NPD Treatment vs BPD Treatment | Dr. Igor Weinberg

yeah so in 2008 and 9 I started expanding my private practice after getting licensed in Clinical Psychology and because of how Junior I was on faculty I was taking everybody who was coming in especially because I was referred a lot of those patients that other people didn't want to treat so soon enough I found myself with the full practice of patients that I was wondering what was going on with them in terms of the treatment I knew that they had some form of personality disorder um and a lot of times I knew that they have some form of difficulties regulating self-esteem and they probably met criteria for narcissistic personality disorder so feeling at that time that I was quite well equipped with treating people with the other personality disorders such as borderline personality disorder I expected that I would see certain outcomes if I was using very similar interventions but I was wrong and soon enough I realized that I was not really helping some of those clients move forward and in fact I was perpetuating some of the difficulties that brought them into treatment um can you say where you saw the fork in the road between what was working for the borderline people that was not working for the narcissistically inclined some of the difficulties that I experienced had to do with defining type of a goals that they were struggling with and also um difficulty engaging persons motivation and sense of agency in making change but also found that a lot of the attachment difficulties were really Central to the difficulty engaging patients in my practice to kind of engage in Psychotherapy that was change oriented and I felt that was different with a lot of patients I had experienced before that were very eager to make changes even though that would produce a lot of anxiety however they also were very attached to me and they were very interested in preserving attachment to me and that used to be a very strong leverage to to help them change things you didn't have that Leverage is what you were saying very soon I realized I did not have the same leverage and the same interventions were not helping them engage more in treatment but in fact we're making them a retreat from treatment and Retreat from attachment to me that made me feel very puzzled but I also started asking questions what would actually help what type of principles need to be incorporated into my Approach so that the same treatments could be more effective and instead of having patients that are struggling they could really start moving forward uh I spoke with colleague can you give one example of what was an intervention you would have given to like a borderline patient that has been effective that you were finding ineffective for um a narcissistic patient I think that some of the interventions had to do with um presenting or confronting people with the uh with their difficulties that would make a lot of patients with borderline personality disorder um engage more and become interested despite the anxiety however I found that a lot of patients with narcissistic pathology would feel very intimidated by this and they would retreat and that was one of the difficulties that I had and that would maybe point to self-esteem regulation issues or something or shame right that could point out to Shane but it also could point out to how they regulate in terms of their attachment ah I see and that made me interested in looking at the attachment literature and think what could be incorporated in treatments to make those treatments more effective

Channel: BorderlinerNotes

Views: 5,450

Keywords:

Id: zisyF4xbW48

Length: 4min 5sec (245 seconds)

Published: Tue Jun 20 2023