Thematic Stages of Recovery in the Treatment of Borderline Personality Disorder

Gregory, Robert J.

doi:10.1176/appi.psychotherapy.2004.58.3.335

Cited by 14 publications

(16 citation statements)

References 7 publications

(10 reference statements)

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“…In addition, there is a strong experiential component to the treatment that relies on moment-by-moment affective responses of both the patient and therapist to support self-other differentiation and to identify and deconstruct negative attributions toward treatment that can interfere with a therapeutic alliance (Gregory, 2005(Gregory, , 2007. Treatment progresses over four thematic stages, each characterized by specific ther-apy tasks and patterns of relatedness (Gregory, 2004).…”

Section: Treatmentsmentioning

confidence: 99%

A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder.

Gregory¹,

Chlebowski²,

Kang³

et al. 2008

Psychotherapy: Theory, Research, Practice, Training

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129

106

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A randomized controlled trial was conducted to determine whether a manual-based psychodynamic treatment, labeled dynamic deconstructive psychotherapy (DDP), would be feasible and effective for individuals with co-occurring borderline personality disorder (BPD) and alcohol use disorder. Thirty participants were assessed every 3 months during a year of treatment with either DDP or treatment as usual (TAU) in the community. DDP participants showed statistically significant improvement in parasuicide behavior, alcohol misuse, institutional care, depression, dissociation, and core symptoms of BPD, and treatment retention was 67% to 73%. Although TAU participants received higher average treatment intensity, they showed only limited change during the same period. The results support the feasibility, tolerability, and efficacy of DDP for the co-occurring subgroup and highlight the need for further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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Section: Treatmentsmentioning

confidence: 99%

A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder.

Gregory¹,

Chlebowski²,

Kang³

et al. 2008

Psychotherapy: Theory, Research, Practice, Training

Self Cite

129

106

View full text Add to dashboard Cite

show abstract

“…However, as patients progress through treatment, therapists must begin to challenge logocentric needs and idealizations to promote differentiation and individuation (Gregory, 2004(Gregory, , 2005. Therapists' responses can either reify the attributions of a given state, or begin to deconstruct them experientially.…”

Section: Treatment Implicationsmentioning

confidence: 99%

Borderline Attributions

Gregory

2007

APT

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Borderline personality disorder is characterized as an identity disturbance or pathology of the self-structure. The author employs concepts from deconstruc tion philosophy and object relations theory to explore how persons with borderline personality disorder attempt to generate meaning, eliminat ambiguity, and maintain idealizations by assigning polarized attributions of value, agency, and motivation to their experiences. The author proposes tha these binary attributions interact to form multiple, discrete self structures or states of being. Each state is characterized by stereotyped expectations for self and other and patterns of relatedness that are self-perpetuating. The author delineates four common states, labeled as helpless victim, guilty perpetrator angry victim, and demigod perpetrator, and suggests treatment strategies t deconstruct each state and to facilitate the development of an integrated and differentiated selfJacques Derrick is considered the founder of deconstruction, a postmodern philosophy that closely examines how meaning is generated. Much of Derrida's writing is a critique of Western philosophical traditions. He points out that Western philosophy is based upon a binary system of logic, i.e. if p, then q. There is a presupposition that universal truths and essential meanings may be discovered through objective observations and logic.Derrida felt that this binary system of absolutes provided an implicit lens for how we perceive ourselves and others and how we make sense of our experiences. In binary logic, any being or entity is defined by what it is not, "which would identify it as this rather than that" (Derrida, 2004, p. 143). For example, an apple is defined by how its shape, color, and texture differ from other fruit, such as a banana. A fruit is either an apple or a banana. There is no in-between. Binary oppositions maintain an either/or -if/then proposition and are thereby able to eliminate doubt and ambiguity and to establish a certainty of meaning.By establishing a certainty of meaning, binary logic eliminates any need for individual interpretations. There is perfect concordance of understand- Derrida employed the terms logocentrism or phonocentrism to describe the Western tendency towards binary oppositions and the personal and interpersonal consequences of that tendency. Derrida felt that a need for certainty of meaning and a desire for idealized unification and perfect understanding between self and other drives logocentrism.Derrida pointed out that one of the consequences of a logocentric tendency is devaluation of contradictory evidence and exclusion of alternative meanings that do not fit within the binary structure. He argued that certainty of meaning is illusory and that "signified meaning. . .always signifies again and differs" (Derrida, 1978, p. 25). For example, an older use of the word "apple" is, as a broader term, used to describe all nuts and fruits (including bananas). "Apple" may also signify a cherished object, as in "the apple of my eye"; an object of temptation...

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“…As a facilitator, he is expected to have humanistic qualities such as being reassuring, validating the client, being willing to spend time with the client and being non-judgmental. These humanistic characteristics correspond to the notion of the therapist as a transitional object for the client (Gregory, 2004) in establishing the therapeutic alliance, considered to be the first thematic stage of recovery for a BPD client according to Gregory (2004). Therapists also have to be dialectical in the sense of being free from prejudices and gender stereotypes.…”

Section: Resultsmentioning

confidence: 78%

“…Such resistance occurs because of clients' extremes in perception of the therapist. BPD clients were also proposed to have dependency features, suggested as part of the core conflict for BPD clients of dependency versus autonomy by Gregory (2004). This dependency is buoyed by their lack of social support, their extreme idealizing of the therapist, and a tendency to perceive the therapist as a friend rather than as a professional.…”

Section: Resultsmentioning

confidence: 99%

Eclectic Therapeutic Relationship with BPD Clients: Examining the Eclectic Therapeutic Relationship with Clients with Borderline Personality Disorder

Ninan

Biswas²

2014

ajs

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Borderline Personality Disorder (BPD) or Emotionally Unstable Personality Disorder (EUPD) clients are characterised by behavioural symptoms of acts of deliberate self-harm, difficulty controlling anger, and instability in relationships, besides others. While specific therapies address specific problem behaviours, an integrated or eclectic approach enables clinicians to adopt a comprehensive therapy plan (Livesley, 2008). Since the therapeutic relationship with BPD clients is characterised by frequent ruptures and fluctuations, it is necessary to understand how the eclectic stance approaches the therapeutic relationship with BPD clients. This study explores these questions through in-depth interviews with seven self-identified eclectic therapists who have worked with BPD clients. Using Thematic Network Analysis, it was found from the interviews that eclectic therapists choose the stance because of the flexibility it offers them, and because of definite client and setting factors. This stance, they suggested, helps in mutual decision-making and leads the therapist to make constant adjustments to the client's level. The process of rapportbuilding was seen to be an on-going process, where the therapist acts as a facilitator, and often works against resisting traits of the clients. Therapists also talked about * MPhil Scholar, Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore; anneninan@gmail.com † Clinical Psychologist in private practice, Bangalore; Artha J Soc SciISSN 0975-329X 54 ruptures in the relationship due to certain factors and identified means through which these can be repaired. Finally, they identified their reactions to BPD clients as consisting of both positive reactions, and negative and unconscious reactions, which require monitoring. The results of this study yield an understanding about the reasons behind the decision to take an eclectic stance, and how it affects the therapeutic relationship.

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Thematic Stages of Recovery in the Treatment of Borderline Personality Disorder

Cited by 14 publications

References 7 publications

A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder.

A controlled trial of psychodynamic psychotherapy for co-occurring borderline personality disorder and alcohol use disorder.

Borderline Attributions

Eclectic Therapeutic Relationship with BPD Clients: Examining the Eclectic Therapeutic Relationship with Clients with Borderline Personality Disorder

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