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

Outline

Understanding Personality Disorders

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

Antisocial Character

• Understanding psychopathology
• Developmental progress in childhood
• Oppositional defiance
• Attachment and family of origin
• Primary defenses and affects
• Importance of personal power
• Managing in-session violence
• Suicide attempts and threats
• Blockades – manipulation and power struggles
• Risk analysis to self and other
• Interpersonal theory techniques
• Transference and countertransference
• Lessen destructive behaviors
• Cognitive-behavioral techniques
• Psychopharmacology and applicability
• Case studies and treatment exercises
• Differential diagnoses

Borderline Character

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

Narcissistic Character

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

Histrionic Character

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