Self-destructive and impulsive behavior in the patient with a borderline personality disorder: rethinking hospital treatment and management.

This article reconsiders current approaches to the inpatient treatment and management of the patient with a borderline personality disorder. It is suggested that current approaches tend to be reactive rather than proactive. An alternative model based on a behavioral therapy program for chronic parasuicidal borderline women, is suggested. The approach reframes self-destructive behavior as a habitual response to overwhelming affect. By targeting core problems such as self-destructive and impulsive behaviors, nurses can help patients begin to consider alternative behavioral responses to intense stress.