Taking care of a real self - description of the psychotherapeutic process of a patient with narcissistic personality disorders in the field of dance/movement psychotherapy

Introduction: Dance/movement psychotherapy (DMT) is a psychotherapeutic trend that belongs to the approaches that involve working with the body. Thinking about a wider perspective, DMT belongs to the group of action-oriented psychotherapies. It assumes that the person, while moving, can show his/her emotional states. Additionally, it can lead to development and personal integration. The goal is to deepen awareness. Psychotherapy with dance and movement is practiced among psychotic patients, patients suffering from neurotic or personality disorders, and as a method of personal development. The aim of the work is to describe the psychotherapeutic process of an individual client in the field of dance/movement psychotherapy as a method in which dance leads to development and personal integration. Material and method: Working with a client, Beata, took place in a strictly defined setting. Meetings took place once a week in the same office during 55 minutes. They were of an individual nature. First, Beata was diagnosed according to the DSM-5 [1] and ICD-10 [2] classification, which was supplemented with the PDM-2 diagnosis [3]. During the therapeutic work, the phenomena of transference and countertransference were taken into account, the patient’s behavior was interpreted according to John Bowlby’s attachment theory and mentalization. During practicing DMT it is important to take care of Authentic Movement method, observation of movement using the Laban Bartenieff Movement System (LBMS) method and the Kastenberg Movement Profile (KMP). Results: The changes that DMT psychotherapy started to bring were observed both in the client’s movement and in the verbal layer. The client has acquired the ability to observe her feelings and needs. This influenced her perception of announcement heard from different people and the decisions she made. The DMT therapy with Beata is not over yet, which makes it possible to take a deeper look at topics related to therapeutic goals. Conclusions: Dance/movement psychotherapy has proved to be an effective method of working with patients with personality disorders psychopathology of the narcissistic type. This method makes it possible to build a sense of the patient’s boundaries and needs, and to strengthen self-esteem. Sessions seem to be very helpful in integrating inner life, feelings and experience. In addition, it helps in dealing with the internal tension of patients and gives the opportunity to expand ranges of movement. In the verbal part, it is possible to discuss the problems that the client carries within himself, which cause him fear, anxiety and other unpleasant emotions.

Sociocultural Context and the DSM-5 Alternative Model of Personality Disorder: Comment on Widiger & Hines

Widiger and Hines provide a brief overview of the development of the Alternative Model of Personality Disorder (AMPD) housed within Section 3 of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). They highlight eight issues and controversies related to the AMPD in need of resolution for improvement of both the AMPD model itself as well as the field of personality disorders more broadly. In this brief commentary, I add a ninth issue in need of attention both with respect to the AMPD but also within the field of personality disorders more broadly: 9) How is sociocultural context to be accommodated in AMPD—and more generally personality disorder—theory, research, and treatment? The historical intra-individual, deficit-based models for conceptualizing personality disorders linger in current personality disorder discourse. However, failure to appropriately consider sociocultural context that systematically predisposes wide swaths of the population to unequal access to resources and exposure to psychological stressors, which can impact the appearance of personality pathology, serves to stigmatize minoritized individuals. The personality disorder field, and the AMPD discourse, must appropriately contend with sociocultural context in its models otherwise it risks developing models with limited generalizability and which hold potential to adversely affect sexual and gender minoritized populations, among others.

Preliminary Steps Toward Extracting the Specific Alternative Model for Personality Disorders Diagnoses From Criteria A and B Self-Reports

The Alternative DSM-5 Model for Personality Disorders (AMPD) retains six specific personality disorders (PDs) that can be diagnosed based on Criterion A level of impairment and Criterion B maladaptive facets. Those specific diagnoses are still underresearched, despite the preference expressed by most PD scholars for a mixed/hybrid classification. This study explores the possibility of using Criterion A and B self-report questionnaires to extract the specific AMPD diagnoses. Plausible prevalence estimates were found in three samples (outpatient PD, private practice, community; N = 766) using the facet score > 2 and t score > 65 methods for determining the presence of a Criterion B facet; diagnoses had meaningful correlations with external variables. This study provides evidence—albeit preliminary—that the extraction of the specific AMPD PDs from self-report questionnaires might be a viable avenue. Ultimately, it could promote the use and dissemination of those diagnoses for screening purposes in clinical and research settings.

Why, How, and When to Integrate Narrative Identity Within Dimensional Approaches to Personality Disorders

Researchers and clinicians are beginning to adopt dimensional approaches in the study and treatment of personality disorders (PD). Although dimensional approaches in the DSM-5 and ICD-11 hold considerable benefit, they need to better incorporate an appreciation of individuals’ life stories, or narrative identities. Doing so will be necessary to flesh out the emphasis that both frameworks place on the role of identity in personality pathology. In this article, the authors review why, how, and when narrative identity theory and research can be integrated within dimensional approaches to PD. The authors describe established ways to assess narrative identity, review extant research on this construct in relation to PD, and signal areas crucial for future research. Stories lie at the heart of what it means to be human. The authors conclude that a greater consideration of the ways in which the self is storied can help further understanding and treatment of PD.