Psychology 2310A/B Lecture Notes - Therapeutic Relationship

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Personality Disorders - Tutorial
Cognitive-Behavioural Theory of Personality Disorders
(Jeffrey Young – Schema Theory)
Early Maladaptive Schemas (EMS)
Unconditional beliefs about self, others
Eg, defectiveness, incompetence, entitlement, etc
Develop early in life – parental relations
Self-perpetuating, resistant to change
Information is distorted to fit the schema
Schema is activated by environmental events
Produce strong emotional reactions, maladaptive behaviours
Development of EMS’s
EMS’s develop when specific core childhood needs are not met
Core childhood needs:
Love, nurturing, attention
Acceptance, praise
Stable base, predictability, and safety
Empathy
Guidance, protection, limit-setting
Validation of feelings and needs, Etc
Parenting and EMS’s
Overly Critical  Defectiveness
Overprotection  Dependency
Cold, unloving  Emotional deprivation
Controlling  Subjugation
Over-indulgent  Entitlement
Neglect, rejection Abandonment, loss
Inconsistency, dishonesty  Mistrust
Overly demanding  Unrelenting standards
Psychotherapy for Personality Disorders
Differences from therapy for Axis I problems:
oPatients more resistant to change – rigid
oLess co-operative, less motivated (e.g., self-monitoring, homework
oCognitions less conscious, accessible
oMore focus needed on the therapeutic relationship, early experience
Issues in Psychotherapy
oGoal: Restructuring the personality
oPerception and understanding of interpersonal events
oAnticipating consequences of actions
oDeveloping a realistic and stable sense of self
oFinding mutuality and intimacy in relationships
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