The ACT Counselling Services Team will shortly be delivering a 1-day CPD event titled ‘Borderline Personality Disorder, Neuroscience and Psychotherapy.’ This will take place on Saturday the 15^th of October 2016 at Stirling Baptist Church and Family Life Centre, 2^nd Floor, 61-63 Murray Place, Stirling, FK8 1AP. ACT Counselling Services Ltd are a private training provider who’s staff have a huge amount of experience of working with complex cases. Staff members have worked in the most challenging settings with the most severe and enduring types of disorder. We are passionate about sharing our knowledge, experience and conclusions to enable others to understand and/or work with complex cases.

What is Borderline Personality Disorder?

Borderline Personality Disorder or BPD for short is one of the most challenging presentations for clinicians to treat. It is, without doubt, the disorder that costs the taxpayer the most money on a yearly basis. Despite these considerations, there is still little training on working with BPD, services available to treat BPD and Clinicians remain reluctant to add the treatment of BPD to their repertoire.

People often ask us ‘what is BPD?’ ‘Can it be treated?’ and ‘how does one even begin to treat it?’ Put very simply, the person who has received a diagnosis of Borderline Personality Disorder constantly flips between different ‘schema modes.’ Modes are considered to be ‘states’ rather than ‘traits’ and are fleeting, short terms ways of thinking, feeling and behaving. Folks with a diagnosis of BPD will frequently ‘flip’ between the ‘vulnerable child,’ ‘Punitive Parent,’ ‘Demanding Parent,’ ‘Angry child,’ and ‘Detached Protector,’ although not necessarily in this order.

What does this mean?

The above means that the person who has been diagnosed with BPD spends very little time in the ‘Healthy Adult,’ ‘Nurturing Parent,’ and ‘Happy Child’ modes and this has a significant impairment on their quality of life.

BPD was for a long time considered to be untreatable but things have changed and it can easily be treated by clinicians with the correct knowledge, skills and attitude. In a universe based on opposites, one need not just ‘be,’ one can ‘become’ the person they were supposed to be.

Get in touch to find out more

If you are interested in finding out more, then please get in touch. You can call ACT Counselling and CBT Services in Glasgow on 0141 554 0838 or email us here.

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The ACT Counselling Services team have had 2 insightful weeks delivering inputs 6 and 7 of the ‘Practising Schema Focused Therapy’ course. The themes have all been about perpetuation and ‘Repetition Compulsion’ (Freud, S), or ‘Schema Chemistry’ (Young, J). We think it is absolutely incredible that we, as human beings continue, albeit unconsciously, continue to play out very specific childhood experiences over and over again. This perpetuation causes us significant problems and distress, but we keep on doing it. The hardest part to come to terms with is that is actually our attempts to cope that continue to cause the problems. This often leads people to approach ACT for relationship advice.

What went wrong…?

We pick our parents as partners. If you don’t believe this, then you are most likely in denial. No parents are perfect and we unconsciously choose partners who we hope will provide us with the opportunity of correcting what went wrong. As a result of parental deficiencies we, at some point, experienced anger, sadness or despair as a result of our unmet needs. Children, however, cannot tolerate these feelings and instead cling to hope. We perceive that the problem actually lies with ourselves and continue, throughout our lives to seek the corrective experience.

Want to find out more or get some relationship advice, get in touch to discuss signing up for the next course, beginning 04/05/16. See more information here in our Services section.

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So what is the value of Imagery Assessment and why is it used in Schema Therapy?

It is important within the Assessment and Education phase of Schema Focused Therapy that the client’s Schemas are accurately identified. The mistake that a lot of Practitioners make is that they provide the client with extensive information and psycho-education as regards schemas. They then administer one or more inventories to help identify the client’s schemas. At this point, if the client’s hypothesised schemas match with the high scoring schemas on the inventories then the Practitioner is satisfied that enough information has been gathered to state with surety that ‘this is one of your schemas.’

How are Schemas stored?

The above, of course, is not enough. How can it be? All of the above is related to logic, words and numbers. This is the fundamental flaw as schemas are stored deep in the reptilian part of our brains, in the amygdala. Schemas are stored in early childhood with images and a high-level of emotion attached to them. Thus, they are not stored with any logic, words, numbers or explanations attached to them. As a result, schemas must be triggered and felt by the client on an emotional level before the client and therapist can be sure that this is a schema belonging to the client.

Imagery Assessment is the main assessment methodology that is used to identify schemas accurately. To find out more about this technique, see how it is used, and practise using it, please refer to our ‘Practising Schema Focused Therapy’ short course information section of this website, where course information and booking instructions can be found.

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We were reminded in both the writing of the materials and in last night’s delivery of the complexity of Schema Therapy but also of the power to effect change in clients with complex and enduring Mental Disorders.

Educational Phase

Last night saw us visit the educational phase involved in Jeff Young’s approach. There were a couple a few points that gave the course team cause for reflection. Firstly the unconscious drive with people with a personality diagnosis to continue to confirm the validity of the Schema, and any information which does not do so is either avoided, distorted or ignored. So the client with an Abandonment schema will unconsciously behave in a way that leaves them abandoned by others. The client with a Defectiveness schema will unconsciously behave in a way that confirms their ‘not good enough’ view of self through self-sabotage or being overly perfectionistic.

Cognitions and Schemas

The next point we wish to make is that of the gap between cognition and Schemas. This leads to cognition and emotion mismatch. So although the person with the Abandonment Schema knows that the evidence disputing their ‘people close to me will leave me’ cognitions to be true, IT DOES NOT FEEL LIKE IT. The person with the Mistrust/Abuse Schema knows the evidence disputing ‘my Partner will let me down’ is true, again, IT DOES NOT FEEL LIKE IT. It is this that leads to Schemas being largely worked on with affect and imagery. Cognitive disputing on its own will do very little to affect change.

Schemas

The last point we wish to make and this is often insightful for Practitioners is that the first 7 Schemas are the core Schemas and the remaining 11 can attempt to cope with the first 7. This often confuses Practitioners as the first 7 come from the Disconnection/Rejection domain and the remaining 11 come from other domains. The point is that domain 1 (the disconnection/rejection domain) is the conditions that lead to the formation of core schemas. The remaining 4 domains are the conditions of worth set by the family, classroom or playground for the client to escape the core schema. Still confused, then get in touch and enrol for our next course.

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