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Ch.8 Borderline, Histrionic, Narcissistic, and Antisocial disorders Pt.II section includes: Borderline PD Histrionic P.D. Narcissistic Personality disorder Antisocial Personality Disorder Cluster B “Psychopaths” Incidence of Antisocial PD Etiolog

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Kathy Foxall

1Dramatic emotional erratic Borderline Histrionic Narcissistic and Antisocial disordersBorderline PD2 of population 3x more women than men receive the diagnosiscomorbidity with mood disorder eating disorder substance abuse PTSDpreoccupation with abandonmentcore of BPDoangerwhen fear abandonment react angrily towards those whom they feel have abandoned themunstable moodpoor sense of identityimpulsive and self destructive may have brief periods of psychosis oparanoid feel that others are conspiring against themohallucinations delusions usually only last 1 dayintense unstable relationships must set strict boundaries they become very needytend to idealize and devalue peoplehigh comorbidity with narcissism Often threaten suicide suicide rate 114many stalkers have BPDsome came from pampered homes others were abused as childrenthey may be quite friendly one day and quite hostile the nextsexual difficulties such as sexual preoccupation dissatisfaction and depression have also been observedthey recognize their imaginary voices or other hallucinations as being unacceptable alien and distressful12Individuals with borderline personality disorders seem to have three basic assumptionsthe world is dangerous and malevolentI am powerless and vulnerableI am inherently unacceptableThe following passage is from a novel written by Jonathon Kellerman a psychologist who is a successful mystery writerThe borderline patient is a therapists nightmare because borderlines never really get better The best you can do is help them coast without getting sucked into their pathologyTheyre the chronically depressed the determinedly addictive the compulsively divorced living from one emotional disaster to the next Bed hoppers stomach pumpers freeway jumpers and sadeyed bench sitters with arms stitched up like footballs and psychic wounds that can never be sutured Their egos are as fragile as spun sugar their psyches irretrievably fragmented like a jigsaw puzzle with crucial pieces missing They play roles with alacrity excel at being anyone but themselves crave intimacy but repel it when they fine it Some of them gravitate toward stage or screen others do their acting in more subtle waysBorderlines go from therapist to therapist hoping to find a magic bullet for the crushing feelings of emptinessThey turn to chemical bullets gobble tranquilizers and antidepressants alcohol and cocaine Embrace gurus and heavenhucksters any charismatic creep promising a quick fix of the painAnd they end up taking temporary vacations in psychiatric wards and prison cells emerge looking good raising everyones hopes Until the next letdown real or imagined the next excursion into self damage Kellerman 1989 pp 113114Silent partnerNew York Bantam books Histrionic PDattention seekingoverly dramaticdraw attention to themselvesextravagant display of emotions but quite shallowself centered overly concerned with physical attractivenessneed to be the centre of attention2
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