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CHALLENGING BEHAVIORS IN THE CLC: Personality Disorder and Mental Illness. Rebecca Fromme, Ph.D. McGuire VAMC Geriatrics and Extended Care. WHAT IS PERSONALITY?. A set of stable and enduring traits and ways of thinking about ourselves and the world which influences how we relate to others
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CHALLENGING BEHAVIORS IN THE CLC: Personality Disorder and Mental Illness Rebecca Fromme, Ph.D. McGuire VAMC Geriatrics and Extended Care
WHAT IS PERSONALITY? • A set of stable and enduring traits and ways of thinking about ourselves and the world which influences how we relate to others • It is formed by our early life experiences with the world, our families, our friends, and the overall environment • Genetics may also play a role in personality formation • These traits dictate how we react to the world, how we interpret the actions of others, and our overall “world view”
HOW DOES PERSONALITYAFFECT BEHAVIOR? • Most people have a repertoire of coping skills that allow them to be flexible in handling stressful situations • People with personality disorders tend to have an extremely LIMITED set of skills that are inflexible and not always appropriate to the situation • Their world is experienced through a filter of either suspicion, anger, or judgment • The most common responses to stress are anger/hostility, emotional dysregulation, and/or dependency (or a combination of these) • The most common trigger is LACK OF CONTROL
DSM-IV PERSONALITY DISORDERS • “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it” • Antisocial, Borderline, Narcissistic, Histrionic, Dependent………. • Disorder vs. Traits
Chronic Mental Illnesses • Schizophrenia • Schizoaffective Disorder • Bipolar Disorder
Common Characteristics • Self-centeredness • Lack of individual accountability • Lack of perspective-taking and empathy • Manipulative and exploitive behavior • Unhappiness • Distorted understanding of events • Socially maladaptive
How can we work with these patients in a productive way? • Understand that you are a human being and you are allowed to have negative feelings toward patients (and accept them!) • Understand that in most cases, their response is not really about you, it’s about the situation and their own turmoil and inability to cope with it • Understand that we CANNOT change them, we can only change OURSELVES and the ENVIRONMENT • Understand that some situations cannot be “fixed” • Consult with your local Psychologist or Psychiatrist to assist with treatment planning and behavior management