Treating Avoidant Personality Disorder With Combined Individual Metacognitive Interpersonal Therapy and Group Mentalization-Based Treatment

- Davide 31 yrs. old patient suffering from Avoidant Personality Disorder and treated with Metacognitive Interpersonal Therapy (Procacci e Popolo, 2003; Procacci, Petrilli, Dimaggio, 2003). He had difficulties to identify his own thoughts and feelings, mindreading difficulties and was not able to detach from his own schemadriven representations of the others. Treatment was initially focused on identifying the range of feelings he experienced in stressful interpersonal conditions: it emerged that the patient representated the self as inadequate and constantly fearing the anticipated harsh critiques from the others. He felt embarassed and socially rejected or humiliated, and these feeling lead him to isolate in order to avoid critiques and suffering. As a consequence he felt different and distant from the others or sometimes reacted with anger to the anticipated stigmatisation. The therapy helped him in recognising positive aspects of the self. A constant regulation of the therapeutic relationship was needed in order to prevent alliance ruptures and prevent early dropout. At the end of treatment patient was more able to understand that his fears of being judged were more the consequences of his life history than the actual trend of relationships.Key Words: Avoidant Personality Disorder; Therapeutic Relationship; Metacognition; Interpersonal Cycles.Parole chiave: disturbo evitante di personalitŕ; relazione terapeutica; metacognizione; cicli interpersonali.

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Metacognitive Interpersonal Therapy for Personality Disorders: The Case of a Man with Obsessive–Compulsive Personality Disorder and Avoidant Personality Disorder

Journal of Contemporary Psychotherapy ◽

10.1007/s10879-018-9404-0 ◽

2018 ◽

Vol 49 (1) ◽

pp. 39-47 ◽

Cited By ~ 6

Author(s):

Keely Gordon-King ◽

Robert D. Schweitzer ◽

Giancarlo Dimaggio

Keyword(s):

Personality Disorder ◽

Personality Disorders ◽

Obsessive Compulsive ◽

Interpersonal Therapy ◽

Avoidant Personality Disorder ◽

Metacognitive Interpersonal Therapy ◽

Obsessive Compulsive Personality Disorder

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Metacognitive Interpersonal Therapy for Borderline Personality Disorder: A Single Case Study

Clinical Case Studies ◽

10.1177/1534650120960234 ◽

2020 ◽

Vol 20 (1) ◽

pp. 56-74

Author(s):

Giampaolo Salvatore ◽

Lorena Bianchi ◽

Luisa Buonocore ◽

Nadia Disturco ◽

Angus Macbeth ◽

...

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Emotion Dysregulation ◽

Single Case ◽

Sense Of Self ◽

Severe Disease ◽

Borderline Personality ◽

Interpersonal Therapy ◽

Metacognitive Interpersonal Therapy

Borderline personality disorder (BPD) is a severe disease, characterized by severe instabilities in identity, affect and relationships. Clinical improvement of BPD can be facilitated by psychotherapy aimed at tackling multiple specific cross-modality impairments and their patterns of interaction: impaired sense of self, maladaptive interpersonal schemas, impaired metacognition, emotion dysregulation and impulsivity. Herein, we describe the steps in the treatment of a young woman meeting the criteria for with BPD with paranoid traits, successfully treated with Metacognitive Interpersonal Therapy, a treatment based on comprehensive assessment of domains. In the initial phase, treatment focused on promoting emotion regulation, integrating opposing patient representations of the therapist, enhancing metacognition, and increasing focus on the maladaptive schema that elicited dysregulated behaviors. Later in therapy, treatment focused on supporting the patient to realize her ideas about self and others were schema-driven; and improving metacognitive capacity to understand others’ minds. General implications for psychotherapy of BPD are discussed.

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