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FATAL ATTRACTION & BORDERLINE PERSONALITY DISORDER
Transcript of FATAL ATTRACTION & BORDERLINE PERSONALITY DISORDER
1. MOVIE TRAILER
2. BRIEF INFO ABOUT CHARACTERS& MOVIE PLOT
3. DESCRIPTION OF THE BORDERLINE PERSONALITY DISORDER
4. BIOLOGICAL& PSYCHOLOGICAL CAUSAL FACTORS
5. SYMPTOMS and DIAGNOSTIC CRITERIA
ALEX FORREST (Glenn Close)
He is in mid
36 years old
Editor of Robbins&Hart
Lost her father at the age of 7
Mother died in birth
Seductive but impulsive and irrational
Obsessed with Dan Gallagher
Beth Gallagher (Anne Archer)
Victimized by Alex Forrest
self-mutilating behavior #5
chronic feelings of emptiness #7
Why we think Alex has BPD?
a) Dialectical Behavior
b) Schema Focused
c) Mentalization Based
Low doses of high potency neuroleptics
Anti- depressants, anti
anxiety agents and mood stabilizers
WHAT IS BORDERLINE PERSONALITY DISORDER?
The central characteristic of BPD is affective instability,manifested by unusually intense emotional responses to environmental triggers
-Drastic and rapid shifts from one emotion to another.
-A highly unstable self-image or sense of self.
-Highly unstable interpersonal relationships.
-Desperate efforts to avoid real or imagined abandonment.
-Instability and impulsiveness are combined.
-Suicide attempts. (8-10% complete suicide)
-BPD is associated with analgesia. (70-80% of women with BPD suffers analgesia)
-75% of people with BPD have cognitive symptoms that include relatively short or transient episodes in which they appear to be out of contact with reality and experience delusions or other psychotic-like symptoms such as hallucinations,paranoid ideas or severe dissociative symptoms
Criteria for BPD DSM-IV
1.frantic efforts to avoid real or imagined abandonment
2.a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
3.identity disturbance:markedly and persistently unstable self image or sense of self
4.impulsivity in at least two areas that are potentially self-damaging
5.recurrent suicidal behavior,gestures,or threats,or self-mutilating behavior
6.affective instability due to a marked reactivity of mood
7.Chronic feelings of emptiness
8.inappropriate,intense anger or difficulty controlling anger
9.transient,stress-related paranoid ideation or severe dissociative symptoms
COMORBIDITY WITH OTHER DISORDERS
BPD commonly co-occurs with a variety of Axis I disorders ranging from unipolar and bipolar and mood anxiety disorders to substance-use and eating disorders.
Axis II disorders are more commonly associated with depression than is borderline personality disorder.
There is also substantial co-occurence of BPD with other personality disorders.
The Way People with BPD Feel
I have BPD and for me it feels like I'm a child being forced to live in an adult world. I feel too fragile and vulnerable for the world I live in.
Feeling bereft and lifeless – with a void I can't fill no matter how much food I put down or activity, exercise, self harm and constant thinking I've gone through. I try to keep busy to combat the emptiness but it only masks it. The best antidote is to try to experience life and relationships more fully, then store the better memories.
When it was really bad, I would be in so much emotional pain that suicide seemed like the only way I could find any release. My attempts at overdosing kept failing: I was secretly screaming for someone to just listen to me and show me a way out. But in the end, if they wouldn't or couldn't be bothered to help me I would rather have been dead than carry on as I was – I just didn't care about anything, apart from getting rid of the pain.
The difficulties that people with BPD face with
Intense fear of abandonment, real or imaginary.
I have BPD. One night I called my girlfriend and she said she would call me back because she was watching TV. She didn’t call for two and a half hours. It hurt so bad because the day before, I had started to believe that she really loved me. By the time the phone rang I had decided to get rid of her before she could get rid of me. It turns out she had still been watching a movie. I felt so ridiculous, but the pain, the fear, and the gut-wrenching poker in my gut were very real.
"From friends, family and strangers in the street, everyone has an opinion and loves to tell you theirs. The most common comments I get are ‘Get a grip!’, ‘Just let it go over your head’, ‘Grow up!’... And the one I hate the most: 'Stop attention seeking!‘’
Engaging in impulsive “pain management" behaviors, such as going on spending sprees, having promiscuous sex, driving recklessly, abusing drugs or alcohol, binge eating, breaking the law, threatening suicide or making attempts, and engaging in self-harm.
Parenting my borderline daughter with is a twenty-four-hour-a-day job. She comes in my bedroom at midnight, crying and bleeding from self-inflicted cuts. She has sex with men she barely knows and doesn’t use birth control. Her current boyfriend sells drugs, and I think she is using them too.
Being emotional unstable: frequent and fast mood changes; uncontrolled, intense anger and rage; and intense sadness and irritability.
When in a rage, it seemed like my BP partner was channeling an evil spirit. Her eyes had no life in them: just a blankness. She didn’t see who I was or how she was hurting me. There was no way to negotiate, no way to reason or argue. She did not understand rational arguments.
-Neurophysiological and neurobiological dysfunctions of emotional regulation and stress
-Psychosocial histories of childhood maltreatment and abuse
-Disorganization of aspects of the affiliative behavioral system, most particularly the attachment system
The anterior cingulate may play a role in the cognitive evaluation/processing of mood and affect regulation, it has also been implicated in responses to conflict that is synonymous with Borderline Personality Disorder.
The orbital prefrontal cortex may be have a role in developing BPD.
Serotonin levels have an huge impact on developing BPD.
Heritability is found to be another significant factor.
Traumatic experiences such as sexual, physical and emotional abuse experienced in childhood have all been implicated in the occurence of BPD,however,abuse alone is neither necessary nor sufficient for the development of BPD.
Paranoia in very stressful situations; episodes of numbness or “zoning out" or “dissociation" (feeling numb or "zoned out").
After we separated, my borderline wife and I sorted out a time when she wouldn’t be home when I would come to pick up my belongings. At the agree-upon time, she went into some kind of real panic and told me she thought I was coming there to rape her.
Another critical factor is family environment.
Caregivers' attitudes toward their children is also significant.
The behavioral disturbances of BPD are also considered to be, at times, due to the social environment.
Parental under-involvement and neglect have also been seen as a contributing factor in the development of the disorder. Emotional under-involvement can contribute to the child’s difficulties in socializing and has also been shown to increase the risk of suicide (The British Psychological Society & the Royal College of Psychiatrists, 2009).
Parents with BPD are regarded as “high” risk as they are likely to continue their attachment and relationship difficulties with their children.
Thus, we can say that the relationship between caregivers and children is crucial.
Dialectical Behavior Therapy
Basic childhood needs (such as needs for safety, acceptance, love) are met inadequately, we develop unhealthy ways of interpreting and interacting with the world, which are called maladaptive early schemas.
Focuses on unhealthy way of thinking
Schemas are triggered when events happening in our current life resemble those from our past
Coping with difficult childhood experiences
Mentalization Based Therapy
Your ability to “mentalize,” or recognize thoughts, feelings, wishes, and desires, and see how these internal states are linked to behavior.
People with BPD are not able to mentalize adequately due problems that occurred in childhood relationships. They propose that the capacity to mentalize is learned in early childhood through interactions between the child and caregiver, and if the child-caregiver relationship is disrupted in some way, development of mentalization is interrupted.
Therapist focus on the present
Exploring your internal states
Forming healthier relationships
difficulty controlling anger #8
1-2 % rate of lifetime occurance (APA,2000)
-more common among women than men
''Johnson and collegues(2003) found that women diagnosed with BDP tend to exhibit more dramatic aspects of symptoms...''
Type of cognitive-behavioral therapy
Finding a balance in emotion, behavior and acceptance.
Grohol, J. (2007). Borderline Personality Disorder Treatment. Psych Central. Retrieved on December 3, 2013, from http://psychcentral.com/lib/borderline-personality-disorder-treatment/0001065
Kraus, G, and Reynolds, DJ. "The A-B-C's of the Cluster B's: Identifying, Understanding, and Treating Cluster B Personality Disorders." Clinical Psychology Review, 21: 345-373, 2001.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision. Washington, DC: American Psychiatric Association.
Johnson DM, Shea MT, Yen S, Battle CL, Zlotnick C, Sanislow CA, Grilo CM, Skodol AE, Bender DS, McGlashan TH, Gunderson JG, Zanarini MC. 2003. Gender Differences in Borderline Personality Disorder: Findings from the Collaborative Longitudinal Personality Disorders Study. Comprehensive Psychiatry 44:284-92.