Psychiatric Interviews for Teaching: Self-Harm
From Debs Storey on October 12th, 2016
In this film, you see a psychiatrist who works in the liaison psychiatry department seeing a patient who has recently been treated in the emergency department for wrist lacerations. The lacerations were self-inflicted after a relationship ended.
The patient describes an emotional response to the end of a relatively short-lived relationship. She also gives a history of cutting since her teenage years and she is aware that she uses cutting to manage difficult emotions. She describes very low self-esteem and also some past alcohol misuse and binge/purge behaviours. She gives an account of hearing voices that are inside her head. There appears to be a pattern in her relationships of rapid attachment and then a strong sense of abandonment when they end. Towards the end of the interview, the patient appears to re-play this pattern in her relationship with the psychiatrist. However, the psychiatrist maintains a firm boundary.
This patient displays features of Emotionally Unstable Personality Disorder of the Borderline type. We may speculate that the origins of her problems lie in her childhood experiences.