Case Studies Flashcards
Borderline personality disorder
- Neurosis vs. psychosis (full break with reality)
- Borderline means at the edge of these (has features of both)
- persistent pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity beginning by early adulthood and present in many contexts as indicated by 5 or more characteristics in the DSM
Dialectical Behaviour Therapy (DBT):
A CBT approach to address pervasive emotion dysregulation
- a behavioural therapy
What is Linehan’s theory behind BPD?
Biosocial theory of BPD: the impact of vulnerable biology and invalidating social environment
Emotional sensitivity/reactivity (biological) + invalidating environment (social) = pervasive emotion dysregulation
- like a diathesis stress model
Emotional sensitivity/reactivity:
There is an individual difference in how easy it is to trigger a negative emotion
invalidating social environment
Your experience is acknowledged as “this experience makes sense” or “something doesn’t make sense about your experience.”
ex: in a movie theatre and you see smoke, but your friend is saying “I don’t think it’s anything, I don’t see anything”
- you’re going to feel extremely anxious, your emotions will be very ramped up
Effects of invalidation: what does it do inside of you?
- Ramps up your emotions
- When you have a strong emotion, it’s like there’s a fire within you
- If you’re high in emotional reactivity, you experience a lot of internal fires throughout your life
- Something profoundly invalidating: being abused in your childhood
Dialectical:
When you put 2 opposing sides against each other
- 2 things that seem like they’re opposites but are both true and you have to balance them
ex: you must accept reality AND work to change it, you must work AND rest, be open AND private, do things you need to do AND do things you want to do
- If you focus on only one side, you’re naive and will fall into a trap
3 Because’s
You hear someone’s thoughts about something, and to validate their feelings, instead of saying what they’re feeling is TRUE (because lying is also invalidating), you say that you understand why they feel the way they do using “because”:
“It makes sense you’re worried about graduating because watching other people move on when you stay in the same place is scary.”
VIDEO: way to put out the emotional fire
- using cold to shock the system and change the emotions
- Ice cubes in hands, ice pack over eyes, very cold shower - Don’t make important decisions in the next 24-48 hours
- No substances
- No decisions about life or death - Realizing the fire doesn’t last forever, and it will go out - find another person, being or picture to make eye contact with (helps get out of your head
DBT skill: distraction
- get yourself out of your head
ex: playing an instrument, watching a show, listening to music, being around other people when it won’t be draining
This wont be a good long term solution but is a good coping mechanism for certain moments
PLEASES
Have to do with looking for how physical elements really influence how were feeling
Example:
- Are you physically sick
- Have you been eating?
Opposite Action
- Throwing yourself into the opposite of what your emotion is telling you to do
- If your emotion is telling you to hide, DON’T, put yourself out there
Do it with body, voice, and posture
Ways to distract yourself from self-destructive behaviours
- squeeze an ice cube
- write on yourself with red marker instead of cutting
- snap a rubber band on your wrist
- crying
Distractions: paying attention to someone else
do something for someone else: chores, call a friend and ask if they need help with something
take attention off yourself: go to the store, shopping, centre, park, and observe others
Procrastination
Why do people do it? (What is the function that procrastination serves)
- Pressure of a deadline helps people work harder because there’s no other choice
- Motivation is based on emotion and a reliable way to increase motivation is to get closer to the deadline
- That’s why in ADHD we shouldn’t give extensions on assignments, we should set more short deadlines actually
- Can be a safety behaviour where you think if you don’t start it, it doesn’t exist
- If you think you’re going to have a lot of “what if” thoughts then you put it off
perfectionism
- If I’m not perfect at it now, I’ll be horrible forever
- Related to eating disorders, social anxiety, and MANY concepts we learned in the course
Auditory Hallucinations
- Most likely diagnosis is no diagnosis especially with children and teens
- The base rate for schizophrenia is VERY low for children and adolescents
- between 5 and 16% of teens will experience a verbal hallucination, but nothing comes with it
- Not uncommon that people endorse this but it doesn’t mean they are on the way to a full psychotic disorder, must explore and monitor it
