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Personality Disorders > Session 6 > Flashcards

Session 6 Flashcards

1
Q

Which approaches (psychodynamic psychotherapy) can be effective in improving symptoms of Cluster C PDs?

A

Both confrontational and supportive approaches were effective

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2
Q

5 approaches to therapy with BPD

A

CBT, DBT, SFT, TFT and MBT

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3
Q

What is the aim in CBT?

A

Identify and modify core dysfunctional beliefs that automatically organize biased perceptions of self, others and the future.

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4
Q

Which types of patients is DBT used for?

A

Chronically suicidal and severely dysfunctional BPD patients.

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5
Q

What is at the core of BPD, according to Linehan?

A

Emotional dysregulation

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6
Q

What does emotional dysregulation stem from?

A

Biological vulnerability and an invalidating environment, which communicates to the person that their reactions aren’t adequate.

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7
Q

What principles is DBT based on?

A

Acceptance, mindfulness and dialectics.

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8
Q

What is the fundamental dialectic of DBT?

A

Between acceptance and change.

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9
Q

Differences between CBT and DBT

A
  1. CBT focuses only on change, DBT also focuses on acceptance
  2. DBT is directed at teaching new skills, CBT focuses on cognitive restructuring
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10
Q

What is the first phase of DBT and its 3 targets

A

Stabilizing the patient and achieving behavioral control

  1. patient needs to be alive and well
  2. productively collaborating on tasks of treatment
  3. and on issues that interfere with their effective functioning
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11
Q

How does DBT make intelligent use of contingencies and reinforcement?

A

Focus of therapist is in helping patient use the appropriate skills to manage current crisis, instead of directly managing the crisis itself.
(If the client executes these skills, and extra session can be scheduled to address the underlying issues)

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12
Q

What are schemata and why are they hard to change?

A

Broad, deep-seated beliefs and themes about the self and the world. Provide a sense of control and predictability and are part of a person’s sense of identity.

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13
Q

Where do schemata stem from?

A

From unsatisfied basic emotional needs during childhood.

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14
Q

What are the 5 core emotional needs?

A
  1. Development of a secure attachment to others
  2. Development of autonomy, competency and sense of identity
  3. Freedom to express valid emotions and needs
  4. Spontaneity and play
  5. Realistic limits and self-control
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15
Q

What are 4 types of early experience that foster the acquisition of schemata?

A
  1. Toxic frustration of needs (deprivation)
  2. Traumatization (mistrust/abuse)
  3. Overindulgence (entitlement and dependence)
  4. Selective internalization (subjugation)
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16
Q

3 types of coping behaviors when a schema is triggered

A

Overcompensation, avoidance and surrender

17
Q

What is a mode in SFT?

A

The schemas and coping style operating at a given moment

18
Q

What are the 5 modes in SFT?

A

The abandoned/abused child, angry and impulsive, detached protector, punitive parent and underdeveloped healthy adult

19
Q

Which 3 phases does SFT follow?

A
  1. Bonding and emotional regulation phase
  2. Shema mode phase
  3. Development of autonomy phase
20
Q

SFT uses 4 mechanisms of healing, which ones?

A
  1. Limited parenting
  2. Emotion-focused work through imagery and dialogues to produce positive change
  3. Cognitive restructuring and education
  4. Behavior pattern breaking
21
Q

What is the aim of transference-focused therapy (TFT)?

A

Understand issues that originated in childhood, and learn to accept conflicting feelings in one person (both bad and good).

22
Q

What’s the main assumption of TFT?

A

That important childhood conflicts will surface in the therapeutic relationships.

23
Q

How is change achieved in TFT?

A
  • Active therapist involvement

- Focus on here-and-now (transference and countertransference)

24
Q

What is splitting?

A

Switching from all-good to all-bad images of self and others, which served as a defensive function in childhood

25
Q

4 stages of TFT

A
  1. Treatment contract
  2. Containment of suicidal and self-destructive behaviors and treatment-interfering behavior
  3. Strengthening of control over self-harming and treatment-interfering behaviors
  4. Increasing emphasis of analysis of unfolding transference and countertransference reactions
26
Q

Which theories is MBT based on?

A

Psychodynamic, attachment and cognitive theory

27
Q

What is mentalizing?

A

Being attentive to our own and others’ feelings, thoughts, desires and intentions

28
Q

How does mentalizing develop?

A

Through having experienced oneself in the mind of another during childhood within an attachment context (-> developmental achievement!)

29
Q

What’s the aim of MBT?

A

To improve capacity to mentalize, especially under stressful circumstances and in attachment relationships

30
Q

What is schema chemistry?

A

The notion that individuals are drawn to people who trigger their schema

31
Q

Which modes are associated with BPD?

A

Shift rapidly between abandoned child, angry child punitive parent and detached protector

32
Q

Which modes are associated with NPD?

A

overcompensation for emotional deprivation and defectiveness schemata, with typical modes of self-aggrandizer, detached self-soother and the lonely child

33
Q

Which schema is associated with PPD?

A

Mistrust/abuse schema

34
Q

What is the generalist model?

A

Treatments that require less training and are less intensive than the major EBTs can be relatively efficacious for patients with BPD. It can be given by non-specialist psychiatrist and other professionals, and provides
effective care which helps address the need for more clinicians to treat patients with BPD.

35
Q

What are important features of clinicians who could use the generalist model?

A

Stable self-esteem, good sense and willingness to get personally involved

36
Q

When childhood mentalizing needs aren’t met, children develop an…

A

alien self :(

37
Q

What are some tasks of the therapist in MBT?

A
  • focus on here and now
  • empathic, non-knowing attitude
  • “stop-rewind-explore”
  • short interventions based on feelings
38
Q

According to Linehan, what are 3 biological susceptibility factors to developing BPD?

A
  1. High emotional reactivity
  2. High emotional sensitivity
  3. Slow return to emotional baseline
39
Q

According to Linehan, what are 3 invalidating environment factors that can lead to BPD?

A
  1. Indiscriminately rejecting private experience
  2. Punishment of emotional display while intermittently reinforcing emotional escalation
  3. Oversimplification of the ease of problem-solving and meeting goals

Personality Disorders (10 decks)

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