Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

Borderline Personality Impulse Control with Schema Therapy
Borderline & Schema Therapy continuing education MFT CEUs

Section 11
BPD: Psychosis & Interpersonal Relations

CEU Question 11 | CEU Answer Booklet | Table of Contents | Borderline
Counselor CEUs, Psychologist CEs, Social Worker CEUs, MFT CEUs

The survey of a wide variety of psychotic symptoms reveals that the borderlines do not have any continuous or severe psychotic experiences. Some of the borderlines report possible hallucinatory psychosis Borderline Personality counselor CEU courseexperiences of both auditory and visual types. These are unrelated to drug usage and prove difficult to evaluate clinically. Most commonly the borderlines report psychotic ideation in the depressed area- namely, extended periods of feeling worthless or hopeless. It is rare to find a more outright delusional depressive percept such as the belief of having hurt someone or committed a crime. The only other psychotic symptom reported with frequency is ideas of reference. Many patients have had periods when they felt unduly suspicious of others' intentions. They characteristically feel uncertain or uncomfortable about any psychotic experience. The interviewers generally noted that the psychotic percept is at least not bizarre and totally unfeasible. There are virtually no nihilistic or religious delusions, delusions of thought-insertion, interference, or broadcasting, or delusions of somatic passivity. Many borderline patients had been hospitalized or treated in individual psychotherapy. As predicted, they often report that these experiences made them worse. Contrary to expectations, these patients rarely experience severe or continuous dissociative experiences of any kind. Depersonalization experiences are somewhat more likely than derealization. The least common dissociative experience is feeling things are changing size or shape and the most common is feeling physically separated from one's feelings.

Psychosis Borderline Schema CEUs

Figure 4 shows that, in addition to their surprisingly low frequency, derealization experiences actually discriminate the schizophrenics, who experience them more frequently (p .023). No significant differences are apparent for depersonalization. Nor does any difference appear for psychotic depressive symptoms. The borderline sample has more brief paranoid experiences than the neurotic group (p = .014) but not than the schizophrenics. The latter group, however, is much more likely to have widespread delusional beliefs in other areas (Ji <.001), which makes clinical discrimination quite easy. Although borderlines are slightly more likely to report psychotic experiences from marijuana or alcohol or persisting psychotic symptoms after psychotomimetics, this occurs too infrequently in these samples for any significant differences to surface. As expected, the schizophrenic sample presents significantly more of those psychotic symptoms specifically felt to be unlikely in borderlines, i.e., hallucinations, nihilistic and grandiose delusions, and patently absurd or bizarre delusional content (~ <.001). In hearing about past psychiatric contacts, the interviewers judged that the borderlines develop transient psychotic experiences within psychotherapy or have had a behavioral regression after hospitalization with much more frequency than either the schizophrenics (p = .003) or the neurotic depressives (p = .004). The section total score is significantly higher for the borderlines than for the neurotics (p = .012) but not than for the schizophrenics.

INTERPERSONAL RELATIONS
Borderlines associate with many people and spend most of their time in the presence of others. They feel a need to have people around and report being bothered when alone. They consider that they have close friends and manage to keep in touch with these people. Almost all of them tend to feel sorry for and make efforts to take care of others. Yet they decidedly do not like having others take care of them and find this uncomfortable when it occurs. This apparent paradox continues in their commonly describing having someone in their lives whom they feel they need but less often having someone who they feel needs them. They usually find it uncomfortable to live with their families of origin and yet they often long to be with their parents when they are away from home.

Their most intense current relationships are frequently troubled by breakups. Their relationships are strongly dependent, masochistic, and marked by devaluation and conscious manipulative efforts. The interviewers could frequently see similarities between these interactional patterns and those described in the patient's relation to one of his parents -usually the mother. The current interactions seem to serve a substitutive function.

During the research interviews, the borderlines are often quite suspicious and problems in rapport are common. Their past psychiatric hospitalizations often include a history of presenting special problems for the staff.

Interpersonal Relations Borderline Schema CEUs

The summary statements all discriminate between one or both groups in this section (see Figure 5). The borderlines differ from schizophrenics both in their disinclination to and their difficulty in being alone (p = .0 1). The schizophrenics are more often judged to be socially isolated "loners" (p <.001). The borderlines seek anaclitic relations in which they act as care givers, yet they are in active conflict about giving and receiving care. These patterns are less common for both the scbizophrenics (p = .006) and the neurotics (p = .029). The quality of borderlines' close relationships are more intense and unstable than for either the schizophrenic (p = .001) or neurotic sample (p = .02). Problems with devaluation, manipulation, and hostility are so characteristic and discriminatory that they contrast with both comparison groups (p <.001). Problems with dependency and masochism are also highly characteristic but only differ significantly from the schizophrenic sample (p .006). After reviewing past relations with therapy persons, the interviewers concluded that the borderline patients have almost always been involved in some problem with staff splitting, countertransference problems, or "special" relations to their past therapist (p <.001 with the schizophrenics, p = .005 with the neurotic depressives). This section is highly discriminatory over-all between borderlines and both schizophrenics (p <.001) and neurotics (p= .005).
- Hartocollis, Peter, Borderline Personality Disorders: The Concept, the Syndrome, the Patient, International Universities Press: New York. 1977.
The article above contains foundational information. Articles below contain optional updates.

=================================

Personal Reflection Exercise #5
The preceding section contained information about BPD psychosis and interpersonal relations. Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 11
How do borderlines differ from schizophrenics? Record the letter of the correct answer the CEU Answer Booklet.

 
Others who bought this Borderline Course
also bought…

Scroll DownScroll UpCourse Listing Bottom Cap

CEU Answer Booklet for this course | Borderline
Forward to Section 12
Back to Section 10
Table of Contents
Top

The article above contains foundational information. Articles below contain optional updates.
Poor sleep in anxiety, depression may make it harder to see positive - April 18, 2017
The dorsal anterior cingulate cortex may have to work harder to modify negative emotional responses in people with poor sleep who have depression or anxiety, new research suggests.
Cross-cultural study strengthens link between media violence, aggressive behavior - April 11, 2017
Media violence affects aggressive behavior, compelling evidence demonstrates. This first-of-its-kind study, conducted in seven different countries, confirms six decades of research showing the effect is the same, regardless of culture.
Why do some with radical views become terrorists yet others don't? - April 06, 2017
Since most people who hold radical views do not become terrorists, what are the factors that drive some to violent extremism? Is there a connection between mental illness and terrorist involvement? And why do some interrogators resort to torture when the body of evidence shows building rapport with suspects is more effective?
Individuals who solely murder children differ from other murderers - April 05, 2017
The neuropsychological profiles of murderers who solely kill children differ significantly from the profiles of those who kill children and adults in the same homicidal act, according to a new study. Murderers of children are impulsive, have lower intelligence and often mental illness. Identifying the differences in the two types of killers adds to the very limited research on the topic and could help predict which children may be at risk.
Self-harm linked to violence towards others - April 05, 2017
There is a link between self-harm and the risk of violent criminality, according to new research.


CEU Continuing Education for
Social Worker CEUs, Counselor CEUs,Psychologist CEUs, MFT CEUs

OnlineCEUcredit.com Login


Forget your Password Reset it!