Psych 380 1nd Edition Lecture 15 Outline of Current Lecture I. Borderline Personality DisorderCurrent LectureI. Vocabulary:II. Borderline Personality Disordera. Instability in relationships, self-image, affects, and impulse control (5+)b. Functions on border of being so irrational that they are psychotici. 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 relationshipsiii. Identity disturbanceiv. Self damaging impulsivityv. Suicidal behaviorvi. Affective instability and reactivityvii. Chronic emptinessviii. Inappropriate, intense angerIII. Case study; Sandraa. 40 years old, executive at a local bank, sent to therapy by her supervisorsb. she got pissed off at a temp worker because she accidently forgot to put a memo about the Columbus day hours in her mailboxc. 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 programi. (psychological problems)e. talk it out with an individualf. emotional difficulties – who are you to tell me this?g. Control emotional outburstsIV. 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 disorderb. Emotional roller coaster that’s very hard to deal withV. Can I be helpful to her to help her control her emotions?VI. And at the same time protect my own vulnerability?VII. She’ll engage in hostile interactionsVIII. Set of characteristics – affect, self-imageIX. Dr. Halgin agrees to see herThese 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. First sessiona. Sandra picks up a lot of people and has many one night standsb. AA meetings – the men there are very dependentc. Bars, etcXI. Invalidating environmenta. When they are upset, they are told to stop crying and their feelings are not taken care ofXII. Imagine that people with borderline personality disorder survived a fire and they havea lot of scarsa. Getting too close and touching their scars scares them because you might hurt themXIII. Famous book – “I hate you, don’t leave me”XIV. 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 malla. She cut herselfXV. Dialectical Behavior Therapya. DBTb. Linehanc. 2 opposing forcesd. validation and support and confronte. 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 perspectivesXVI. Sandra’s childhooda. History of abuse (emotional or psychological)b. Her mother was narcisstic writer – she would leave Sandra a lot with her fatherc. Her father was physically abusive who would spank/hit her when she overreactedXVII. Dr. Halgin addresses the situation at worka. 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 heard. Some things may be hard for you to heare. Validate what you are expecting but help to change by confrontingXVIII. Psychological services centera. Suicidal thoughts – Ben (security in relationship)b. Attention getting, manipulativec. Contain emotionalityXIX. Sandraa. Occasional outburstsb. Obsessional, ruminateXX. SSRI’s help people obsess less – don’t have to ruminateXXI. Supervisor brought her candy for birthdaya. She thought this was an invasion of her privacy when in reality it was just a gesture of kindnessXXII. Trial/low dose of Prozac – 20 – obsessional thinking reduceda. Affects seratoninXXIII. Psychiatrista. Emergency, 15 mins late, you think your time is more valuable than mine? World doesn’t revolve around youXXIV. Met for a year – wants to meet twice per weeka. Risk of cultivating tendencyb. Dr. Halgin reduced her frequency of visitsc. He wants Sandra to be less dependent on himd. Walk this line carefullyXXV. Sandra gave Dr. Halgin a jar of jam for Christmasa. Out of the frame of their relationshipb. He takes the gift but reminds Sandra that he generally can’t accept gifts from his patientsc. Dr. Halgin gives an example of another gift he was given by a past patientd. She gave him Tupperware which is virtually indestructibleXXVI. Videoa. Show on HBO – In Treatmentb. About a psychologist session with 17-year-old Jessec. He was adoptedd. Gaye. Brought his mother to a session in order to tell her that his birth mother contactedhimf. Very intense episodeXXVII. Choices madea. 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 thisc. He says that it pisses him off and he can go out and date an adult womand. He is unable to see from another’s perspectivee. He threw his glasses at the wall and they shattered f. Metaphor in the scenario – doesn’t want to seeXXVIII. Sandraa. Walking the lineb. Within the context of supportc. You won’t believe what this person did to med. Person cuts her off – she followed theme. Felt extremely disrespectedXXIX. After seeing her for 2 years, Dr. Halgin plans to meet with Sandra episodicallyXXX. He is stepping back because he has given her the tools she needs to moderate her dysregulationXXXI. Team works with client, page therapyXXXII. DBT – Linchen was speaking in Hartforda. Was asked if she herself had Borderline personality disorder and she finally admitted that she didb. She used to bang her head against the wall and was hospitalized at 18 years oldc. She was put in the seclusion room and was severely illd. She bruised her wrists and cut herselfe. It was as if someone else was doing it to her and she felt totally empty.f. No way to communicate or understandg. 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 yourselfi. Therapists step over the line – lost perspective (pathology of