ABSTRACT

The coronavirus (COVID-19) pandemic has both a profound effect on mental health and affects how psychosocial interventions are delivered. In this paper, we outline particular difficulties patients with Borderline Personality Disorder (BPD) may encounter as a result of the pandemic. We also consider changes in the provision of treatment, specifically the transition from face to face encounters to remotely delivered sessions. Building on a mentalization-based developmental framework, we use clinical vignettes to chart some of these challenges for patients, clinicians and teams. We then make practical recommendations for adaptations to work during the pandemic via the phone or video-link with BPD patients and other groups characterized by a vulnerability to unstable and imbalanced mentalizing. We conclude that the response to these challenges benefits from an existing treatment context that aims at fostering mentalizing and resilience, in which practitioners address the hierarchy of patient needs and their individual responses to the experience of remote treatment during the COVID-19 pandemic.

摘要

冠状病毒 (COVID-19) 大流行既对心理健康产生深远影响，又影响社会心理干预的实施方式。在本文中，我们概述了边缘型人格障碍 (BPD) 患者可能因大流行而遇到的特殊困难。我们还考虑了治疗提供的变化，特别是从面对面接触到远程提供治疗的过渡。基于基于心理化的发展框架，我们使用临床小插曲为患者、临床医生和团队绘制了其中的一些挑战。然后，我们通过电话或视频链接与 BPD 患者和其他以不稳定和不平衡心理化为特征的群体为适应大流行期间的工作提出切实可行的建议。