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1. Strengths Based
Biopsychosocial Approach
to Recovery from
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
 Review the characteristics of cluster B personality
disorders
 Explore the functions of these symptoms
 Identify what may cause these symptoms to develop
 Explore what is maintaining these symptoms
(benefits to the client)
 Explore the effects of these symptoms on significant
others
 Identify interventions to help the person more
effectively manage emotions and relationships

3. First Step
 Address Emotional and/or Behavioral Dyscontrol
 Identify and prevent vulnerabilities
 Identify what works to help self-soothe
 Identify helpful distraction techniques
 Develop a safety plan
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4. Next Step
 Identify the most salient symptoms
 Their function (and alternate ways to meet that need)
 What it looks like
 How that behavior is being maintained (what are the
benefits)
 How can the person achieve the same benefit in a less
problematic way
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5. Characteristics of Cluster B
 In General
 4 Core Features of Personality Disorders
Rigid, extreme and distorted thinking patterns (thoughts)
Problematic emotional response patterns (feelings)
Impulse control problems (behavior)
Significant interpersonal problems (behavior)
 Cluster B is considered the dramatic, emotional, and
erratic cluster
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6. Characteristics of Cluster B
 Borderline
 DESPAIRER*
 Disturbance of identity
 Emotionally labile
 Suicidal or self-injurious behavior
 Paranoia or dissociation
 Abandonment (fear of)
 Impulsive
 Relationships unstable
 Emptiness (feelings of)
 Rage (inappropriate)
* Created by Jason P. Caplan, MD
Recovery & Resilience International in partnership with AllCEUs.com
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7. Characteristics of Cluster B
 Histrionic
PRAISE
 Provocative (or seductive) behavior
 Relationships are considered more intimate than they actually
are
 Attention-seeking
 Influenced easily by others or circumstances
 Speech (style) wants to impress; lacks detail
 Emotional lability; shallowness
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8. Characteristics of Cluster B
 Antisocial
 CORRUPT
Conformity to law lacking
Obligations ignored
Reckless disregard for safety of self or others
Remorse (Empathy) lacking
Underhanded (deceitfulness, lying, cons others)
Planning insufficient (impulsive)
Temper (irritable and aggressive)
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9. Characteristics of Cluster B
 Narcissistic
 SPECIAL:
Special (believes he or she is special and unique)
Preoccupied with fantasies (of unlimited success, power,
brilliance, beauty, or ideal love)
Entitlement
Conceited (grandiose sense of self-importance)
Interpersonal exploitation
Arrogant (haughty)
Lacks empathy
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10. Interventions
 4 Core Features of Personality Disorders
 Rigid, extreme and distorted thinking patterns (thoughts)
 Address faulty cognitive patterns enabling the person to evaluate
and act based on facts not feelings
 Cognitive Processing Therapy “Challenging Questions Worksheet”
 Examine common cognitive distortions
 All or Nothing Thinking
 Mental Filter
 Overgeneralization
 Discounting the positive
 Jumping to Conclusions
 Emotional Reasoning
 Examine prior experiences which may be influencing perceptions
of current events in order to allow the client to challenge
schemas

11. Interventions
 4 Core Features of Personality Disorders
 Rigid, extreme and distorted thinking patterns (thoughts)
Address faulty cognitive patterns enabling the person to
evaluate and act based on facts not feelings
 Examine prior experiences which may be influencing
perceptions of current events in order to allow the client to
challenge schemas
 Problematic emotional response patterns (feelings)
Mindfulness to prevent vulnerabilities and become aware of
distress sooner
Distress tolerance to enable the person to choose to ride the
wave through the initial flood of emotions and act in their
wise mind

12. Interventions
 4 Core Features of Personality Disorders
 Impulse control problems (behavior)
 Identify and Address Triggers
 Distress Tolerance & Distractions
 Coping Strategies
 Significant interpersonal problems (behavior)
 Mindfulness and empathy to increase awareness of self and others
 Development of a stable, positive internal sense of self to reduce
the need for external validation
 Interpersonal Skills
 Communication
 Boundaries

13. Interventions cont.
 General Tips
 Personality Disordered behaviors are egosyntonic
 Most of the time the presenting issue is the result of the PD
Behaviors
 The therapist can help the person work backwards and
identify
 What caused the current issue
 Other similar examples
 Common themes leading to this problem (usually PD behavior)
 A person with PD traits will likely demonstrate these same
traits and behaviors in session, and need to be
compassionately identified and addressed. (Model and
Practice)
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14. Summary
 Cluster B Disorders are characterized by
 A lack of a sense of self
 Difficulty forming authentic relationships
 High levels of anxiety and emotionality
 One of the first goals of treatment is to identify
the client’s dysfunctional behaviors and their
function
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15. Summary cont…
 Most personality disordered behavior is
egosyntonic.
 Help the patient identify the behaviors they
exhibit which may be problematic
 Discuss in session what triggers those behaviors,
what function the behavior served and other ways
to meet that need.
 While it is true the behaviors characteristic of
personality disorders cannot be completely
erased, they can be boxed up and stored in the
archives
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