Margaret Wehrenberg – Rewiring the Brain: Treatment Techniques for Obsessive Compulsive, Narcissistic, Antisocial, and Borderline Personality Disorders

Outline

PART I: THE DEVELOPMENT OF PERSONALITY DISORDERS

• Biology and temperament
• Agency and a desire to be affiliated
• Anxiety and harm avoidance
• Interpersonal Neurobiology – The concept of neural repair and neural integration

PART II: TREATMENT STRATEGIES

I. Antisocial Personality Disorder

• Anxiety and APD
  • Develop harm avoidance
  • Utilize active relaxation
  • Anxiety in disguise: Find anxiety and tame
  • Anger with the anger diary
  • Anger escalator tools for anger management
• Depression and the Antisocial PD
  • The hidden emotion
  • Cost-benefit analysis of behaviors
  • Use HALT tips to modulate expression
• Interpersonal Relationships and APD
  • Turn agency into positive paths
  • Journaling to identify implicit memory to increase awareness
  • Train the “wise mind” for better self-control
  • Storytelling for attunement and empathy

II. Narcissistic Personality Disorder

• Anxiety and NPD
  • Diminish the intensity of harm avoidance
  • Teach appropriate assertiveness
  • Worry management strategies
  • Energy therapies and self-soothing
  • Dispute irrational fears of humiliation
  • Resolve childhood humiliation
• Depression and NPD
  • Increase agency
  • Accept responsibility for vicious circles of grandiosity and loss
  • Battle grandiosity by increasing achievement
  • Improving awareness of and attunement to others
  • Mindfulness techniques and cost-benefit analysis
• Interpersonal Relationships and NPD
  • Using desire for affiliation
  • Reframe indifference to others and motivate connection with dialectical constructs
  • Genuine contributions: The path to legitimate self-worth

III. Obsessive-Compulsive Personality Disorder

• Anxiety and OCPD
  • Breaking the rule of harm avoidance
  • Identify the conflict with inner values
  • CBT to change worry and rumination
  • Real self- focusing techniques to find feelings
  • Discharging anger – the underlying trigger of anxiety
  • Learning to tolerate anxiety of making mistakes
  • Breaking free from “technology slavery”
• Depression and OCPD
  • Increase positive agency
  • Change derogatory self-talk
  • Interrupt and dispute compulsive behavior
  • Prescribe fun!
• Interpersonal relationships and OCPD
  • Affiliation and anger
  • Mindfulness practices to increase attunement to others
  • “I” statements and negotiation skills:
  • Deflate resistance to increase self/other honesty
  • Systems therapy strategies
  • Eliminate passive aggression

IV. Borderline Personality Disorder: The Quest for Connection

• Anxiety and BPD
  • The forgetfulness of harm avoidance
  • Fill in skills deficits: Teach and practice conflict resolution skills
  • G round techniques to increase emotional stability
  • Journaling techniques
• Depression and the BPD
  • The forgetfulness of agency
  • Interrupt self-injurious behavior
  • EMDR practices to loosen the grip of the past
  • Minimize catastrophic rumination w/CBT
• Interpersonal Relationships
  • Craving affiliation and its destructive impact
  • Improve therapeutic relationships
  • Relationship histories
  • Practice assertiveness vs aggression

Please Note: PESI is not affiliated or associated with Marsha M. Linehan, PhD, ABPP, or her organizations.