Impact of Therapist Vacations on Inpatients With Borderline Personality Disorder

For patients with borderline personality disorder, separations from significant figures in their lives, including therapists, are thought to be particularly painful. According to clinical wisdom, these patients manifest aggressive and self-destructive behavior around the time of separation. However, virtually no empirical studies have been conducted to test these beliefs. In this study, the behaviors of a sample of 41 inpatients with borderline personality disorder were recorded and analyzed to determine what, if any, effect their therapists' vacations had on target behaviors, including acting up, self-destructive behaviors, and somatic complaints. Results indicated significant variations in the rates of acting up and somatic complaints before, during, and after therapist vacations. No significant variations were observed in the rate of self-destructive behaviors, failing to support the commonly held belief that self-destructive acts in borderline patients may be especially prevalent around therapist vacations. Possible reasons for the pattern of findings are discussed, as are the implications for clinical practice.