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Lecture 8

PSYC36H3 Lecture 8: PSYC36 Lecture 8 - Dialectical Behavior Therapy (March 7)

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University of Toronto Scarborough
Amanda Uliaszek

Lecture 9 Dialectical BehaviorTherapy DBT: Historical Context Treating Borderline Personality DisorderSuicidal Clients o Namely suicidal women was why and how DBT came about o CBT was in reaction to psychoanalysis and the fact that many of the theories of psychoanalysis didnt work o Clientcentered therapy was a reaction to psychodynamic theory and psychoanalysis o DBT was in reaction to a therapy, major changes based on one therapy that wasnt working What are the symptoms of BPD? o Strong emotions o Relationships are considered to be perfect or horrible o Stressrelated Disassociation o Suicidality people with BPD have high likelihood of attempting suicide outside of depressing episodes, high likelihood of selfharm (cutting, burning, head banging) o Typical case: interpersonal dysregulation (hard time in relationships), cognitive dysregulations (dissociation, identity disturbance), emotion dysregulation (extreme emotions w. maladaptive consequences), behavior dysregulation (self harming, drug use, promiscuity) What are the primary treatment techniques in CBT? o Primary ways we teach someone is to identify maladaptive thoughts and to change those thoughts o You need to change how youre thinking and then youll feel better Why might CBT and BPD be incompatible? o People with BPD are actually extremely sensitive to things such as body language, tone of voice these can be triggers for interpersonal dysregulation o By telling someone with BPD their thoughts are maladaptive, the response may be a very strong emotional response even to the treatment rationale of CBT Problems with CBT Marsha Lyneham Change focused and naming thoughts as maladaptive was invalidating to them (they found this offensive and as those she didnt understand them at all, they didnt want to change their thoughts they needed someone to tell them that what they were doing made sense) o Invalidation Reinforcement of therapyinterfering behaviors o Treating BPD with CBT therapyinterfering behaviors were reinforced o In therapy, what kind of behaviors can a client do that can interfere with therapy being done Refusing to answer questions, refusing to do the techniques that the therapist would offer 1
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