| |
Healthcare Training Institute - Quality Education since 1979CE for Psychologist, Social Worker, Counselor, & MFT!!

Section
6
Cognitive-Affective System in Borderline Personality Disorder
| |
Read content below or listen to audio.
Left click audio track to Listen; Right click to "Save..." mp3
In this section, we will examine the characteristics of
schema clusters: two or more schemas interfering with one client's life and interaction
between schemas. Also, we will discuss indicators, such as trigger situations,
that prompted a schema attack.
♦ Schema Clusters
I have
found that very rarely does one schema inhabit a client. More likely than not,
a Borderline Personality diagnosed client suffers from a cluster of schemas that
negatively affects their life. Schema clusters result when two or more schemas
operate in a single personality. Penelope, age 35, was a BPD diagnosed client
suffering from schema clusters.
Penelope had a husband, John, and two children.
Her entire life centered around keeping John happy, making sure the kids didn't
make him mad, and doing everything that would keep him with her while he ignored
her needs.
Penelope's 3 Schemas
After extensive sessions, I found that Penelope was suffering from
the following three schemas:
1. Deprivation
2. Abandonment and
3. Subjugation.
Penelope's
deprivation schema stemmed from her refusal to tell John of his neglect towards
her needs. Her abandonment schema made her so terrified of John leaving her alone,
it soon fed her subjugation schema. To keep him, Penelope would do anything--even
if it was degrading. As a result of this dysfunctional marriage, Penelope became
resentful of John.
She stated, "He doesn't give a damn about me. I don't
think he even loves me. It doesn't sound like he loves me, does it? I think the
jackass might even be cheating on me. If he leaves me for her, I don't think I
could go on living." As you can see, Penelope's schema disorder created
a marriage that was a one-way street and threatened her own well-being.
♦ Early
Interaction
A second characteristic of schema clusters is interaction.
Schemas that develop early on in childhood can become influential in developing
a second schema later on.
Mary, age 24 and diagnosed with BPD, acquired an unlovability
schema when her mother ignored her and expelled all her attention on Mary's three
other sisters. When she began school, Mary noticed that she fell into her mother's
favor when she brought home good grades. This appreciation shown by her mother
was not the affection Mary should have been receiving during her developmental
stage, but it was the closest she had ever come. She soon cultured a perfectionist
schema, neurotically worrying about her grades, not for her own benefit and self-improvement,
but for her mother's attention.
By high school, Mary slept about four hours a
night to finally reach her goal of becoming valedictorian and achieving the ultimate
reward from her mother. Mary stated, "I knew. I knew deep down she didn't
really love me . She loved my sisters, and, even accounting for my exceptional GPA,
I could never be those perfect angels in her eyes. It was disgusting. I guess
it stemmed from her own narcissistic tendencies and her obsession with physical
beauty, which I don't have, but I don't think that harlot even noticed when I
got the scholarship to Duke. I was the ugly duckling and still am today."
Mary's perfectionist schema drove her to obsess over her mother's affections,
but with mild success. As you can see, Mary's primary schema, unlovability, created
a firm foundation for her secondary schema, that of perfectionist.
♦ How to Detect a Schema
Now
that we've discussed the characteristics of schema clusters, let's discuss how
to detect a schema. As you may have observed, each schema has its own signature
quality. Many times, this can be discovered through the schema's triggers and
reactions.
Sixteen year old Mindy's triggers related to her deprivation schema.
She stated, "As my boyfriend is saying good-bye, he'll talk about how busy
he's going to be over the next few weeks, but doesn't mention that he'd like to
get together again. He's avoiding me, and I know it. This is his way of telling
me. He doesn't even get it when I give him the cold shoulder. It's like, duh,
I can give rejection like you can dish it out."
I asked Mindy why she didn't
just tell her boyfriend that she felt he was ignoring her needs. Mindy responded,
"In my family, any expression of strong emotion was frowned upon as a 'dramatic
display'. I learned to suppress these feelings. Telling people that I'm angry
won't do anything. They'll either be terrified of me or ignore me completely.
It's a universal truth." As you can see, Mindy has assimilated a self-fulfilling
idea that no one will want to meet her needs because the world is cold and apathetic.
♦ Technique: Feelings Block To help Penelope, Mary,
and Mindy address their schemas and better link their behavior to the past, I
found the "Feelings Block" exercise helpful. I asked these three to
look at a list of emotions and write about a time in the past that they felt this
way and to explore the general feelings associated with the primary emotion. Mary
addressed the feeling of perfectionism whose associated general feeling is inadequacy.
Mary related, "My dad once told me that when I took my
first steps, my mother was too fascinated with my little sister's first communion
dress to see it. He came home and found me walking. He asked her how long I'd
been on my two feet and she said, 'Huh, she's walking now?' When I heard
that story, I felt so incompetent and low. One of the greatest achievements in
a person's life, and the woman who brought me into this world barely saw it. From
then on, I felt embarrassed to be around other mothers that actually loved their
children. I thought I might reach out, grab them, and scream, 'Will you be
my mother?' I still feel that way sometimes."
By
linking her past feelings of inadequacy, Mary can find the source of her perfectionist
schema. Think of your Mary, Mindy, or Penelope. Would they benefit from the "Feelings
Block" technique?
In this section, we discussed the characteristics
of schema clusters: two or more schemas interfering with one client's life and
interaction between schemas. Also, we discussed indicators, such as trigger situations,
that prompted a schema attack.
Reviewed 2023
Peer-Reviewed Journal Article References:
Cavicchioli, M., & Maffei, C. (2020). Rejection sensitivity in borderline personality disorder and the cognitive–affective personality system: A meta-analytic review. Personality Disorders: Theory, Research, and Treatment, 11(1), 1–12.
Lind, M., Jørgensen, C. R., Heinskou, T., Simonsen, S., Bøye, R., & Thomsen, D. K. (2019). Patients with borderline personality disorder show increased agency in life stories after 12 months of psychotherapy.
Psychotherapy, 56(2), 274–284.
Niedtfeld, I., Renkewitz, F., Mädebach, A., Hillmann, K., Kleindienst, N., Schmahl, C., & Schulze, L. (2020). Enhanced memory for negative social information in borderline personality disorder. Journal of Abnormal Psychology, 129(5), 480–491.
QUESTION
6
What are two characteristics of schema clusters? To select and enter
your answer, go to .
|