A client with borderline personality disorder (BPD) tells the nurse, "You are good but the nurse on the afternoon shift is bad. The doctor is bad, too, but the therapist is good." The nurse interprets this statement as reflecting which of the fo
A) Splitting
B) Identity diffusion
C) Dissociation
D) Cognitive schema
Ans: A
Persons with BPD view the world in absolutes; nurses and other treatment team members are alternately categorized as all good or all bad. This defense is called splitting, and presents clinicians with a challenge to work openly with each other, as well as the client, until the issue can be resolved through team meetings and clinical supervision. Identity diffusion occurs when a person lacks aspects of personal identity or when personal identity is poorly developed. Dissociation is a cognitive dysfunction reflected as thinking, feeling or behaving outside a person's awareness. Cognitive schema refers to patterns of thoughts that determine how a person interprets events.
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