Which statement by a patient with borderline personality disorder best indicates the treatment plan is helping?
a. "I think you are the best nurse on the unit.".
b. "I hate my doctor. He never gives me what I ask for.".
c. "I feel empty and want to cut myself, so I called you.".
d. "I'm never going to get high on drugs again.".
C
The patient's seeking a staff member when distressed, instead of impulsively self-mutilating, shows that the patient has adopted an adaptive coping strategy. "You're the best nurse" demonstrates idealization, which is a symptom of the disorder and not a sign of improvement; the same is true of devaluing one's doctor. "I'm never going to use drugs" is a statement of a goal. It may be the patient's intention, but unless the patient demonstrates adaptive coping and sobriety-related behaviors, it is not necessarily an indication of progress.
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