Borderline Personality Disorder and Chronic Pain: A Practical Approach to Evaluation and Treatment

  • Vicki Kalira
  • Glenn J. Treisman
  • Michael R. Clark
Psychiatric Management of Pain (M Clark, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Psychiatric Management of Pain


Patients with chronic pain present a spectrum of complexity that can be overwhelming for the individual practitioner. These patients require thoughtful care and a comprehensive treatment plan. This complexity should be acknowledged, not avoided, and the patient should be engaged, not shunned. A practical approach will assist in developing expertise and proceeding empathically. The presence of a superimposed personality disorder significantly increases the difficulty of caring for these patients. Studies investigating the prevalence of borderline personality disorder in patients with chronic pain averaged 30 %, highlighting the importance of being able to effectively treat this patient population. Appropriate management of these patients should focus on a collaboration to practice productive behaviors despite intense emotional distress. Longitudinal research provides a foundation for an optimistic prognosis that can be enhanced with this rehabilitative approach.


Chronic pain Borderline personality Personality disorders Difficult patient Pain Personality Psychotherapy Cluster B 


Compliance with Ethics Guidelines

Conflict of Interest

Dr. Vicki Kalira reported no potential conflicts of interest relevant to this article.

Dr. Glenn J. Treisman reported no potential conflicts of interest relevant to this article.

Dr. Michael R. Clark is a Section Editor for Current Pain and Headache Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Vicki Kalira
    • 1
  • Glenn J. Treisman
    • 1
  • Michael R. Clark
    • 1
  1. 1.Department of Psychiatry & Behavioral SciencesJohns Hopkins MedicineBaltimoreUSA

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