Healthcare Training Institute - Quality Education since 1979
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In the last section, we discussed three techniques for cultivating interpersonal relationships. The three techniques are Learning from Others, Remembering, and Engaging in Inner Work and Outer Play.
In this section... we will discuss cognitive distortions used by BPD clients. There are five cognitive distortions commonly seen in BPD clients. These five distortions are polarized thinking, personalization, control fallacies, catastrophizing, and emotional reasoning.
As you listen to this section, evaluate your BPD client for applicable cognitive distortions. Often times it is hard to see a change in BPD clients. To help increase your awareness of a change. you might rate your BPD client on a subjective scale from 1 to 10. One is low and rarely exhibits the distortion and 10 is high frequently exhibiting the distortion.
Five Cognitive Distortions
♦ Distortion #1 - Polarized Thinking
♦ Distortion #2 - Personalization
Also, Mara frequently asked questions like
♦ Distortion #3 - Control Fallacies
Mara stated, "I feel like I am responsible all the time for everything. And it’s like I have no control. The other night I went out to dinner with my mother. I felt like I had to make her happy, so I stayed longer than I wanted to. I started feeling strange when it got real quiet, so I told her she was being stupid. Then she wouldn’t even talk to me! She stormed out of the restaurant. There I was, alone with my chocolate ice cream, feeling like I had lost control!"
Are you treating a BPD client like Mara who reinforces her own cognitive distortions? If so, perhaps the technique of Challenging the Critic described later in this section will provide some benefit.
♦ Distortion #4 - Catastrophizing
Has your BPD client related situations to you that reflect catastrophizing? Often evident in BPD characterized by paranoia, catastrophizing generally leads to false assumptions. On a scale of 1 to 10 how often and intense are your Mara’s episodes of catastrophizing?
♦ Distortion #5 - Emotional Reasoning
Periodically, Mara would act on an emotion and then discover her feelings and impressions weren’t really based on the truth after all. Think of a specific situation in which your Mara applied emotional reasoning, you might consider using the Challenge the Critic technique in your next session.
♦ Technique: Challenge the Critic
--Step 1 - First, Mara listed which of the above cognitive distortions she believed affected her. For each one, Mara wrote a recent example of the distortion at work. For example, Mara wrote, "Dan is always late. He is trying to get a raise out of me by being late."
--Step 2 -Second, Mara challenged the distortion and rewrote the statement. Mara’s rewritten statement was "Dan came to a meeting late. I overgeneralized that he is always late."
Mara continued with her list until she began to develop affirmations that she could think about repeating whenever she found herself in a negative pattern of thinking. Here are eight examples Mara used to create her list. As you listen to these eight examples, consider how they might be used to your client.
Do you agree that once BPD clients like Mara can begin to identify and challenge cognitive distortions, those clients can begin to internalize change? Think of your BPD client. How can you help him or her to avoid reinforcing negative perceptions? Would a colleague of yours who is treating a BPD client benefit from listening to this section?
In this section... we have discussed cognitive distortions used by BPD clients. There are five cognitive distortions commonly seen in BPD clients. These five distortions are polarized thinking, personalization, control fallacies, catastrophizing, and emotional reasoning.
In the next section, we will discuss helping BPD clients rebuild self-esteem. Two aspects of self-esteem that we will examine are low self-esteem and setting boundaries. We will also review the self-esteem assessment and the ‘LEMON’ Enforcement technique.
Peer-Reviewed Journal Article References: