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1. Strengths Based
Biopsychosocial Approach to
Recovery from Addictions and
Personality Disorders
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
Recovery & Resilience International in partnership with AllCEUs.com
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2. Objectives
 Define Personality Disorders
 Examine the similarities between the behaviors of
certain personality disorders and addictions
 Identify ways to address these behaviors and
thought patterns
 Encourage clinicians to critically examine
behaviors in patients with addiction in order to
effectively differentially diagnose
Recovery & Resilience International in partnership with AllCEUs.com
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3. Why I Care/How It Impacts Recovery
 When personality disorders are viewed as pervasive & perpetual, it
 Provides an “excuse for relapse”
 Often derails treatment because patterns of behavior thought to be
due to the PD are essentially ignored
 Personality Disordered & Addictive Behavior often look the same
 Goals for recovery from both:
 Honesty with self & others about thoughts/feelings/needs/wants
(Mindfulness)
 Distress tolerance and the ability to self-soothe
 Hope and faith in self/future/others through addressing cognitive
errors
 Development of self esteem to eliminate need for external validation
 Development of healthy, supportive relationships
Recovery & Resilience International in partnership with AllCEUs.com
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4. Personality Disorders
 Represent a cluster of behaviors that is pervasive
beginning before the age of 15.
 Addictive behaviors also often begin before 15
 Due to immature cognitive development, children tend
to be more egocentric, overgeneralize and think in
terms of dichotomies
 From a survival perspective, most of these behaviors
make perfect sense when viewed through the eyes of a
child
Recovery & Resilience International in partnership with AllCEUs.com
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5. Personality Disorders
 Treatment
 Since these behaviors formed the foundation for
further development patients must
Understand their function in the past
Identify how these behaviors and beliefs are faulty in the
present
Develop alternative skills
Be empowered to interface with the world with the
strengths, knowledge and tools of the adult
Recovery & Resilience International in partnership with AllCEUs.com
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6. Addictions
 Represent one way to cope with distress
 Can begin early in life
 Have overlapping symptoms with personality
disorders, especially Cluster B
Recovery & Resilience International in partnership with AllCEUs.com
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7. Addictions & Personality Disorders
 Cluster A (Paranoid, Schizoid, Schizotypal)
 Characterized by social awkwardness and withdrawal
 Often co-occur with addictions
 Cluster C (Obsessive-Compulsive; Dependent)
 Characterized as anxious and fearful
 May co-occur with addiction
 Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
 Characterized by dramatic, emotional, erratic behavior
 Behavioral patterns overlap with addiction
Recovery & Resilience International in partnership with AllCEUs.com
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8. Addictions & Personality Disorders
 Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
 Characterized by
Dramatic, emotional, erratic behavior
All or Nothing thinking
Hostility and Aggression
Hypersensitivity
Manipulative
Low Self-Esteem / Weak Self-Concept
Recovery & Resilience International in partnership with AllCEUs.com
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9. Addictions & Personality Disorders
 Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
 Antisocial:
Disregard for the rights of other people
Impulsivity
Hostility and/or aggression
Deceit and manipulation
Seem to lack empathy
Recovery & Resilience International in partnership with AllCEUs.com
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10. Addictions & Personality Disorders
 Cluster B
 Histrionic
Excessive emotionality and attention seeking
 May become enraged at perceived rejection
Need to be the center of attention
Inability to engage in authentic relationships but
uncomfortable being alone
Imagine relationships to be more intimate in nature than
they actually are
Tend to be suggestible and easily influenced by other
people's suggestions and opinions.
Recovery & Resilience International in partnership with AllCEUs.com
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11. Addictions & Personality Disorders
 Cluster B (Borderline, Narcissistic, Histrionic,
Antisocial)
 Borderline:
Low self-esteem
Feel helpless, anxious and constantly fear abandonment
Perceptions of themselves and others may quickly
vacillate back and forth
Hypervigilant
Extremely emotionally reactive with inability to de-
escalate
Often have a history of neglect, abuse or a dismissive
style of parent-child attachment
Recovery & Resilience International in partnership with AllCEUs.com
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12. Addictions & Personality Disorders
 Cluster B
 Narcissistic
Powerful sense of entitlement
Believe they deserve special treatment, and to assume
they have special powers, are uniquely talented, or that
they are especially brilliant or attractive.
Need to be powerful, and admired
Lack of empathy for others
Relationships that are often superficial and devoid of real
intimacy
Recovery & Resilience International in partnership with AllCEUs.com
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13. Addictions vs. Personality Disorders
 Take home message
 Many behaviors characteristic of active addiction
Overlap with personality disorders
Begin in late childhood/early adolescence
Are pervasive
 As people’s experiences and knowledge expanded, their
coping skills and behaviors remained relatively primitive
 Recovery from addiction requires
Development of effective coping skills
Addressing cognitive distortions
Recovery & Resilience International in partnership with AllCEUs.com
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14. Addictions vs. Personality Disorders
 Take home message
 Recovery from addiction requires addressing…
Dramatic, emotional, erratic behavior
 Distress Tolerance
 Mindfulness to identify and process the source of the
distress
 Coping skills
All or Nothing thinking
 Awareness and elimination of cognitive distortions (CBT)
Hostility and Aggression
 Understanding of the fight or flight response
 Development of anger awareness and management skills
Recovery & Resilience International in partnership with AllCEUs.com
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15. Addictions vs. Personality Disorders
 Take home message
 Recovery from addiction requires
Hypersensitivity esp. to rejection
 Awareness of and addressing thinking errors
 Awareness and addressing abandonment issues
 Development of self-esteem
Manipulative
 Interpersonal skill development (boundary setting,
communication skills)
Low Self-Esteem / Weak Self-Concept
 Development of self-esteem and the ability to internally
validate
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16. Summary
 Most patients with addictions have traits associated with
personality disorders
 These traits can be loosely classified into
 Thinking errors  the perception of a threat
 Behavioral reactivity to escape or eliminate the threat
 The first steps in the recovery process…
 Honesty with self and others (Mindfulness and Awareness)
 Hope & faith (Identifying cognitive distortions and thinking errors to
encourage and empower)
 Courage and discipline to remain constantly mindful, accept and
address thoughts and feelings, make conscious choices based on
facts
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17. Summary cont…
 A child growing up in an unstable, neglectful,
emotionally detached environment may develop
 PD traits to survive
 Addictions to numb the pain and escape from the lack of
control.
 Behaviors characteristic of addictions and personality
disorders
 Were learned and reinforced
 Will always be in the recesses of the toolbox
 Must be made less rewarding than alternative, healthy
behaviors
Recovery & Resilience International in partnership with AllCEUs.com
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