If you have a client that you feel stuck with, have feelings of irritation, feel manipulated by, could mean that you are working with someone with a personality disorder. These clients generally have issues with important relationships and can sometimes have problems keeping a job.
These clients usually have trauma backgrounds. They could have been raised in dysfunctional, chaotic families with issues of being neglected and or abused. In order for these children to survive they created false selves that enabled them to some how make it out of their childhood. But now when they know something is not right with who they are or their lives they have created, they don’t know how to get healthier on their own. Something is not working for them.
So they may try to come see a counselor because they are in emotional pain and they want relief.
Our job is to help them develop an authentic real self because their real self is hidden deep inside. They are wounded and they need our help and compassion.
If they are pulling on you to take care of them, if they regress in their behaviors, if they want to be loved, you may be working with some one on the Borderline Personality Disorder specturm.
If the client you are working with wants to be seen, understood, if they hate being vulnerable, have big feelings of shame and feel easily criticized then they could be on the Narcissistic Personality Disorder spectrum.
The reason it is important to be able to diagnose who you are working with is because of the difference in how you approach them.
Working with someone on the NPD spectrum, what you do in the early stages of therapy is mirror mirror and mirror what they are saying. When you have a strong relationship built and trust is there you can start to make interpretations of the clients’ dilemmas.
Working with someone on the BPD spectrum, you do gentle confrontations between the grown up part of them who tries to be responsible and the child part who wants to be impulsive and act out.
If you ask questions, then I will come back and answer them, to the best of my ability.
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