Beyond Remission: Powerpoint by Kiera Van Gelder

Mapping BPD Recovery: Beyond Remission Kiera Van Gelder, MFA Middle Path © Kiera Van Gelder 2008

The Need for BPD Recovery Model © Kiera Van Gelder 2008

What Does Recovery from BPD Look Like? ,[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

REMISSION from BPD 2 years = 40% Remission 6 years = 68% Remission 10 years = 85% Remission ( Zanarini, 2005, 2006) Remission is defined as “no longer meeting 5 of 9 criteria” However, “Remission” does not necessarily signify a better quality of life © Kiera Van Gelder 2008

The “Subsyndromal Phenomenology” of BPD What resolves most quickly : “ Symptoms reflecting core areas of impulsivity (e.g. self-mutilation and suicide efforts) and active attempts to manage interpersonal difficulties (e.g. problems with demandingness/entitlement and serious treatment regressions) seemed to resolve most quickly.” Least resolved : “ In contrast, affective symptoms reflecting areas of chronic dysphoria (e.g. anger and loneliness/emptiness) and interpersonal symptoms reflecting abandonment and dependency issues (e.g. Intolerance of aloneness and counter-dependency problems) seemed to be the most stable.” (Zanarini, Am J. Psychiatry, 2007 June 164(6):929-35 ) © Kiera Van Gelder 2008

Remission does not address: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Recovery Vision ,[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

The Goal of a Transformed System: Recovery ,[object Object],[object Object],The President’s New Freedom Commission on Mental Health © Kiera Van Gelder 2008

DBT : Dialectical Behavior Therapy (Marsha Linehan, WA) www.behavioraltech.org CBT: Cognitive Therapy (Aaron Beck, PA) www.academyofct.org SFT: Schema-Focsued Therapy (Jeffrey Young, NY) www.schematherapy.com Mentalization (Andrew Bateman and Peter Fonagey, UK) www.menninger.edu TFP: Transference-focused Psychotherapy (Otto Kernberg, NY) www.borderlinedisorders.com STEPPS: Systems Training for Emotional Predictability and Problem Solving (Nancy Blum et al, IO) www.uihealthcare.com/topics/medicaldepartments/psychiatry/stepps/index.html Treatment for Borderline Personality Disorder © Kiera Van Gelder 2008

“ DBT” Stages of Recovery from Borderline Personality Disorder* ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object], Stage 2: “Overcoming Quiet Desperation”  Emotional Experiencing: Dealing with PTSD and trauma, fear of emotions, understanding triggers Behavioral Emotional & Cognitive Interpersonal Sense of Self * Adopted from M.M Linehan, 2004 Stage 3: “Problems in Everyday Living”  Ordinary Happiness and Unhappiness: Rebuilding a life, generalizing skills to relationships and work, involved with life. © Kiera Van Gelder 2008

Judith Herman’s Stages of Recovery ,[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Treatment Triage ,[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Mapping BPD Recovery as a Journey ,[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Surviving the Dysregulation Zone Ludwig Meidner, The Burning City, 1913 © Kiera Van Gelder 2008

Survival in the Dysregulation Zone ,[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Emergence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Confronting Core Schemas: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Mentalization, Cognitive Therapy, Transference-Focused Psychotherapy, Schema-focused Therapy and Internal Family Systems Therapy © Kiera Van Gelder 2008

“ Challenges That Happen in the Wake of Gains” -- Dr. Loren Crabtree ,[object Object],© Kiera Van Gelder 2008

Emergence Cycle © Kiera Van Gelder 2008 Challenge/ Risk Trigger / Destabilize Safety Renewed support/ structure

Aspects of the Emergence Process ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Pathways of Emergence Require Nurturance and Structure ,[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Relationship and Belonging ,[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Work and School / Purpose ,[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Living with BPD Means Encountering a New Set of Dialectics I have BPD but I am not the disorder A disorder that involves one’s sense of Self A sense of Self that is not defined by the disorder © Kiera Van Gelder 2008

Living with BPD Means Encountering a New Set of Dialectics Experiencing vulnerabilities that interfere with living Managing one’s life to compensate for those vulnerabilities Ie- I have problems but am not helpless to deal with them © Kiera Van Gelder 2008

Living with BPD Means Encountering a New Set of Dialectics ,[object Object],Developing relationships and pursuing goals which will make us symptomatic © Kiera Van Gelder 2008

Positive and Negative BPD Characteristics are two sides of the same coin! Sensitivity to social and emotional cues, especially negative ones Empathy to the moods and thoughts of others, especially the suffering of others Spontaneity Fear of Abandonment Reactivity Lack of Boundaries Ability to merge (easily fall in love, see things in new ways) Neediness Willingness to please Intensely Emotional Passionate & Creative Vengeful Strong sense of right and wrong Strong personal attachments Unstable Sense of Self Flexibility © Kiera Van Gelder 2008

Integration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Supports for Integration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],© Kiera Van Gelder 2008

Beyond Remission: Powerpoint by Kiera Van Gelder

Recommandé

Recommandé

Contenu connexe

En vedette

En vedette (20)

Similaire à Beyond Remission: Powerpoint by Kiera Van Gelder

Similaire à Beyond Remission: Powerpoint by Kiera Van Gelder (20)

Beyond Remission: Powerpoint by Kiera Van Gelder

Notes de l'éditeur