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Psycology » Psychiatry and psychotherapy » Personality disorder » Psychotherapy in personality disorders

The method of application of dynamic psychotherapy for personality disorders are not much different from that used in the neuroses. Such treatment may be conducted individually or in groups (see Sec. 18).

For individual treatment of personality disorders, there are some differences in emphasis compared to treatment of neuroses. Less attention has been paid to the restoration of past events and more analysis of the behavior at the moment. In the so-called analysis of character study in detail how the patient relates to other people, how he copes with external constraints and controls as their own feelings. This approach is more prescriptive than the classical methods of analysis of neurotic symptoms, although the analysis of the transference is an essential element. To emphasize the discrepancy between the patient's usual attitude to other people and the real life situation, the physician should reveal themselves to a greater extent than is usual in the classical analysis. At the same time, analysis of the emotional attitude of the doctor to the patient can be an important indicator of the likely reactions of other people on the patient.

Histrionic personality disorder

Murphy and Guze (1960) made an interesting message about the complexities that arise in the treatment of patients with hysterical personality disorder. They describe the direct and indirect requirements that such patients may present doctor. Direct requirements include unreasonable requests for medical treatment, frequent requests for assurances in constant readiness to help, phone calls at the wrong time and attempts to impose unrealistic conditions of treatment. Indirect requirements are expressed in various forms, such as seductive behavior, threats to commit dangerous acts, such as overdosing medication repeated unfavorable comparisons are now getting treatment occurred in the past. The physician should be alert to the appearance of the first signs of such claims and to establish certain framework of the relationship, making it clear to what extent the patient going to tolerate behavior. This must be done before the claim of excessive increase.

Obsessive personality disorder

Patients with obsessive personality disorder often express a greater willingness to please the doctor. However, when this type of personality disorder therapy usually gives a positive effect, but unqualified it can lead to excessive painful introspection, whereby the condition worsens rather than improves.

Schizoid personality disorder

Schizoid inherent tendency to avoid close personal contact makes it difficult to use any form of psychotherapy. Often, after a few sessions of the patient stops to visit them, but if he continues treatment, his tendency to intellectualization of their problems and doubts as to the scientific validity of the methods used in the clinic.

The physician should try to gradually penetrate these intellectual barriers and help the patient to recognize his emotional problems. Only a doctor can then start looking for ways to solve them. At best, it is a slow process, but it often fails.

Borderline Personality Disorder

Patients with borderline personality disorder do not give a positive response to the exploratory psychotherapy, besides attempts such treatment may worsen their emotional control and strengthen impulsive actions. Usually better supportive care, directing all efforts to turn to practical purposes associated with the solution of everyday problems.


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