Strengths Based Biopsychosocial Approach
to Recovery from Narcissistic Personality
DisorderDr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
Recovery & Resilience International in partnership with AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89
Recovery & Resilience International in partnership with AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89
Objectives Define Personality Disorders List the characteristics of Narcissistic
Personality Examine the similarities between the behaviors
of certain personality disorders and addictions Identify ways to address these behaviors and
thought patterns Encourage clinicians to critically examine
behaviors in patients with addiction in order to effectively differentially diagnose
Why I Care/How It Impacts Recovery When personality disorders are viewed as pervasive & perpetual, it
Provides an “excuse for relapse” Often derails treatment because patterns of behavior thought to be due
to the PD are essentially ignored Personality Disordered & Addictive Behavior often look the same Goals for recovery from both:
Honesty with self & others about thoughts/feelings/needs/wants (Mindfulness)
Distress tolerance and the ability to self-soothe Hope and faith in self/future/others through addressing cognitive errors Development of self esteem to eliminate need for external validation Development of healthy, supportive relationships
Recovery & Resilience International in partnership with AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89
Recovery & Resilience International in partnership with AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89
Personality Disorders Represent a cluster of behaviors that is
pervasive beginning before the age of 15. Addictive behaviors also often begin before 15 Due to immature cognitive development, children
tend to be more egocentric, overgeneralize and think in terms of dichotomies
From a survival perspective, most of these behaviors make perfect sense when viewed through the eyes of a child
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Personality Disorders Treatment
Since these behaviors formed the foundation for further development patients must
Understand their function in the pastIdentify how these behaviors and beliefs are faulty
in the presentDevelop alternative skillsBe empowered to interface with the world with the
strengths, knowledge and tools of the adult
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Addictions Represent one way to cope with distress Can begin early in life Have overlapping symptoms with personality
disorders, especially Cluster B
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Addictions & Personality Disorders Cluster A (Paranoid, Schizoid, Schizotypal)
Characterized by social awkwardness and withdrawal
Often co-occur with addictions Cluster C (Obsessive-Compulsive; Dependent)
Characterized as anxious and fearful May co-occur with addiction
Cluster B (Borderline, Narcissistic, Histrionic, Antisocial) Characterized by dramatic, emotional, erratic
behavior Behavioral patterns overlap with addiction
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Addictions & Personality Disorders Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
Characterized by Dramatic, emotional, erratic behaviorAll or Nothing thinkingHostility and AggressionHypersensitivityManipulativeLow Self-Esteem / Weak Self-Concept
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Antisocial Personality Disorder CORRUPT (3 criteria)
C: Conformity to law lackingO: Obligations ignoredR: Reckless disregard for safety of self or othersR: Remorse lackingU: Underhanded (deceitful, lies, cons others)P: Planning insufficient (impulsive)T: Temper (irritable and aggressive)
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Addictions vs. Personality Disorders Many behaviors characteristic of active
addiction Overlap with personality disorders Begin in late childhood/early adolescence Are pervasive
As people’s experiences and knowledge expanded, their coping skills and behaviors remained relatively primitive
Recovery from both requires Development of effective coping skills Addressing cognitive distortions
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Recovery Interventions Dramatic, emotional, erratic behavior
Distress Tolerance Mindfulness to identify and process the source of the
distress Coping skills
All or Nothing thinking Awareness and elimination of cognitive distortions (CBT)
Hostility and Aggression Understanding of the fight or flight response Development of anger awareness and management
skills
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Addictions vs. Personality Disorders Hypersensitivity esp. to rejection
Awareness of and addressing thinking errors Awareness and addressing abandonment issues Development of self-esteem
Manipulative Interpersonal skill development (boundary
setting, communication skills) Low Self-Esteem / Weak Self-Concept
Development of self-esteem and the ability to internally validate
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Summary Most patients with addictions have traits associated with
personality disorders These traits can be loosely classified into
Thinking errors the perception of a threat Behavioral reactivity to escape or eliminate the threat
Important concepts in early recovery Honesty with self and others (Mindfulness and Awareness) Hope & faith (Identifying cognitive distortions and thinking errors to
encourage and empower) Courage and discipline to remain constantly mindful, accept and
address thoughts and feelings, make conscious choices based on facts
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Summary cont… A child growing up in an unstable, neglectful,
emotionally detached environment may develop PD traits to survive Addictions to numb the pain and escape from the lack
of control. Behaviors characteristic of addictions and
personality disorders Were learned and reinforced Will always be in the recesses of the toolbox Must be made less rewarding than alternative, healthy
behaviors
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