What practices should be avoided in treating patients with borderline personality disorder?
Patients with borderline personality disorder are more likely than controls to report the use of prescription opiates. Prescribing opiates and benzodiazepines provide unique challenges in patients with borderline personality disorder. These medications provide an opportunity to escape, rather than cope with, unpleasant sensations. These medications produce robust positive reinforcement that is difficult to extinguish. As a result, poor coping strategies are rewarded. Scolding such patients should also be avoided, as this provides attention to negative behaviors, and may actually result in their reinforcement.