Armenian Medical NetworkHealth.am
Health centers
CancerHeart & Blood VesselsBrain & NervesMental HealthDiabetes & HormonesWeight & NutritionWomen's HealthPregnancy & FertilityChildren's HealthSexual HealthMen's HealthInfections, HIV & STIsLungs, Asthma & AllergiesDigestive HealthBones, Joints & PainSkin, Hair & BeautyEyes, Ears & TeethAddictionSleepHealthy AgingPublic HealthMedicines & Treatments

Table 84-4 Phase 3 in the treatment of histrionic personality disorder: identifying and counteracting defensive control processes

Table 84-4 Phase 3 in the treatment of histrionic personality disorder: identifying and counteracting defensive control processes
Objective: Modify defensive control processes that are an obstacle to therapy.
1. Counteract the tendency to avoid or quickly drop a topic that contains conflicts and dilemmas. Bring up topics related to unresolved memories or fantasies and hard choices. Encourage attention on these topics without premature closure (as in the patient saying "I do not know" or "I will just do [not do] this").
2. Counteract the tendency to leave concepts within unresolved topics in a cloudy matrix of loose associations. Clarify the key issues. Translate enactive and visual image representations into words. Repeat key chains of concepts.
3. Reinforce by approval acts of paying attention, to observing the behaviors and intentions of self and others, rather than making assumptions as to what a situation or a person is like based on habitual stereotypes.
4. Address and modify by repetitions the apparent "unreality" of some real events and the apparent "reality" of some acts of imagination.
5. Discourage efforts to rationalize impulsive decisions to exit from undermodulated states or disavow personal responsibility for actions.
6. Help the patient understand "not knowing" cognitive styles in terms of who emulated such styles in the past or what social and interpersonal reinforcements occurred for "not knowing" what was going on.
7. Model, in the course of therapy dialogue, how to stay with unresolved topics until rational choice points are reached. Teach the patient to later reappraise and possibly revise previous decisions.