1. Dr. Julia warrener University of Hertfordshire 11th July, 2017
  ‘A social perspective on personality disorder; enhancing responsibility & resilience’
Dr. Julia warrener
University of Hertfordshire
11th July, 2017

2. Social & Responsibility
Value in encouraging responsibility and resilience in service users and staff
Multifactorial nature of personality disorder
High levels of childhood abuse, physical, sexual, emotional and neglectful and/or inconsistent parenting
Under represented in social work research
(Keys & Lambert, 2002)
Social perspective can encourage responsibility & resilience

3. Social perspective
The content of the person’s distress and its probable relationship to early traumatic social experience
Humane, empathic, pro-social responses
Knowledge and understanding of both person and personality disorder
Respect for, listening and engaging, the person
Broad social supports which can support the person’s connection or re-connection with self, others and the world around
Connection- can be an effective antidote for trauma
(Herman, 1992)

4. Responsibility
Encouraging service users to take responsibility for actions is key
Control or conscious knowledge of their behaviour and are therefore responsible, which risks the attribution of blame
Responsibility can promote change, blame can be counterproductive
Blame ‘hurts’- it can be perceived as punishment…..
(Pickard, 2011)
Malignant alienation
(Watts & Morgan, 1994)

5. Changing minds
‘Social’- both in terms of experience and relationships comes into its own
As a survivor- battling, often alone, in the face of overwhelming adversity.
Compassion can promote strengths and resilience
Crisp & MacCave, 2007
 Reasons for their thoughts, feelings and behaviours
Trying to tolerate ‘intense and unalloyed suffering’
Irresponsible and inadvisable behaviour
Bray, 2003, p.274

6. Through
Our inter-personal skills and the ‘therapeutic’ relationship as an agent of change
Devote our attention to understanding the person’s past history
Limited choices
Reasons for thoughts, feelings and actions
Encourage responsibility without apportioning blame

7. Critical path Understanding and knowing the person and the diagnosis
‘…it is very important to understand the person just as much as the diagnosis, because at the end of the day the diagnosis has come from what has happened to the person through their life, so you’ve got to kind of understand the bare bones of somebody to understand everything that’s gone on and what’s made them what they are’ (Phase 2, )
Transparency & Consistency
Information held and in communication, especially around decision making

8. Critical path
‘I think they were kind of... I think they a bit prejudiced in a way. I kinda think they had their own notion. Maybe they thought I was untreatable, maybe they believed in their head that I was untreatable, that’s what they would have said in their meetings... but they didn’t say that to me’ (Phase 1, )
Transparency and consistency are not ‘simple goods’
Connect or re-connect with self and others
‘… going to the supermarket, getting on a bus, any of these practical things is the issue, and they are very practical ways that the social worker could help’

9. Critical path The practical
…I’ll sit with them and say “Go on, I’ll sit with you while you make the call” and as we struggle with it, it might be “OK, I’ll dial”, and they come back, come back, come back until we get something they can do and they succeed. So there‘s always that push towards them being competent, but it‘s always the support is there as well
Professional & Organisational responsibility

10. Professional & organisational responsibility
Workload demands
Degree of employee control over workplace arrangements
Healthy work-place relationships free of unacceptable or discriminatory behaviours
The support and information employees receive from colleagues and line managers (Health & Safety Executive, 2010)
Compassionate, empathic, transparent and consistent relationships, to enable
Responsibility, positive change and resilience

11. Compassionate, empathic, transparent and consistent relationships
Conclusion
Compassionate, empathic, transparent and consistent relationships
Responsibility, positive change and possible connection or reconnection

12. References
Bray, A. (2003). Moral responsibility and Borderline Personality disorder. Australian and new Zealand journal of psychiatry, 37,
Crisp, C. & McCave, E. (2007). Gay affirmative practice: a model for social work practice with gay, lesbian and bisexual youth. Child Adolescent Social Work Journal, 24,
Herman, J.L. (1992). Trauma and recovery. New York: Basic Books.
Keys, D. & Lambert, G. (2002). Concept of ‘personality disorder’ and its relationship to social work. Australian Social Work, 55(3),
Pickard, H. (2011). Responsibility without blame: Empathy and the effective treatment of personality disorder. Philosophy, psychiatry and psychology, 18(3),
Watts, D. & Morgan, G. (1994). Malignant alienation: Dangers for patients who are hard to like. British Journal of Psychiatry, 164,
Warrener, J. (2017). Critiquing personality disorder; a social perspective. Northwich; critical publishing

13. Dr. Julia Warrener Professional/Academic LEAD FOR SOCIAL WORK University Hertfordshire
In order to work effectively with people with personality disorders it is important that Mental Health Social Workers (MHSWs) have a clear understanding of trauma and its impact on the person. It is also important that they have good relational skills and the support of the team and organization. Drawing on an analysis of the similarities (and differences) in service user and MHSWs’ perspectives, Critiquing Personality Disorder outlines the further skills, knowledge and conditions that will help them to make a more effective contribution to the support of those with personality disorder.