Treating Personality Disorders: Advances from Brain Science and Traumatology

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Clients with personality disorders—narcissistic, borderline, antisocial, sociopathic—often have profound traumatic childhoods, which leave them without a solid inner core from which to function. Often “nudged” into treatment by others, including the law, their inability to trust and their need for power make forming a therapeutic alliance seemingly impossible. They come armed with defenses developed at very early ages that are designed to ensure their survival by protecting their fragility. In this workshop, you’ll explore:

• How to develop a therapeutic alliance in the face of mistrust, control issues, and rock solid defenses while staying out of power struggles
• How to work with the pathological dissociation typically present in personality disordered clients
• Practical, effective interventions informed by neuroscience that help clients safely manage frightening symptoms, including violence and emotional meltdowns, and develop healthier boundaries and a more differentiated sense of self

OUTLINE

• Personality disorders in the US, prevalence and personal history

            Risk factors, therapeutic options

• Diagnostic criteria for personality disorders

            Cluster characteristics

            Developmental characteristics

• Narcissistic Personality Disorder

            Differential diagnostic criteria and defining characteristics

            Pathological v. healthy narcissism                 

• Grandiose v. vulnerable narcissism
• Continuum of disturbance and loss of self
• Borderline Personality Disorder

            Differential diagnostic criteria and defining characteristics

            Boundary setting and treatment approaches

            Attachment and therapeutic relationship considerations

• Antisocial Personality Disorder

            Differential diagnostic criteria and defining characteristics

            Victim v. perpetrator symptom expression

• Psychopathy and personality characteristics
• “No Solid Self”

            Complex therapeutic history

            Common underpinnings to varied personality diagnoses

            Relationship characteristics

• Developmental processes underlying personality disorders

            Family systems

            Neurophysiological systems

• Treatment approaches

            Determining level of intervention

            Self-regulation, positive regard, mirroring

            Creating attachment and inserting self into therapy

            Importance of non-verbal communication

            Language selection and techniques

• Identifying meaning of disordered behavior and emotional regulation
• Therapist self-regulation, necessity and strategies
• Pictoral Coherence technique
• “Undissociation” technique
• General principles for therapeutic intervention

OBJECTIVES

• Explore how to develop a therapeutic alliance in the face of mistrust, control issues, and rock solid defenses while staying out of power struggles
• Explore how to work with the pathological dissociation typically present in personality disordered clients
• Explore practical, effective interventions informed by neuroscience that help clients safely manage frightening symptoms, including violence and emotional meltdowns, and develop healthier boundaries and a more differentiated sense of self