Borderline personality disorder (BPD) and is self-harming.

XASE STUDY: MARY-JANE

Mary-Jane Smith is a 29-year-old woman who has been diagnosed as having borderline personality disorder (BPD) and is self-harming. She has made two suicide attempts in the past. She has experienced severe physical (from infancy) and sexual (from age four) abuse from her parents and, at the age of eight, was removed from their care by the state child protection authority.

Mary-Jane has been a poly drug user (alcohol, benzodiazepines, opiates, and cannabis) since the age of 17. She has a history of abusive relationships, and her two children were removed from her care 3 years ago due to physical and emotional abuse by both Mary-Jane and several of her partners. She regularly presents at hospital emergency units after self-harming or overdosing and can be verbally aggressive towards staff. She is currently couch-surfing with friends but has outworn her welcome and may be homeless soon.

How might workers in a non-trauma sensitive service respond to Mary-Jane? What knowledge systems, beliefs and attitudes might inform their behaviour?

If you were to work with Mary-Jane from a trauma-informed perspective, how would you:

a) Raise the topic of trauma with her? Explain what you would do

b) Respond to a disclosure of traumatic experiences by Mary-Jane during the assessment interview?

c) Ensure that you do not re-traumatise Mary-Jane in your work?

d) Describe three issues will you need to be aware of if Mary-Jane identified as Aboriginal?

How would you use reflective practice and gathering of feedback from Mary-anne to help with your work practice?