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23-12-2021, 08:18 PM
(23-12-2021, 08:11 PM)Bigiron Wrote: Borderline Personality Disorder Basically, individuals with borderline personality disorder are impulsive, emotionally labile, and relationally unstable. While treatment of such individuals involves a number of unique therapeutic challenges, it can be highly effective and successful. This chapter describes a framework for effective treatment of this disorder from a cognitive behavioral perspective. It includes sections on assessment, case conceptualization, and treatment interventions. The section on assessment includes behavioral and cognitive factors, as well as a DSM-5 description and a prototypic description of this disorder. A prototype is a brief description that captures the essence of how a particular disorder commonly presents. Prototypic descriptions are useful and convenient and clinicians commonly rely on them rather than lists of behavioral criteria and core and instrumental beliefs (Westen, 2012). The section on case conceptualization provides both cognitive and behavioral formulations of this disorder. The longest section is on treatment. It emphasizes engagement, pattern analysis, pattern change, and pattern maintenance and termination strategies for effectively managing and treating this disorder. In addition to individual psychotherapeutic strategies and tactics, group, marital and family, medication, and integrative and combined treatment strategies are included. An extensive case example illustrates the treatment process. Assessment Behavioral A behavioral assessment of this disorder emphasizes individual and interpersonal behaviors. Individuals with this disorder are characterized by a diverse array of behaviors ranging from anxiety, anger, and mood lability, to disturbances of consciousness such as depersonalization and dissociation, and even brief psychotic episodes. Chronic loneliness, a sense of emptiness, boredom, identity confusion are commonly observed, as well as impulsive behavior that can include self-injury or self-mutilation. Their occupational accomplishments are often less than their intelligence and ability warrant. Their personal lives are characteristically unfocused and unstable and are marked by frequent disappointments and rejections. They often have irregular circadian rhythms, especially of the sleep-wake cycle. Accordingly, chronic insomnia is a common complaint. Interpersonally, they tend to be emotionally labile and exhibit a pattern of intense and chaotic relationships. They fl uctuate quickly between idealizing and clinging to an individual and then devaluing and opposing that same individual. They are exquisitely rejection-sensitive, and experience feelings of depression and fears of abandonment following the slightest relational confl ict (Sperry, 2003).
DSM-5 Description Individuals with this personality disorder are characterized by an unremitting pattern of unstable relationships, emotional reactions, identity, and impulsivity. They engage in frantic efforts to avoid abandonment, whether it is real or imagined. Their interpersonal relationships are intense, unstable, and alternate between the extremes of idealization and devaluation. They have chronic identity issues and an unstable sense of self. Their impulsivity can result in self-damaging actions such as reckless driving or drug use, binge eating, or high-risk sex. These individuals engage in recurrent suicidal threats, gestures, acting out or self-mutilating behavior. They can exhibit markedly reactive moods, chronic feelings of emptiness, emotional outbursts, and diff i culty controlling their anger. They may also experience brief, stress-related paranoid thinking or severe episodes of dissociation (American Psychiatric Association, 2013).
Well, the learned doctor already assessed that RK is mentally sound and is mentally capable to make her own decision even though she could and may hv some symptoms of PTSD not amounting to a disorder
Geddit? It's a trap that COP, RK and the learned doctor fell right into
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