1
Q
Is personality disorder complex
A
- yes
- >its treatment for personality disorder tends to be targeted and specialized to diagnosis
2
Q
What is the definition of a personality disorder
A
- persistent and pervasive dysfunction in processing and interpersonal strategizing
- > impacts various life domains
- > it is a developmental disorder with late adolescence onset
3
Q
What is crucial to treating personality dysfunction
A
- it is done through relationships
- experiencing safety, epistemic trust, perspective-taking and psychological flexibility
4
Q
What are traditional CBT’s
A
-comes from Beck, Ellis and Meichenbaum
- cognitive restructuring is key here
- > so therapy is involved in correcting errors and thinking/appraisal(identify cognitive distortions)
5
Q
What is CBT appropriate for personality dysfunction
A
- contextual cognitive behavioral therapies
- > eg; dialectical behavioural therapy, mindfulness cognitive therapy, compassion-focused therapy, emotion efficacy therapy and acceptance/commitment therapy
- these therapies are focusing on the process of how we come to perceive and make sense
- > how do we arrive at thinking and the process of thinking
- > all of these approaches here are emphasizing mindfulness, acceptance, perspective-taking and valued action
6
Q
What is therapy
A
- therapy is a present moment process
- > assessment and intervention happens in the here-now of therapy
-assessment is the ability to formulate a working hypothesis based off what you observe and what the client self reports
- intervention is what you do in response to the hypothesis
- > it is what you say next
7
Q
Describe the acceptance and commitment therapy
A
- it is rooted in traditional behavioural analysis
- > it is also recognized as a robust evidence based approach
- > works to promote psychological flexibility(doesn’t just focus on the elimination of symptoms)
- > a functional analytic approach(how a behavior works in a context, not what the behavior is)
- > it is experiential not conceptual. really works on skill development
-ACT really explores a client’s experience of doing, assessing mental functions and addressing perfformance skills
8
Q
What are the six components of the psychological flexibility model
A
1) Present Moment Awareness
- >is client attentive
2) Values
- >look at the client’s motivation
3) Committed Action
- >look at client’s overt behavior
4) Self-as-context
- >what is the client’s conceptualized self
5) Cognitive defusion
- >look at client cognition
6) Acceptance
- >what is the affect of the client
9
Q
What is psychological flexibility
A
- it is all about describing behaviours
- it is also describing the skills involved in doing something really challenging
- > doing something where we are confronted with pain, discomfort or limitation
10
Q
How do we promote psychological flexibility when it comes to the ACT approach
A
- through
- > ourselves(modelling psychological flexibility)
- > language(experiential inquiry, metaphors)
- > play(activities, exercise)
- as a therapist, approach a client situation with an attitude of discovery
- > not knowing what is going to happen
- > be willing to let the exercise flop
11
Q
What does ACT indicate of signs that flexibility is occurring
A
- noticing aspects of their experience
- a sense of wonder and awe
- > wow look at what we are doing here
- willingness to feel what was previously avoided
- spontaneous realization
- expressing emotions
- increased verbal fluency
- start using non-evaluative language
- being able to verbalize values
- identifying workable toward moved
12
Q
What is the point of psychological flexibility according to ACT
A
- you become intimate and non-attached to the conscious experience
- handle information as information; as it is, not what it says is
- > I notice my system telling me failure is not true. I am just facing difficulties
-live a life worth living
13
Q
What is a relational frame theory
A
- language is the learned behavior of attributing meaning to stimuli
- this process of framing influences our perceptions and behavior
- > it is called the transformation of stimulus function
- > the way we perceive stimuli influences the way we behave
- what is crucial is that language enables us to frame relationships between stimuli which we might never directly encounter with our 5-senses experience
- > language produces imagination
- > words enables us to imagine stuff
14
Q
What is perspective-taking? Is personality dysfunction related to perspective-taking defecits?
A
- the ability to attribute mental states to oneself
- understand that others have beliefs, desires, intentions and perspectives differing from one’s own
- personality dysfunction is related to perspective-taking deficits
- > sense of self disturbances, affect dysregulation and interpersonal difficulties
15
Q
Does psychological flexibility skills promote perspective-taking skills and vice versa
A
-yes
16
Q
Does the health of our social and cultural contexts exert a powerful influence on our sense of self
A
- yes
- it causes
- > certain ideals
- > inaccurate rules regarding our psychology
- > assign and encourage labels
- > organizes roles to which we conform
17
Q
What is tacting and describe the process of tacting
A
Tacting is verbally discriminating experience
- done through
1) notice(can they orient and attend to what is there)
2) name(can they name and describe what’s there using non-evaluative language)
3) let go(can they speak about what’s there from different angles)
4) soften(can they hold what’s there lightly and express some kindness and care)
5) Expand(can they connect to what matters in presence of what’s there)
-the last three steps are really perspective taking and the first two are tacting
18
Q
How does your brain make sense of stimulation
A
- it relies on sensory stimulation from meaningful information about our context
- > information is the perception of difference
- > if your brain cannot make sense of stimulation, then it does not exist(it goes unnoticed and is noise)
- > when we are able to perceive differences, then we are able to differentiate information
19
Q
What is exteroception
A
-sight, taste, touch, pressure, hearing, smell, temperature
20
Q
What is introception
A
- detecting signals from our “internal milieu”
- >kinesthesia, proprioceptive, viscerosomatic cues(feelings like butterflies in your tummy), interoceptors
21
Q
What is a socioverbal community
A
-interpersonal relationships, sociocultural messaging from which we internalize meanings
22
Q
Does tacting begin in early interaction with others?
A
- yes
- > early relationships play an instrumental role in our ability to make sense of and take perspective on our experience
- > caregivers help infants organize and make sense of their sensory experience
- early caregiver experience can lead to
- > affect regulation
- > interoception
- > interpersonal boundaries
23
Q
What is accurate tacting
A
- you are able to notice what is showing up for you and coherently describe what stuff is showing up
- > eg; heaviness in our chest and sadness in our mind
-tacting is a fundamental skill to perspective taking
24
Q
What are the four different types of attention regulation
A
1) Shift
- >attentional switching
2) Stay
- >sustained attention, with concentration
3) Broaden
- >receptive awareness(noticing variation in experience)
4) Narrow
- >focus, tact(stable perspective)
25
What does inaccurate tacting look like(an individual is not reading themselves correctly)
- absence of emotional talk
- deliberate distortion
- >is what we see in abuse
- >survivor internalizes abuse(child thinking they deserve child abuse)
- avoidance
26
What are deficits that can lead to inaccurate tacting
- alexithymia(individuals who have difficulty in identifying and communicating emotions)
- underdeveloped interoception(can't read inner cues)
- fear of experience, emotional avoidance
- social interaction skills deficits
27
What are activities to train tacting
- sensory interventions
- interoception curriculum
- guided meditations
- somogram/body map
- physical activity
- mindful movement
- mindful listening to music
- breath work
28
How do you train tacting
- do brief exercises
- get the client to notice
- be specific with what you are asking them to notice
- >sensory input
- >physical sensations
- >thoughts
- >emotions
- >memories
- >urges and impulses
- go slow and give time for the client to notice
- help the client identify which sensory information feels manageable to notice
- incorporate activity
- start with pleasurable or tolerable sensations
29
Why use selfing
1)Directly facilitating in occupational therapy
2) Self exerts a powerful influence over your behavior
- >rule governed behavior: self-content functions as a set of rules that specify what we do, what we do not do do, what we think is possible
3) Brings depth to therapy
- >enhancing client centeredness
- >brings a spiritual dimension into what we do
30
Why is the self so important
-because the self is what you have learned you are capable of
31
Is selfing responding to one's own responding?
- yes
- >for example, look at your own hand
- >you notice you are looking at your own hand
32
Is selfing a language function
- yes
- >we are framing ourselves over and over making all types of evaluations about ourself
- it happens over a lifespan
- it is motivated by belonging and connection
33
What is the self-as-content(I am x)
- it is a self-concept
- >totality of inferences a person has made about himself or herself
- evaluative statements about oneself that regulate behavior
- >"I am"
- not just cognitions but sensations, affects, etc
- self coherence is highly reinforcing: individuals may behave in accordance with their conceptualizations, commonly resulting in dysfunctional behavior(eg; "I am not good enough because I did not meet my expectations")
34
What is the self-as-process(I notice x)
- moment-to-moment experience
- noticing and mindfulness
- it is about knowing the self
- >"Now i am feeling this, now I am thinking that, now this sensation occurred"
35
What is the self-as-context(x is a part of my experience)
- hierarchical framing
- >it is putting the parts into a whole unity
- it is all about perspective-taking self
- transcendent self
- pure consciousness
- metacognitive experience
- >experience facilitated by sustained attention(such as meditation)
36
What is flexible selfing
- hold self-concept lightly
- attention regulation
- developed self-awareness
37
What is inflexible selfing
- rigid self-concept
- attention is underdeveloped
- diminished self-awareness
38
What do Higher QUEST scores correspond to
-it corresponds to flexible selfing
39
What does overevaluation of self-content result in
-narcissism
40
What does underevaluation of self-content result in
-depression, avoidant or dependent personality
41
What does rigidity self-content result in
- compulsive and rigid behavior
| - experience aspects of self as 'not me'/external/foreign
42
What does the underdeveloped self-as-process result in
-it results in ATTENTIONAL DEFICITS
- overwhelmed by aversive experience
- incoherent sense of self
- difficulty changing perspective
- over dominance of past and future
43
What does the underdeveloped self-as-context result in
-it results in Perspective-taking deficit
- unstable identity
- fear or annihilation with aversive experience
- trouble connecting with others
- lack of empathy or compassion
- social anhedonia
44
Is self-as-context related to psychological health
-yes
- transforms influence of learning history on present experience
- sense of connection to others
- neuroception of safety. When we hang out in self-as-context, you feel safe and connected
- increase in flow states
- transcendent/spiritual experiences
- >sense of oneness/non-duality
45
What are self-as context practices
-yoga, mindful movement, meditation, pryer, breath work, ritual, ceremony, art
46
What does meditation result in according to research
- medium-sized brain structure differences in prefrontal cortex and body awareness regions
- regulates the autonomic nervous system
47
What are the challenges of meditation
- perceptions: hypersensitivity to stimuli, hallucinations
- cognition: executive functioning and delusions
- affect: increased emotional lability or affect blunting
- symptom exarcebation: trauma flashbacks and other symptoms, mood disturbances
- sleep disruptions
- twitches, tremors
48
What is deictic framing
- our perspective is co-developed in and through our interactions with others
- >particularly the feedback we receive about our own behavior
-whenever we speak at someone or something, we are engaging in deictic framing
49
How do we practice deictic framing
- responding to your own responding in a way that broadens perspective
- helping clients learn to take perspective on their experience is a common feature of all psychological intervention
50
What is compassion
- we become aware in order to care
- activation of the care system
- responding to self-content with attitude/motivation to:
- >openness to suffering
- >a desire to end suffering
- >kindness and love towards those who are sufferring
- >taking valued action without expectation
51
What are the three pillars of psychological flexibility
-being open, aware and engaged
518 Class
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Decks in class (6)
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