An Interpersonal Approach To The Definition Of Personality Disorder

The elaboration of interpersonal input may be healthy or disordered depending on the developmental history of interpersonal situations characterizing an individual's life. In normative social environments, reasonably accurate interpretations of interpersonal input from others may lead to adaptive relationship-enhancing behaviors (output) and a positive, stable self-image serious distortions of interpersonal input may lead to both chronic interpersonal dysfunction and problems with self or...

Clinic In Interpersonal Reconstructive Therapy

The treatment approach described in Benjamin (2003) is called interpersonal reconstructive therapy (IRT). The IRT individualized method of diagnosis identifies links among presenting behavioral problems (e.g., self-criticism and drivenness to take care of everyone), Axis I disorders (e.g., Marianne's anxiety and depression), current stresses (e.g., all her responsibilities), and developmental adaptations (described later in this chapter) that are specific and unique to each individual. The...

Modes of Adaptation The Passive Active Polarity

The passive-active polarity (Millon, 1990b, pp. 64-77, 2003, pp. 14-18) is conceptualized in terms of ecological modification (active) and ecological accommodation (passive) that is, whether initiative is taken in altering and shaping life's events or whether behaviors are reactive to and accommodate those events (Millon, 2003, p. 14). Personality Implications of the Passive-Active Polarity At the ecologically accommodating end of the passive-active continuum are personality adaptations that...

Recent Advances In Self Psychology

This section incorporates the expanded view of a psychology of the self, a broader perspective extending beyond Kohut's (1966, 1971) initial description of the narcissistic personality and behavior disorders. This is a development in self psychology that may not be familiar to those primarily acquainted with self psychology's attempt to understand a previously un-treatable group of narcissistic disorders. Thus, the self psychological formulations I discuss emphasize the self rather than drive...

Integrating Psychodynamic Personality Disorder Processes

Although every PD can be described in terms of ego strength, defenses, and introjects, it is the complex interplay among these variables that determines the underlying dynamics and surface manifestations of each syndrome. Brief reviews of borderline, dependent, and narcissistic PDs illustrate the interactions among these variables. Table 9.4 Self and Object Representations in Different PDs Note Discussions of self and object representations in PD syndromes are found in Psychodynamic...

Early Onset Course And Outcome In Personality Disorders

Well before the development of diagnosable disorders, children may express their vulnerability through early behavioral disturbances. Children at the age of 3 with unusually high levels of aggression and irritability have been shown to be at risk for antisocial personality disorder in early adulthood (Caspi, Moffitt, Newman, & Silva, 1996). When conduct symptoms begin earlier in childhood and are more severe, antisocial personality is likely to develop in adulthood (Zoccolillo, Pickles,...

Self Psychologically Influenced Framework For Personality Disorders

To this point, I have traced the diverging paths that self psychology and descriptive psychopathology followed. These paths were marked by the shift in emphasis in psychoanalytic theory from drive and ego to self and by the declining influence of psychoanalytic constructs associated with the multiaxial reconfiguration of psychopathology. Further, I have outlined several concepts representing evolutions of Kohut's original ideas, expanding his theories while still remaining within the...

Empirical Findings

Millon's normal personality styles and dimensions have assessed their internal consistency, temporal stability, convergent and discriminant validity, factor structure, and comparability to PDs. Many subject populations have been sampled, including non-help-seeking adolescents, college students, noncollege adults, and the elderly psychiatric patients medical patients with a variety of diagnoses including cancer and chronic pain employees in a variety of occupations including...

Cognitive Therapy For The Personality Disorders

LEAHY, JUDITH BECK, and AARON T. BECK Cognitive therapy was first developed as a treatment for depression and the anxiety disorders (A. T. Beck, 1976 A. T. Beck, Emery, & Greenberg, 1985 A. T. Beck, Rush, Shaw, & Emery, 1979). According to this model, emotional disorders can be understood in terms of the biases in thinking that are activated with, for example, depressed individuals predisposed toward seeing events in terms of loss, failure, and depletion, and anxious individuals...

The Interpersonal Reconstructive Therapy Case Formulation Method

Treatment-resistant patients, who typically are personality disordered, respond to internalized representations of important persons more than to persons in their present day real world. IRT, therefore, addresses their relationship with those internalizations. The assumption is that after old expectations and hopes in relation to the internaliza-tions are given up, the usual and customary treatment procedures (e.g., medications, client-centered, cognitive behavioral, and psychodynamic therapy)...