Thesis (Ph.D.) - University of Queensland, 2004. / Includes bibliography.

Thesis (M.A.) University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on August 28, 2007) Includes bibliographical references.

Thesis (M.A.)--University of Montana, 2007. / Title from title screen. Description based on contents viewed Aug. 28, 2007. Includes bibliographical references (p. 44-60).

Thesis (Honors)--College of William and Mary, 2009. / Includes bibliographical references (leaves 42-48). Also available via the World Wide Web.

This thesis presents an in-depth exploration of psychotherapists’ lived experience of working with borderline personality (BPD) disorder in psychodynamic psychotherapy, using interpretative phenomenological analysis (IPA). The existing research literature suggests that working with borderline patients is very difficult, as they can evoke negative counter transference experiences in therapists and thus make the working alliance difficult to maintain. The stigmatising and negative attitude towards BPD, which is found amongst mental health professionals, can cause many therapists to avoid working with this patient population, leaving many patients without the necessary help for treatment. Some literature also suggests that psychodynamic therapy may not be helpful for the treatment of BPD in its traditional form, because of the neutrality of the model and borderline patients’ ‘reduced capacity to mentalise’. Instead, empathy and the therapeutic relationship have been reported to be significant factors. This qualitative study aimed to provide a rich and detailed examination of the experiences, which psychodynamic psychotherapists and counselling psychologists might have in their work with BPD patients. Five psychodynamic psychotherapists were interviewed twice in one unstructured and one semi-structured interview, and IPA was used to analyse the data. The five master-themes (Negative countertransference feelings; “Sitting in the dark together”; Hindrance in therapeutic work; Therapist omnipotence; Labelling as problematic) found in this study suggested that borderline patients could benefit from a modified version of psychodynamic 1 Note that the ‘psychodynamic’ and ‘psychoanalytic’ terms will be interchangeably used in this study. 2 The researcher, as a trainee-counselling psychologist, is in favour of using the word ‘client’. However, psychodynamic practitioners talk about their ‘patients’ rather than ‘clients’, and as this study focuses on psychodynamic therapists’ experiences, the researcher will use these two terms interchangeably. Thus, the word ‘patient’ here is applied in the psychodynamic and not in the medical sense. 9 psychotherapy with a focus on empathy and a bond between therapist and patient. Furthermore, the therapists’ awareness of negative countertransference feelings and emergent obstacles in the therapeutic work, as well as their understanding of BPD as a label and its effects on their borderline patients were crucial. Finally, the therapists’ experienced ‘omnipotent’ feelings, which may have emerged in response to their negative countertransference feelings. While these findings support many of the previous publications and accounts reported in the literature, they also shed new light on therapists’ experiences, which might have implications for the approach that psychotherapists and counselling psychologists take towards working with borderline individuals within the psychodynamic modality.

D.Litt. et Phil. / The aim of this study was to evaluate a feasible rating scale to measure the adherence of therapists carrying out Dialectical Behavior Therapy (DBT) with Borderline Personality Disorder (BPD) clients. Adherence referred to therapists carrying out DBT and how frequently and thoroughly they executed the specific targets and strategies of the therapy, which included taking the context into account. DBT is very specific in its treatment targets and in their hierarchical order of importance. The 97 item adherence scale was rated on a 7 point (0-6) scale. Some 86 items, that corresponded with the therapist ethological scale, were selected and then compared to the therapist and client ethological scales from an earlier study. These ethogram scales were process coding instruments which rated minute-by-minute, the frequency of specific categories of client and therapist verbal behaviors. The adherence scale was further compared to client self-report diary card measures. The diary card measures were also compared to the therapist and client ethological scales. Randomly selected client-therapist dyads (N = 10) were used, meeting criteria for BPD. All clients were women and between the ages of 18-45. The clients were seen by a total of 7 DBT trained therapists. Random sessions (N = 6) were selected from the first 16 sessions for each clienttherapist dyad. Some 60 sessions were chosen. 57 tapes were coded as 3 were too inaudible to code. Results indicated that the adherence rating of the respective therapist increased as the negative behaviors of the client increased (p < 0.05). Conversely, the greater the client's positive behavior on the ethological scale, the lower the DBT adherence rating of the therapist (p < 0.05). The problem solving category on both the adherence and therapist ethological scale covaried significantly (p < 0.02). Other therapist strategies (i.e., reciprocal, irreverence, primary targets 1-4, contingencies and validation) between the two scales were not significantly correlated. A test of the validity of the adherence scale to measure DBT fidelity draws its strongest support from two findings: 1) that when a client portrayed positive behaviors the therapist needed not to follow the primary targets so closely, resulting in a decrease in the adherence rating; and 2) the greater the negative behaviors of the client, the more stringently the therapist focused upon the primary targets and a wider array of strategies, which led to an overall increase in the adherence rating. The results of this study confirmed that a rating scale of therapist adherence is possible even with a flexible therapy such as DBT. Further, that minute-by-minute ethological ratings may serve to validate a more holistic adherence scale as tested here. Finally, recommendations are discussed for the further improvement and enhancement of the DBT adherence scale when used as a tool for rating DBT's treatment fidelity.

The aim of this study was to describe the female elf-mutilator's lived experience of cutting herself. A question which would elicit a description of the experience of this phenomenon was formulated. Five self-mutilators were interviewed. The four psychologically richest narratives were chosen for this study. Using the empirical phenomenological method. the four protocols were analysed in detail. Self-mutilation is conceptualized as a cycle wherein the mutilator experiences a diffuse bodily felt-sense that mounts to an unbearable point. She has an irresistible urge to alleviate the distress. She isolates herself and cuts herself with a sharp blade. Upon seeing the blood appear she is overcome with a deep sense of satisfaction. power, and ecstatic pleasure. The blood is perceived to carry the distressing contents out of the body. Concomitantly the self-mutilator recollects a sense of her feelings and her body as belonging to her. Her previously alienated body is felt to be a site of vitality. She also feels removed from further harm. encased in a cocoon of safety that renders her invulnerable to others. However. the cutting can never totally rid the body of distressing feelings. As a result the cycle of cutting wiII be re-enacted. The cutting cycle is conceptualized as a process whereby the self-mutilator suffers from a traumatization of the psyche such that the psychic container is fractured and rendered painfully porous. The act of cutting rids the psyche of unwanted contents such that a sense of going-on-being is restored. The cutting acts to temporarily shore up the rent fabric of the psychic envelope and thereby consolidate a sense of personal boundary. This is a temporary respite from the fracturing of the psychic container in that, once again confronted with interpersonal existence, the self-mutilator begins to feel vulnerable and defenceless. When it seems as if disintegration is again imminent, a cycle of cutting is reconstituted. The findings emergent from the interviews were dialogued with the literature on psychic containers, particularly that which addresses the role of the skin in the formation and functioning of psychic containers.

<p>Attachment and personality disorders (PDs) both describe patterns of interpersonal dysfunction. Indeed, there are many similarities and few differences between these constructs, suggesting that they may represent two iterations of a common dimension. However, the paucity of empirical tests on this topic has precluded integration of clinical efforts. Also limiting clinical efforts is the inability to target individuals and relationships most prone to dysfunction. The current study used a large sample (N=812) of unselected undergraduates (N=355) and adults currently in psychological treatment (N=457) to test whether a joint hierarchical factor structure of attachment and PDs is tenable and whether it varies reliably by gender, treatment status, or attachment figure. Results suggested that attachment and PDs can be quantified jointly in specific instances of emotional lability and detachment, but attachment was not isomorphic with antagonistic, impulsigenic, or psychosis-spectrum traits. This joint structure was relatively consistent across attachment figures and treatment status but varied somewhat across gender. Clinical applications of these findings on commonalities of interpersonal dysfunction are discussed. </p>

A review of the scholarly literature suggests that mental health struggles in Generation Z have escalated in recent years. However, there is a lack of psychological research that examines antisocial behaviors in Generation Z. This study aims to determine the prevalence rates of antisocial behaviors in Generation Z. It was hypothesized that our sample of Generation Z students would show higher prevalence rates of antisocial behaviors than previous generations. We examined the data collected from our survey, which was composed of demographic and antisocial personality disorder questions. A one-way ANOVA, revealed significant differences in the categories of age, gender, school year, and race compared to the antisocial score. A Tukey post hoc analysis revealed statistically significant differences for antisocial behaviors in Generation Z when compared to the 41-50+ age group. Significant differences between students were not found when examining the categories of sexual orientations and political affiliations.

Borderline personality disorder (BPD) is associated with distress in and dissolution of romantic relationships. BPD is a relational disorder. The complex interaction between BPD and romantic relationships continues to warrant further attention, as decreased BPD symptoms are associated with increased relational effectiveness. The current study was one of the first qualitative studies that used dyadic data to examine the experience and impact of BPD on couples' relationships. Semi-structured conjoint interviews were conducted with couples with a partner with BPD (N = 10) using interpretative phenomenology. This study provides a rich understanding of the experiences of couples with BPD by exploring not only how BPD impacts couples' romantic relationships, but how couples cope with BPD. Although BPD was experienced as a relational stressor, couples utilized resources to buffer against the impact of BPD in their relationship. Three superordinate themes emerged from the data that illustrate the couple experience of navigating BPD: (a) the individual lived experience of BPD, (b) the shared experience of BPD as a relational stressor, and (c) adaptive dyadic coping in the context of BPD. Dyadic coping and shared externalization emerged as key factors in adaptive couple functioning in the context of BPD. The lived experiences of these couples provide therapists and other couples with an increased understanding of the resources and skills that support successful dyadic coping with BPD. / Master of Science / Borderline personality disorder (BPD) imposes significant stress on romantic relationships. BPD is associated with increased distress in and dissolution of romantic relationships. However, individuals in recovery from BPD report high relationship satisfaction. Decreased BPD symptoms are associated with increased relational effectiveness, but it is less clear whether reducing BPD symptoms leads to greater relational effectiveness or if relational effectiveness reduces symptoms of BPD. To better understand the complex relationship between BPD and romantic relationships, conjoint interviews were conducted with couples who were navigating the management of BPD. Ten semi-structured conjoint interviews were analyzed using interpretative phenomenology. Three themes emerged from the data that illustrate the couple experience of navigating BPD: (a) the individual lived experience of BPD, (b) the shared experience of BPD as a relational stressor, and (c) adaptive dyadic coping in the context of BPD. Dyadic coping and shared externalization emerged as key factors in adaptive couple functioning in the context of BPD. Couples navigating BPD benefit from many of the same couple coping strategies that other couples utilize to manage common stressors in life.