Splitting

[psm1776]

I'm wondering how everyone handles patient splitting (and the introjection) when they are working on inpatient service? I guess I'm curious as to what strategies the staff use amongst themselves. The reason I ask, is because this has come up (the recent contentious thread, IMO - just for a practical example) - in various situations. Do the staff get together and discuss/deal with this or is countertransference dealt with quietly/individually? I find it telling when a particular pathology can interfere with the workings of a group - what's the best way to deal with this?

---

Members don't see this ad.

 

[outofhere]

I'm wondering how everyone handles patient splitting (and the introjection) when they are working on inpatient service? I guess I'm curious as to what strategies the staff use amongst themselves. The reason I ask, is because this has come up (the recent contentious thread, IMO - just for a practical example) - in various situations. Do the staff get together and discuss/deal with this or is countertransference dealt with quietly/individually? I find it telling when a particular pathology can interfere with the workings of a group - what's the best way to deal with this?

Yes, a team meeting is absolutely necessary. Then, it is important to come up with a plan that is consistent and neutral, and have all the members of the team agree on it.

 

[Poety]

Yes, a team meeting is absolutely necessary. Then, it is important to come up with a plan that is consistent and neutral, and have all the members of the team agree on it.

We never undermine what someone else on the team says and take the approach of confronting the splitting as part of the DBT the patient is involved in. Often times, with borderlines, you have to be direct and its all abbout setting limits. IE When you tell me that I'm your favorite doctor and that you don't agree with dr x's treatments, I'm concerned that you're not willing to have an open mind to different options in your therapy that you may not agree with but may in fact be beneficial for you... blah blah, although i could go into more discussion about this with you now, I feel its important for me to have this talk with the group since it our entire team that is treating you, not just me alone.

i say something ot that effect which seems to work without making them hate me and lowers the degree to which they're splitting (doesn't alway work mind you, I've been called an sob for this multiple times too!)