"clarification of a work stress issue and a proposal for schema therapy with histrionic patients"case Discussion by ZACHARIOS zachariou, ECKHARD Roediger & Alexandra schosserSUMMARY: The original complaint of a patient can be
sometimes a real enigma that requires a thorough work out for its solution. We
hereby propose a Schema Therapy (ST) approach, facilitating the progressive
deployment of various psychosocial issues. It tackles them successfully by the
application of its own appropriate diagnostic and intervention techniques but also
combined with other psychotherapeutic strategies specific to the current
situations. The involvement of situational factors and their complications is
taken into account and a fairly weighted treatment on individual, especially
personality’s, aspects is granted. The key point for this presentation concerns
a ST application on Histrionism which is a therapeutic challenge on the one
hand and a classic intervention field for psychoanalytic and psychodynamic
approaches on the other. It is treated in other psychotherapeutic paradigms
rather rarely in a trouble specified manner. In this presentation, specific
interventions will be presented and illustrated by a study case of a mid-life,
male histrionic out-patient having a middle management position at work. Among
other motives, he also sought specialized treatment for a work stress and
psychosocial risks prevention issue. We hereby proceed to an overview of the
schema modes conceptualization. The modes, their biographic function and the
empathetic confrontation will be detailed. The systematic observation of the
speed change of dysfunctional modes appears crucial for the adaptation of the
various intervention techniques. These ones are progressively introduced
because of patient’s numerous resistances deserving consideration and
enlightenment. We point them out as indicators and treat some emergences of
self aggrandizing compensation coping mode but also the impulsive and
undisciplined mode. Clarification of an arbitrary punishing mode and reduction
of inappropriate compliant surrender are beneficial for the patient in order to
better cope with current life’s situations, especially social interactions and
behavior at work place. Introduction of patient’s spouse into the psychotherapy
is presented under the modes circles perspective. In principle, the
dysfunctional modes are treated by the usual ST techniques such as imagery
rescripting, chair work and dysfunctional pattern breaking. In the mean time,
metaphors and symbolic work are used to facilitate the reinforcement of the
healthy adult mode. The last one will finally become an “autonomous and
efficient new life’s screenwriter”. Such an achievement can also be counted as
the result of patient’s creating skills and resources reactivation by the
treatment. Debate about the use of all these techniques and therapist’s stance
toward speed mode change may have the ambition to promote the use of ST in
rather new application fields and considerations. The positive outcome of this
patient shows a promising application of such a therapeutic setting. Further,
openness for existential choices for a better life quality seems to be a
natural consequence of the therapeutic impact. EXPECTED POINTS OF DISCUSSION:
DISCUSSANTS:
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Why Schema Therapy?Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.
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