Gregory W. Lester – Borderline, Narcissistic, Antisocial and Histrionic Personality Disorders: Effective Treatments for Challenging Clients

Outline

Understanding Personality DisordersUnderstanding Personality Disorders

• Updates to DSM-5® and future changesUpdates to DSM-5® and future changes
• The real purpose of diagnosisThe real purpose of diagnosis
• Treatment errors and misdiagnosisTreatment errors and misdiagnosis
• Core vs. surface structuresCore vs. surface structures
• Four central components to diagnosisFour central components to diagnosis

Antisocial CharacterAntisocial Character

• Understanding psychopathologyUnderstanding psychopathology
• Developmental progress in childhoodDevelopmental progress in childhood
• Oppositional defianceOppositional defiance
• Attachment and family of originAttachment and family of origin
• Primary defenses and affectsPrimary defenses and affects
• Importance of personal powerImportance of personal power
• Managing in-session violenceManaging in-session violence
• Suicide attempts and threatsSuicide attempts and threats
• Blockades – manipulation and power strugglesBlockades – manipulation and power struggles
• Risk analysis to self and otherRisk analysis to self and other
• Interpersonal theory techniquesInterpersonal theory techniques
• Transference and countertransferenceTransference and countertransference
• Lessen destructive behaviorsLessen destructive behaviors
• Cognitive-behavioral techniquesCognitive-behavioral techniques
• Psychopharmacology and applicabilityPsychopharmacology and applicability
• Case studies and treatment exercisesCase studies and treatment exercises
• Differential diagnosesDifferential diagnoses

Borderline CharacterBorderline Character

• Symptom presentation along the spectrumSymptom presentation along the spectrum
• Attachment and family backgroundsAttachment and family backgrounds
• Feeling identification and behavioral controlFeeling identification and behavioral control
• Manage rage, boundaries, self-mutilation and suicidalityManage rage, boundaries, self-mutilation and suicidality
• Facilitate pattern recognition, create stability, and build therapeutic collaborationFacilitate pattern recognition, create stability, and build therapeutic collaboration
• Develop true sense of self and lessen maladaptive need for attentionDevelop true sense of self and lessen maladaptive need for attention
• Underlying wishes and fearsUnderlying wishes and fears
• Build DBT core mindfulness skillsBuild DBT core mindfulness skills
• DBT techniques to dissolve distraction, calm interpersonal upheavals, and focus on the “genuine relationship”DBT techniques to dissolve distraction, calm interpersonal upheavals, and focus on the “genuine relationship”
• DBT emotion regulation skillsDBT emotion regulation skills
• Psychopharmacology and applicabilityPsychopharmacology and applicability
• Case studies and treatment exercisesCase studies and treatment exercises
• Differential diagnosesDifferential diagnoses

Narcissistic Character Narcissistic Character

• Narcissism and environmental contextsNarcissism and environmental contexts
• Attachment and family backgroundsAttachment and family backgrounds
• Primary defenses and affectsPrimary defenses and affects
• Tackle the veneer of perfectionismTackle the veneer of perfectionism
• Blockades – power struggles, empathy and criticismBlockades – power struggles, empathy and criticism
• The narcissistic/borderline clientThe narcissistic/borderline client
• Interpersonal strategies for empathyInterpersonal strategies for empathy
• CBT techniques to clarify behaviors, values and goalsCBT techniques to clarify behaviors, values and goals
• Tactics to avoid arguingTactics to avoid arguing
• Motivational interviewing to overcome resistanceMotivational interviewing to overcome resistance
• Prevent sabotagePrevent sabotage
• Build a sense of true selfBuild a sense of true self
• Psychopharmacology and applicabilityPsychopharmacology and applicability
• Case studies and treatment exercisesCase studies and treatment exercises
• Differential diagnosesDifferential diagnoses

Histrionic Character Histrionic Character

• Moody to excited to flamboyant: the erratic clientMoody to excited to flamboyant: the erratic client
• Attachment and family backgroundsAttachment and family backgrounds
• Primary defenses and affectsPrimary defenses and affects
• Coquettish behavior, avoidance drama, inauthenticityCoquettish behavior, avoidance drama, inauthenticity
• Dangers of the histrionic clientDangers of the histrionic client
• Link between emotions and behaviorLink between emotions and behavior
• Interpersonal strategies for expression of true selfInterpersonal strategies for expression of true self
• Enhance sense of self and lessen the “spotlight”Enhance sense of self and lessen the “spotlight”
• Motivational interviewing techniquesMotivational interviewing techniques
• DBT techniquesDBT techniques
• Interpersonal strategies for positive relationshipsInterpersonal strategies for positive relationships
• Strengthen self-initiative and independent actionStrengthen self-initiative and independent action
• Psychopharmacology and applicabilityPsychopharmacology and applicability
• Case studies and treatment exercisesCase studies and treatment exercises
• Differential diagnosesDifferential diagnoses