Psych 380 1nd Edition Lecture 15 Outline of Current Lecture I Borderline Personality Disorder Current Lecture I II III IV V VI VII VIII IX Vocabulary Borderline Personality Disorder a Instability in relationships self image affects and impulse control 5 b Functions on border of being so irrational that they are psychotic i Abandonment fear so intense that it is irrational kind of crazy about everything hate being excluded from anything even minor things such as lunch etc ii Unstable and intense relationships iii Identity disturbance iv Self damaging impulsivity v Suicidal behavior vi Affective instability and reactivity vii Chronic emptiness viii Inappropriate intense anger Case study Sandra a 40 years old executive at a local bank sent to therapy by her supervisors b she got pissed off at a temp worker because she accidently forgot to put a memo about the Columbus day hours in her mailbox c she screamed at the girl in the middle of the lobby You little bitch you think you can skip my mailbox after working here for a week d boss addressed the situation said it was very demeaning and mean and told Sandra she needed to see EAP employee assistance program i psychological problems e talk it out with an individual f emotional difficulties who are you to tell me this g Control emotional outbursts Dr Halgin at this point he takes a step back and asks himself what am I getting myself into a Nothing more apprehensive then borderline personality disorder b Emotional roller coaster that s very hard to deal with Can I be helpful to her to help her control her emotions And at the same time protect my own vulnerability She ll engage in hostile interactions Set of characteristics affect self image Dr Halgin agrees to see her These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute X XI XII XIII XIV XV XVI XVII XVIII XIX XX XXI XXII XXIII First session a Sandra picks up a lot of people and has many one night stands b AA meetings the men there are very dependent c Bars etc Invalidating environment a When they are upset they are told to stop crying and their feelings are not taken care of Imagine that people with borderline personality disorder survived a fire and they have a lot of scars a Getting too close and touching their scars scares them because you might hurt them Famous book I hate you don t leave me Interview with a woman who has borderline personality disorder she would freak out if her friends even left her alone in a store while they were at the mall a She cut herself Dialectical Behavior Therapy a DBT b Linehan c 2 opposing forces d validation and support and confront e you need to tell them that you see how something might bother upset them but then confront them and ask them how the other person may have seen the situation they are very one sided and sometimes can t see multiple perspectives Sandra s childhood a History of abuse emotional or psychological b Her mother was narcisstic writer she would leave Sandra a lot with her father c Her father was physically abusive who would spank hit her when she overreacted Dr Halgin addresses the situation at work a How do you think the temp worker felt after you screamed at her b How adaptive was it on your part c Not coming just to hear what you want to hear d Some things may be hard for you to hear e Validate what you are expecting but help to change by confronting Psychological services center a Suicidal thoughts Ben security in relationship b Attention getting manipulative c Contain emotionality Sandra a Occasional outbursts b Obsessional ruminate SSRI s help people obsess less don t have to ruminate Supervisor brought her candy for birthday a She thought this was an invasion of her privacy when in reality it was just a gesture of kindness Trial low dose of Prozac 20 obsessional thinking reduced a Affects seratonin Psychiatrist a Emergency 15 mins late you think your time is more valuable than mine World doesn t revolve around you XXIV Met for a year wants to meet twice per week a Risk of cultivating tendency b Dr Halgin reduced her frequency of visits c He wants Sandra to be less dependent on him d Walk this line carefully XXV Sandra gave Dr Halgin a jar of jam for Christmas a Out of the frame of their relationship b He takes the gift but reminds Sandra that he generally can t accept gifts from his patients c Dr Halgin gives an example of another gift he was given by a past patient d She gave him Tupperware which is virtually indestructible XXVI Video a Show on HBO In Treatment b About a psychologist session with 17 year old Jesse c He was adopted d Gay e Brought his mother to a session in order to tell her that his birth mother contacted him f Very intense episode XXVII Choices made a Example of a high school teacher who decided to get involved with one of his student 18 years old b Dr Halgin asked him to think about what others would say to him about this c He says that it pisses him off and he can go out and date an adult woman d He is unable to see from another s perspective e He threw his glasses at the wall and they shattered f Metaphor in the scenario doesn t want to see XXVIII Sandra a Walking the line b Within the context of support c You won t believe what this person did to me d Person cuts her off she followed them e Felt extremely disrespected XXIX After seeing her for 2 years Dr Halgin plans to meet with Sandra episodically XXX He is stepping back because he has given her the tools she needs to moderate her dysregulation XXXI Team works with client page therapy XXXII DBT Linchen was speaking in Hartford a Was asked if she herself had Borderline personality disorder and she finally admitted that she did b She used to bang her head against the wall and was hospitalized at 18 years old c She was put in the seclusion room and was severely ill d She bruised her wrists and cut herself e It was as if someone else was doing it to her and she felt totally empty f No way to communicate or understand g Wounded healer after experience wants to help others with the same thing I have been there h Caution how much are you trying to take care of yourself i Therapists step over the line lost perspective pathology of client