gesellschaft für Psychiatrie und Psychotherapie,Psychosomatik und Nervenheilkunde e.V. (DGPPN)
May 12, 2015·Archives of Suicide Research : Official Journal of the International Academy for Suicide Research·Alcinéia Donizeti FerreiraCristina Marta Del-Ben
May 31, 2019·Medicina·Joel Paris
Sep 20, 2019·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Michelle DewarChristophe A Fortin

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