I’m skeptical about this, and there are VERY few therapists even trained in this, but if it could work, it would be a great (and very expensive!) way to rehabilitate hardened criminals and deter crime. The speaker in this video (Dr. David Bernstein) is riveting. One thing’s for sure–you’d have to have nerves of steel to make a career out of this.
The only “easy” thing about the patients Dr. Bernstein treats are that they’re not difficult to get into therapy, since these are forensic patients who are already in prison. They can’t quit when things get uncomfortable. Such is not the case with most NPDs, who usually aren’t in prison and don’t often seek out therapy for themselves.
BPDTransformation used to be one of my commenters but has not posted anything in his blog in over a year, or made any more comments here. Edward (his real name) wrote fascinating, intelligent, and extremely well researched articles about BPD, which he was diagnosed with. At some point he came to believe BPD was a bogus diagnosis, a catchall for an array of symptoms that weren’t easily classified or understood. (Some people believe BPD and C-PTSD are the same disorder, which does make sense to me).
Edward, who became BPD-free, writes here about how motivated many borderlines are to recover, and how effective psychotherapy can be in healing this disorder. This flies in the face of the common belief that because BPD is in the Cluster B group of personality disorders, that it’s just something you have to resign to yourself to having forever.
The article, like all of Edward’s articles, is a bit on the scholarly side, but is still a very good read and helps reduce the stigma against people with BPD.
This post will answer critics who say: “Borderlines are not motivated to attend therapy. Borderline patients don’t stay in treatment. At best, therapy can manage but not cure BPD.”
These statements are absolutely false. Yet these myths continue to appear online, often being communicated to people recently diagnosed. As the studies below demonstrate, most people diagnosed with BPD do want help, most will stay in good treatment, and most do recover to different degrees.
Earlier posts have elaborated my dim view of the (non) validity of the BPD diagnosis. Since it cites studies using the BPD construct, this post might be viewed as hypocritical. That may be a valid criticism! Nevertheless, these studies provide evidence that people with “borderline symptoms”, however defined, can be motivated and recover both with and without therapy
Study 1: 88 Borderline Patients Treated Twice a Week for Three Years
Schema therapy was developed by Dr. Jeffrey Young for treating personality disorders, which are deeply ingrained patterns of behavior that are not receptive to traditional therapies used for depression, anxiety, neurotic disorders, etc.
(You can read more about how Schema therapy is used for NPD patients here.)
NPD is one of the most difficult of the personality disorders to treat, and it’s rare a patient will present themselves for treatment, unless they have suffered a narcissistic crisis that led to them becoming depressed.
These three videos are part of a graduate school practicum, showing schema therapy in action on a narcissistic patient (non-pathological narcissism/low spectrum NPD).* In the first video (session 1) the patient, “Sam,” has come to therapy because he is having problems relating to his wife and feels rejected by his coworkers. He is easily irritated and shows a number of narcissistic traits, including entitlement and grandiosity. He doesn’t understand or have empathy for his wife’s complaints about feeling hurt by his “brutal honesty.”
In the second video (session 8), Sam begins to talk about himself at five years old, when he broke his arm and felt rejected because his immediate physical and emotional needs were dismissed by his mother, who took him to the babysitter instead of showing the empathy and concern she should have. Then he is asked to relate how “little Sam” feels and begins to explore the emotions he shut himself off from feeling because of his mother’s rejection.
In the third video (session 16), Sam begins to show emotional discomfort as the therapist has “little Sam” (his true self) talk to “Detached Sam” (his narcissistic mask). He admits he wants to be able to show his wife how much he loves her.
Session 1:
Session 8:
Session 16:
Schema therapy is also commonly used to treat people with Borderline Personality Disorder.
* The patient is an actor but this is still an interesting look at how this method of therapy works.
Lucky Otters Haven 