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On the last track, we discussed how schemas affect
everyday lives: as a way to view the world; and a stored response to an emotional
trauma. Also, we addressed various maladaptive schemas that characterize many
clients diagnosed with BPD: selective perception; overgeneralization; and jumping
On this track, we will address patternschemas,
how they form, and particular pattern schemas that are found in borderline personalities:
subjugation; mistrust; and unlovability.
first step in addressing a BPD diagnosed client's maladaptive schema is to detectthepattern for that particular schema. For example, Linda, age 35, described
this incident between her mother and her. She stated, "I had just gotten
back from a vacation and was feeling very relaxed, so I called my mother. She
asked me about my trip, and I started to tell her. But she cut me off and immediately
started talking about herself. That set something off in me. God I hate her. I
thought, 'She couldn't care less about me' and I got sad, and then very pissed
off. Within minutes, we were arguing again, shouting at each other. I got so furious
that I hung up on her. I don't know why this keeps happening to us."
can see, Linda was experiencing the schema of "No one really cares about
me." When her mother had interrupted her, Linda immediately jumped to the
conclusion that her mother did not care for her at all. This recurring scene is
an example of the way a schema can destroy a client's view of themselves. Does
your client diagnosed with BPD have the "No one really cares about me"
3 Wishes at the Core of Conflict
According to Dr. Luborsky of the University of Pennsylvania,
at the core of every conflict, a person has three wishes: -- 1. to be respected; -- 2. to
be understood; and -- 3. to feel confident.
When a client has preconceived notions of
how their wishes will be recognized or not recognized at all and these notions
are reinforced by other people, it leaves the BPD diagnosed client feeling hopeless
and anxious about their surroundings.
Forty-two year old Christine, diagnosed
with BPD, was suffering from preconceived notions about her husband. She recalled,
"I came home from work and I was so exhausted. I just wanted to slump on
the couch and rest, you know? But when I got there, Carl had all his shit all
over the living room that I couldn't find anywhere to lie down. Well, of course
I got pissed. I knew he was going to ruin my day even more, somehow. Carl does
not give a damn about how I feel or whether I'm so tired I can hardly stand. He
always does that to me. And you know the worst part? He didn't even know why I
was so mad."
Christine's preconceived idea that Carl didn't really care for
her was enforced by his behavior, even though his actions really had no reflection
on his feelings for her.
3 Schema Patterns
Schema Pattern 1: Subjugation
Now let's discuss
several pattern of schemas that many BPD diagnosed clients portray. The first
of these is known as subjugation. The client diagnosed with BPD suffering from
a subjugation schema has been taught from an early age to give in to what others
want. While these clients easily give in, the constant repressing of their true
feelings erupts in a deluge of anger, which, as you know, is a characteristic
of a client diagnosed with Borderline Personality Disorder.
Twenty-four year old
Thad, a client I treated for BPD, related this story about his childhood to me,
"My mother was extremely domineering. She decided everything for me, even
when I was a teenager. I had no voice. She would shop for my shoes, for my clothes,
never asking what I liked. Everything was always her way. Now, in my relationships,
I can never speak up for what I want. I just go along with what the other person
wants until I explode. Then we have this huge fight, and I eventually give up."
While Thad reacted to his overbearing parents by means of resignation, Courtney,
age 17 and diagnosed with Borderline Personality, took the opposite road and rebelled against her parents. She said, "I do crack, and I screw any guy I feel like.
My parents don't know what to do with me. It's hilarious. Now they know they can't
control me anymore."
Schema Pattern 2: Mistrust
Mistrust, as you
know, is another characteristic of Borderline Personality Disorder. This pattern
of mistrust stems from early childhood abandonmentandbetrayal and is common
in clients suffering from sexual abuse.
Ashley, age 19, and her sisters had been molested by a close relative and when she had finally reported the abuse to her alcoholic mother, the reply was, "He probably didn't mean nothing like that."
Because of her mother's dismissive and unsupportive attitude to a traumatic event,
Ashley remained mistrustful. Although at times she could be charming and vivacious,
she became hostile and mistrustful at the least sign of betrayal.
As Ashley described
it, "I'm just as paranoid as I-don't-know-what! Whenever I hear my boyfriend
walking around at night, I immediately go to where my daughter sleeps to reassure
myself that she hasn't been touched." As you can see, Ashley's mistrust schema
has affected her social life and now threatens her relationship.
Schema Pattern 3: Unlovability
A third pattern schema prevalent in Borderline Personality diagnosed clients
is unlovability. This occurs when the client believes that they are unworthy or
incapable of being loved by any other person. Usually, like the mistrust schema,
this stems from early childhood abandonment.
Thirty year old Samantha, another
client I treated for BPD, was abandonedbyherfather when she was eight. Samantha
stated, "I know I can't be loved. My own father doesn't love me. No guy thinks
I'm good enough for him. I'm just so messed up, who could love me? They'd have
to be messed up themselves." Samantha's firm belief that she is unworthy
of any affection restrains her from a loving relationship that could be beneficial
Technique: "Changing the Emotion"
help Christine, Linda, Thad, Courtney, Ashley, and Samantha address their negative
feelings in their everyday life, I found the "Changing the Emotion"
exercise beneficial. I told them that when they begin to feel negative emotions
such as anger, mistrust, or despair taking hold to stop and analyze other emotions
that are also at the core of that specific feeling. These other negative emotions include: 1. Anger
Thad related his analysis of
his emotions as such, "At first, I was so mad that she hadn't shown up for
our dinner. Then, when the anger died away, I analyzed my feelings." I asked
him, "What did you feel?" Thad stated, "I knew that at the root
of my anger, I felt sad, because something had not turned out as I planned."
I asked, "Why do you think you were sad about this?" He responded, "I
guess the loss of a sociable dinner made me feel this way. I felt a little abandoned and taken advantage of, I guess."
By analyzing his feelings
after his initial anger, Thad could better understand why his emotions took hold
of him so quickly and better understood how his feelings of abandonment and vulnerability affected his reaction.
On this track, we discussed address
pattern schemas, how they form, and particular pattern schemas that are found
in borderline personalities: subjugation; mistrust; and unlovability.
Borderline Personality Disorder and Emotion Regulation:
Insights from the Polyvagal Theory
- Austin, M. A., Riniolo, T. C., and Porges, S. W. (2007). Borderline Personality Disorder and Emotion Regulation: Insights from the Polyvagal Theory. Brain Cogn. 65(1). p. 69-76.
Peer-Reviewed Journal Article References:
Dixon-Gordon, K. L., Peters, J. R., Fertuck, E. A., & Yen, S. (2017). Emotional processes in borderline personality disorder: An update for clinical practice.Journal of Psychotherapy Integration, 27(4), 425–438.
Houben, M., Vansteelandt, K., Claes, L., Sienaert, P., Berens, A., Sleuwaegen, E., & Kuppens, P. (2016). Emotional switching in borderline personality disorder: A daily life study.Personality Disorders: Theory, Research, and Treatment, 7(1), 50–60.
Liebke, L., Koppe, G., Bungert, M., Thome, J., Hauschild, S., Defiebre, N., Izurieta Hidalgo, N. A., Schmahl, C., Bohus, M., & Lis, S. (2018). Difficulties with being socially accepted: An experimental study in borderline personality disorder.Journal of Abnormal Psychology, 127(7), 670–682.
Online Continuing Education QUESTION
3 What are three pattern schemas that characterize a Borderline Personality?
To select and enter your answer, go to the CE Test.
Online Continuing Education QUESTION
4 What are the three wishes at the core of every conflict? To select and enter your answer, go to the CE Test.