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Introduction to Personality Disturbances. Diagnostic and Social Remarks

Updated: Feb 1


Book cover of Gestalt Therapy in Clinical Practice: From Psychopathology to the Aesthetics of Contact (Gestalt Therapy Book Series 2). Gianni Francesetti, Michela Gecele, Jan Roubal, and Leslie Greenberg

by Michela Gecele in Gestalt Therapy in Clinical Practice: From Psychopathology to the Aesthetics of Contact (Gestalt Therapy Book Series 2). Gianni Francesetti, Michela Gecele, Jan Roubal, and Leslie Greenberg






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Introduction to Personality Disturbances, Diagnostic and Social Remarks
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Chapter 29 Introduction to Personality Disturbances. Diagnostic and Social Remarks by Michela Gecele (loc: 14,063)


1. The Social Dimension of a Diagnosis (loc: 14,076)

DSM(s) divide the mental disturbances (loc: 14,078)

on one side we find symptom clusters (loc: 14,078)

on the other “ways of (loc: 14,079)

being”. (loc: 14,079)

these ways of being often become a fixed entity, (loc: 14,079)

Making diagnoses, we always run the risk of (loc: 14,081)

causing and maintaining pathology, (loc: 14,081)

The definition of personality disturbances is a useful tool as long as their pictures are not fixed but ever changing with contexts and situations, (loc: 14,082)

More and more these ways of understanding experience turn into labels defining clusters of people. (loc: 14,083)

Note:consider reading Perls Hefferline and Goodman - Goodman's chapter on the verbal..

The definition of personality disturbances is often used to describe and label not only pathological experiences but also ways of feeling, thinking and behaving. (loc: 14,086)

the social and cultural background of a given context largely contributes to shaping its own “pathological” figure. (loc: 14,089)

Devereux’s (loc: 14,090)

personality disturbances are the ethnic disturbances of our time. (loc: 14,091)

Moreover the social context infects the individual with its own difficulties and unease. (loc: 14,093)

personality disturbances are an expression of our “western” social context, crystallizing some of its difficulties and risks. (loc: 14,095)

We overlook all the intermediate steps of relational and social suffering (Ronningstam, 2005) which can develop into symptoms. (loc: 14,100)

“intermediate pictures” are the various modalities of creative adjustment (loc: 14,101)

we sometimes refer to when speaking of personality disturbances. (loc: 14,101)

When both people and society lack a shared narration, the flow of life is diminished, as is the capability to make memories. (loc: 14,109)

A dual relationship and society constantly refer to each other (Spagnuolo Lobb, 2007a). (loc: 14,111)

causes impairments in personal and social growth, that is to say in assimilation. Impairment in assimilation is present both in personality disturbances and in our social context at large. (loc: 14,112)

In “extreme situations” the personality-function cannot exert its capability of connecting and supporting, (loc: 14,114)

At the contact boundary we find absence and void that do not allow families, groups, societies to grow and relationships to develop. (loc: 14,115)

2. Focusing More on Personality Disturbances (loc: 14,118)

experiences defined as personality disturbances a chaotic and fragmented social background contributes to setting a sensitive point (loc: 14,119)

When something (loc: 14,121)

in a present relational field recalls that very sensitive moment, this part becomes figure and provokes a reaction. (loc: 14,121)

field polarizes and crystallizes around the resulting figure. (loc: 14,122)

to give support, the therapist has to be aware of this process, (loc: 14,123)

catch which fragment has become the dominant figure, (loc: 14,123)

help restore it within the therapeutic relationship. (loc: 14,124)

Note:This might be a useful key reading the following chapters. (loc: 14,124)

In dealing with these phenomena it is useful to refer both to gestaltic developmental theories (loc: 14,132)

(see chapter 11 in this book) (loc: 14,132)

In the wide range of personality disturbance experiences the under-developed social background comes to the surface. (loc: 14,138)

The social background is the fundamental ground for the evolutionary and the socializing processes, (loc: 14,141)

The fabric of community is fundamental in order to socialize emotions and thoughts, (loc: 14,141)

supporting and giving utterance to them. (loc: 14,142)

“It’s the way I am” is a statement as deadly as it is pervasive nowadays, in our here and now. (loc: 14,143)

The more it is socially approved the more it feeds the shaping of individuals as opposed to persons in a circular way (loc: 14,144)

Note:«Thus personality is the responsible structure of the self. To give what is not so much an analogy as an example: a poet, recognizing the kind of situation and the kind of attitude of communication required, may contract to write a sonnet, and he responsibly fills out this metric form; but he creates the imaginary, the emotional rhythm, the meaning as he more and more closely contacts the speech» (Perls, Hefferline and Goodman, 1994, p. 161). )

Working at the therapeutic field involves building a frame (loc: 14,148)

to give support, space, breath and coherence – not rigidity (loc: 14,149)

to the person and his history, (loc: 14,149)

Overlapping introjective processes may occur during the developmental age (loc: 14,152)

Portions of the environment might be used to fulfill some voids at the contact boundary. (loc: 14,152)

These introjects often maintain and amplify the very void they should cover (loc: 14,153)

if the introjected environment is fragmented as well, the process will become circular. (loc: 14,153)

3. Biographic and Social Dimensions (loc: 14,156)

How is the social context responsible for the structuring of the relational fields (loc: 14,158)

How much is the evolutionary individual history responsible? (loc: 14,158)

emotional dynamics, in relationships and families, and the consequent building of resources and limitations are influenced by the social context. (loc: 14,159)

social context moulds ways of suffering and creative adjustment. (loc: 14,160)

this paper proposes (loc: 14,161)

there are different levels of (loc: 14,161)

the personality disturbances (loc: 14,161)

more or less connected with developmental experiences and other life events. (loc: 14,162)

Every personality disturbance somehow corresponds to some modalities enhanced by our society, (loc: 14,167)

Think about mistrusting, manipulating relationships and situations, magnifying or repressing reactions, the firm belief in having to be self-sufficient. (loc: 14,168)

The broad-spectrum of each personality disturbance (loc: 14,169)

corresponds to the different degrees and life phases (loc: 14,170)

the community contributes (loc: 14,170)

Note:Let’s give an example: does the narcissist’s need to be self-sufficient originate from a relationship with parents who have strongly introjected this social “rule” and, consequently, pass on the same behavior to their child – perhaps through an unsympathetic and insufficiently relational style? Does it originate from the mothers’ or fathers’ more articulate and complex difficulty? From the couple mother-father? Inside the triad parents-child? Or does it arise among groups of peers, in which “using” the others becomes a sort of rule (“ I-It” relationship, to use Buber’s (1923) terms), so as to avoid risking too much in sentimental ties? Does it derive from relationships with the opposite sex? Or arise within the working field? Or within the totality of all these human contexts? Obviously, according to the most involved stage in the life cycle, the level of seriousness differs. )

it is important to work towards building relational backgrounds (loc: 14,178)

restore complexity to real-life (loc: 14,179)

4. Therapeutic Directions (loc: 14,182)

How do we work at the background? (loc: 14,184)

Gathering contradictions and polarities and allowing them to permeate? (loc: 14,184)

When working at background without passing by the contact figure (loc: 14,185)

the path toward awareness and assimilation is long and uneven. (loc: 14,186)

In a relational field where borders and protection are lacking, the therapist can feel his own wounds and sensitive points, (loc: 14,188)

The therapeutic relationship works at restoring failures of attunement and mirroring in early development. (loc: 14,191)

It collects and contains partial, (loc: 14,192)

confused, intense, unstable, scary fragments coming from previous relationships. (loc: 14,193)

it is supposed to enable spontaneity, potentiality and presence at the contact boundary (Perls, Hefferline and Goodman,1994). (loc: 14,193)

The therapeutic relationship cannot be apart from the awareness of being inside society, (loc: 14,196)

The therapist particularly needs this awareness of being part of a larger society in order to stay within such a difficult therapeutic field. (loc: 14,197)

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