PDD
different approaches to personality theory
1. scientific theories
2. personal narratives
3. multicultural perspectives
4. own personal development
three perspectives on personality
1. universal, human nature
2. particular human culture
3. a singular human life
common mistakes and confusions about personality
1. naturalize cultural categories
2. reduce every aspect of who we are to cultural narratives
3. forgetting about cultural and subjective positions from where the author speaks
4. treating all accounts as equally subjective opinions
big three
- positive emotionality
- negative emotionality
- constraint
3 layers underneath personality
- actor (dispositional traits)
- agent (characteristic adaptations)
- author (narrative identity)
problems of the three personality layers
- self-regulation
- self-esteem
- self-integration
self-perception theory
actors observe their behavior + that of others and use observations to define themselves
central forms that connect animals, arts, human development and personality:
1. basic emotional systems
2. attachment
3. form of vitality
4. co-regulation
5. marking and mirroring
6. attunement and misattunement
7. mentalizing
8. epistemic trust
3 layers of the brain
- reptilian
- old-mammalian
- neo-mammalian
7 primary emotional systems
1. seeking
2. fear
3. care
4. play
5. rage
6. lust
7. panic/grief
4 basic properties of the emotional systems
1. once activated they remain active for some time
2. they color the world we see
3. they shape movement in the world
4. they are a strong motivation force
forms of vitality
patterns of arousal that are associated with sensory experiences + movement
mentalization
capacity to use, feel and reason from the assumptions of agency in self and others
4 assumptions of mentalization
1. neuroscience: mentalization is an evolutionary prewired capacity
2. developmental: needs environmental inputs to develop
3. transdiagnostic/transtheoretical: common in many psychological problems/disorders
4. recovery: mentalization = associated with successful therapy for many disorders
three findings of neurobiology about mentalization
1. it has specific neural circuits
2. it’s a multidimensional capacity
3. it’s an umbrella concept
4 dimensions of mentalization
1. automatic vs controlled
2. self vs others
3. internal vs external focus
4. cognitive vs affective
psychic equivalence
own thoughts/feeling become too real
epistemic trust
ability to identify knowledge given by others as personally relevant + generalizable to other contexts
salutogenesis
ability to benefit from positive influences of environment
epistemic vigilance
capacity to identify + filter info conveyed by others when perceived to be misleading/deceitful...
social learning in treatment is promoted by 3 communication channels
- channel 1: lowering epistemic hypervigilance
- channel 2: enabling mechanisms of social learning
- channel 3: re-engaging with social world
teleological
person only recognizes only real + observable + goal-directed goals and actions that can impede achieving these goals
pretend
thoughts and feelings are detached from reality (hyper-mentalizing) + narratives become cognitively/emotionally overwhelming
two processes at play when forming identity:
- identification
- seperation
2 ways in which identity formation can go wrong:
1. sameness taken too far = uniform group
2. separation taken too far = individualism
list of needs + 2 additional needs
1. stability, nurturance, safety and acceptance
2. autonomy, competence, sense of identity
3. freedom to express needs and emotions
4. spontaneity and play
5. realistic limits and self-control
6. fairness
7. self-coherence and meaningful world
7 emotional needs are linked to maladaptive schemas
1. disconnection + rejection
Ø abandonment insatbaility
Ø mistrust/abuse
Ø defectiveness/shame
Ø emotional deprivation
Ø social isolation/alienation
2. impaired autonomy and achievement
Ø dependency/incompetence
Ø vulnerability to harm and illness
Ø enmeshment/undeveloped self
Ø failure
3. over vigilance and inhibition
Ø negativity/pessims
Ø emotional inhibition
Ø unrelating stadnards
Ø punitiveness
4. other-directedness
Ø subjugation
Ø self-sacrifice
Ø approval-seeking
5. impaired limits
Ø entitlement/grandiosity
Ø insiffucient self-control
6. unfairness injustice
7. lack of coherence
Ø lack of self-coherence
Ø lack of meaningful world
schema modes
activated schema + way of coping with it
4 types of schema modes
1. dysfunctional child modes EMS
2. dysfunctional parent modes
3. dysfunctional coping modes
4. healthy modes
3 main way to cope with schema activation:
- surrender (resignation)
- avoidance
- overcompensation (inversion)
two types of experiential exercises
- chair dialogues
- imagery work
chair dialogues
patient switches chairs representing different modes relevant to specific problem
imagery work
- imagery rescripting
- diagnostic imaging exercises
creator of DBT
Linehan
assumptions of DBT
1. patients with PDs are doing best they can and need to do better/try harder and be more motivated
2. patients want to change
3. patients didn’t cause their problems but need to deal with them
4. lives of those with PD are currently unbearable
5. patients need to learn new behaviors
6. patients cannot fail therapy (therapy may fail)
7. therapist needs support
8. patients should learn new supported learning in all relevant contexts
roots of DBT
- mindfulness
- dialectics
- behaviorism
5 functions of DBT
1. improve motivation to change
2. enhance capabilities
3. facilitate generalization
4. enhance therapist’s motivation + capabilities
5. help structuring environment so that it boosts patients/therapist’s capabilities
stages of DBT
stage 1: first 3 months
- goal = behavioral control -> stop suicidal behavior
stage 2: 3 months/ 1 year after
- trauma comes out, they hurt a lot inside but don’t show it stage 3: patient experiences problems in living
- goal = ordinary happiness + unhappiness
stage 4: patient feels incomplete
- goal = freedom
types of childhood trauma
1. emotional abuse
2. psychical abuse
3. sexual abuse
4. emotional neglect
5. physical neglect
classical psychodynamic model:
every syndrome disorder comes from personality disturbance
CBT model:
personality disorders don’t exist
stepped care model:
treat syndrome disorders first and consider PD when the first doesn’t work/there are complications