Personality problems

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Personality problems
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Lecture contents

• Trait approaches
• Psychodynamic approaches
• Cognitive approaches
• A comparison between psychodynamic and cognitive
  approaches
• Humanistic approaches

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Wiggins Circumplex of Interpersonal Behaviour
Trapnell Wiggins (1990)
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Mapping personality disorders Wiggins Pincus
(1989)
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Psychodynamic Anxiety

• From threat to self.
• Stems from repetition of earlier trauma.
• May be focused or free-floating.

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Psychodynamic psychopathology

• Inappropriate frustration can lead to fixation or
  regression.
• Instinct-expression anxiety conflict.
• Defence mechanisms and possibly symptoms.

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Behaviour Change

• Developmental changes.
• Following psychopathology, requires insight.
• Transference and transference neuroses employed
  in therapy.

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Crick et al. (1994)
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Tang DeRubeis (1999)

• 62 clinically depressed out-patients received up
  to 20 CBT sessions.
• BDI prior to each session and at follow-ups.
• 24 patients exhibited sudden gains preceded by
  exceptional cognitive changes.
• These patients better off at end of treatment and
  up to 18 months after it (next slide)

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Sudden gains in CBT
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Sudden gains in CBTTang DeRubeis (1999)
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Tang DeRubeis (1999)
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Jones Pulos (1993)
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Jones Pulos (1993)
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Jones Pulos (1993)

• Psychodynamic technique
• Deep experience of emotions
• Interpretation of fears and defences
• Cognitive Behavioural technique
• Teaching and homework
• Patient resistance
• Rejection of relationship or interpretations
• Patient negative affect (and self-evaluation)

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Rogers (1956/1992)

• For constructive personality change to occur
  the following conditions are necessary and
  sufficient
• A client exists with symptoms, stemming from
  incongruence.
• Client will also have, or be vulnerable to,
  anxiety, which stems from dim awareness of the
  incongruence and of its threat to the
  self-concept.
• A congruent therapist exists.
• Psychological contact occurs between the needy
  client and the congruent therapist.
• The therapist experiences and successfully
  communicates unconditional positive regard for
  the client.
• The therapist accurately experiences and
  successfully communicates empathic understanding
  of the client's internal frame of reference.
• No other conditions are necessary. If these six
  ? conditions exist, and continue over a period
  of time, this is sufficient. The process of
  constructive personality change will follow.

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Unconditional positive regard

• To the extent that the therapist finds himself
  experiencing a warm acceptance of each aspect of
  the client's experience as being a part of that
  client, he is experiencing unconditional positive
  regard

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Empathy

• the therapist is experiencing an accurate,
  empathic understanding of the client's awareness
  of his own experience. To sense the client's
  private world as if it were your own, but without
  ever losing the "as if" qualitythis is empathy.

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Thank youRespect yourself