Differentiating prepersonal from transpersonal psychosis

Prepersonal Psychosis

• distortions of identity, place, and time

• confused disjointed, tangential sentences

• delusions unresponsive

• hallucinations unresponsive

• absence of empathy

• inability to integrate roles

• inability to listen

• chronic

endogenous

Treatment of Prepersonal Psychosis

• medication

• protection of self and others

• interviewing harmless but unhelpful

Transpersonal Psychosis

• history of intense meditation, fasting, vision-questing, etc.

• temporary

• exogenously induced

Treatment of Transpersonal Psychosis

• protection of self and others

• benign neglect: do not medicate!

• back off on the practice

• interviewing OK

Using IDL with Physical Illnesses

• interview the physical pain

• interview the virus or bacteria

• interview emotions

• sleep/dream incubation

• Sangha intervention

What is a Personality Disorder?

• early developmental failure

• failure of empathy

• inability to take the role of the other

• unresponsive to most talking, behavioral interventions, or medications

Personality Disorders and Integral Deep Listening

• inability to take autonomous roles implies a personality disorder

• the identification with autonomous roles that are not integrated, as in dissociative disorder, implies a personality disorder

• inability to take the role of the other

• unresponsive to most talking, behavioral interventions, or medications

Borderline Personality Disorder

• frantic efforts to avoid real or imagined abandonment.

• a pattern of unstable and intense interpersonal relationships,

characterized by alternating between extremes of idealization and devaluation

• identity disturbance: markedly and persistently unstable self-image or sense of self

• impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

• recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

• affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

• chronic feelings of emptiness

• inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

• transient, stress-related paranoid ideation or severe dissociative symptoms

Borderline Personality Disorder and IDL

• attempt to turn feelings of abandonment into a color and shape to interview.

• in interviews, look for characters demonstrating extremes of idealization and devaluation.

• attempt to access self-aspects that have a more stable sense of self.

• attempt to access self-aspects that are not impulsive.

• interview personifications of the feelings associated with suicidal behavior

• deal with emotional instability by interviewing it

• interview any feelings of emptiness

• interview anger

• interview dissociated self-aspects.

• interview the fear underlying paranoia – turn it into a color, shape…

Dependent Personality Disorder

• has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.

• needs others to assume responsibility for most major areas of his or her life.

• has difficulty expressing disagreement with others because of fear of loss of support or approval.

• has difficulty initiating projects or doing things on his or her own because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy.

• goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant

• feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.

• urgently seeks another relationship as a source of care and support when a close relationship ends.

• is unrealistically preoccupied with fears of being left to take care of himself or herself.

Dependent Personality Disorder and IDL

• approach interviewing as a way to help the client make everyday decisions without an excessive amount of advice and reassurance from others.

• approach interviewing as a way to help the client assume responsibility for most major areas of his or her life.

• use experience of the support and approval of high scoring self-aspects as a way to overcome fear of expressing disagreement with others.

• use self-aspects scoring high in self-confidence to help in learning to initiate projects or doing things on his or her own.

• experiencing internal nurturance and support reduces the need to go to excessive lengths to obtain nurturance and support from others.

• experiencing self-aspects that care and are always there is intended to counteract feelings of discomfort or helplessness when alone because of exaggerated fears of being unable to care for himself or herself.

• the experience of internal support from internal self-aspects is intended to reduce the need to urgently seek another relationship as a source of care and support when a close relationship ends.

• is less likely to fear being left alone or loneliness.

Narcissistic Personality Disorder

•  have a grandiose sense of self-importance.  They exaggerate achievements and talents and expect to be recognized as superior without commensurate achievements.

•  are preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

• believe that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people or institutions.

•  require excessive admiration.

•  have a sense of entitlement.  They make unreasonable expectations of especially favorable treatment or automatic compliance with their expectations.

•  are interpersonally exploitative.  They take advantage of others to achieve their own ends.

•  lack empathy. They are unwilling to recognize or identify with the feelings and needs of others

•   are often envious of others or believes that others are envious of them.

•  lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

Narcissistic Personality Disorder and IDL

•  Getting in touch with self-aspects that are autonomous is a great threat to the need for control behind their grandiose sense of self-importance.

•  Your first responsibility is to avoid falling into the drama triangle. If you are successful  they are unlikely to want to have anything to do with you because you can’t be manipulated.

•   Beware confusing their charm, charisma, and sociability for empathy.

•   Beware confusing their confidence with strength.

•  Beware of believing that if you only say the right words that they will return your kindness or realize that they are as wonderful as you think they are.

Paranoid Personality Disorder

• They suspect, without sufficient basis, that others are exploiting, harming, or deceiving them.

• They are preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.

• They are reluctant to confide in others because of groundless fears that the information will be used maliciously against them.

• They read hidden threatening or demeaning meanings into benign remarks or events

• They persistently bear grudges.  They are unforgiving of insults, injuries, or perceived slights.

• They perceive attacks on their character or reputation that are not apparent to others and are quick to react angrily or to counterattack.

• They have recurrent unjustified suspicions regarding the fidelity of their spouse or sexual partner.

Paranoid Personality Disorder and IDL

• IF you manage to get them into role, the object is to put them in touch with self-aspects that are not exploiting, harming, or deceiving them.

• Interview the personifications of doubts about the loyalty or trustworthiness of friends or associates.

• Since they are reluctant to confide in others because of groundless fears that the information will be used maliciously against them, encourage them to confide in self-aspects.

• When they read hidden threatening or demeaning meanings into benign remarks or events, attempt to ask high scoring Sangha members what they make of those interpretations.

• They persistently bear grudges.  They are unforgiving of insults, injuries, or perceived slights. Therefore the goal is to help them experience that how they view others is how they are viewing the part of themselves they represent.

• When they perceive attacks on their character or reputation that are not apparent to others and are quick to react angrily or to counterattack, interview their anger, if possible-it probably won’t be.

• Interview their fear when they have recurrent unjustified suspicions regarding the fidelity of their spouse or sexual partner.

Schizoid Personality Disorder

• neither desires nor enjoys close relationships, including being part of a family

• almost always chooses solitary activities

• has little, if any, interest in having sexual experiences with another person

• takes pleasure in few, if any, activities

• lacks close friends or confidants other than first-degree relatives

• appears indifferent to the praise or criticism of others

•  shows emotional coldness, detachment, or flattened emotions

Schizoid Personality Disorder and IDL

• If they show any interest, interview the feeling of being interested.

• Interview isolation.

• if any pleasure is demonstrated in something, interview it.

• The goal is to develop internal friends and confidants.

Schizotypal Personality Disorder

• ideas of reference (excluding delusions of reference)

• odd beliefs or magical thinking that influence behavior. In children and adolescents, bizarre fantasies or preoccupations.

• unusual perceptual experiences, including bodily illusions

• odd thinking and speech such as vague, circumstantial, metaphorical, overelaborate, or stereotyped speech.

• suspiciousness or paranoid thinking.

• inappropriate or constricted affect.

• behavior or appearance that is odd, eccentric, or peculiar.

Schizotypal Personality Disorder and IDL

• Beware of succumbing to the pre-trans fallacy with these people!

• They may talk about their dreams but they will avoid actually getting into role.

• Interview something they want from you, like food or money, before giving it to them.

Antisocial Personality Disorder

•  failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest.

•  deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.

•  impulsivity, or failure to plan ahead.

•  irritability and aggressiveness, as indicated by repeated physical fights or assaults

•  reckless disregard for safety of self or others.

•  consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.

•  lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Antisocial Personality Disorder and IDL

•  Some of these people can get into role!

•  Interview their dreams.

•  Interview the pleasure they experience when they perform acts that are grounds for arrest.

•  Interview the pleasure they get from lying.

•  Interview the impulsivity.

•  Interview the aggressiveness.

•  Interview recklessness.

•  Dream interviews will address their irresponsibility and their repeated failure to sustain consistent work behavior or honor financial obligations.

•  Have them become a victim of their actions or irresponsibility and interview them.

Histrionic Personality Disorder

• is uncomfortable in situations in which he or she is not the center of attention.

• interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.

• displays rapidly shifting and shallow expression of emotions.

• consistently uses physical appearance to draw attention to self.

• has a style of speech that is excessively impressionistic and lacking in detail.

• shows self-dramatization, theatricality, and exaggerated expression of emotion.

• is suggestible, i.e., easily influenced by others or circumstances.

•  considers relationships to be more intimate than they actually are.

Histrionic Personality Disorder and IDL

• Interview discomfort of being in situations in which he or she is not the center of attention.

• Interview the recipient of inappropriate sexually seductive or provocative behavior.

• Interview emotions, regardless of how superficial they are.

• consistently uses physical appearance to draw attention to self.

• Use their suggestibility to help them get into role.

Obsessive-Compulsive Personality Disorder

• are preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

• show perfectionism that interferes with task completion.  These clients are unable to complete a project because their own overly strict standards are not met.

• are excessively devoted to work and productivity to the exclusion of leisure activities and friendships.

• re overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values.

• are unable to discard worn-out or worthless objects even when they have no sentimental value.

• are reluctant to delegate tasks or to work with others unless they submit to exactly their way of doing things.

• adopt a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

• shows rigidity and stubbornness.

Obsessive-Compulsive Personality Disorder and IDL

• Use the focus on correct task completion to stay in role

• Support the successful completion of homework by associating it with work and productivity.

Dissociative Identity Disorder

• the presence of two or more distinct identities or personality states

• these recurrently take control of behavior

• an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness

Dissociative Identity Disorder and IDL

• IDL views dissociated identities as self-aspects having needs and wants.  When these are respectfully considered the balance between autonomy and integration is more likely to be restored.

• Whatever identity is present can be asked to take a dream role or the personification of a life issue.

• Anything that is interviewed can be asked questions about any and all identities.

Possession and IDL

• IDL views possession as a form of dissociative personality disorder.

• In other words, the entity is best treated as an aspect of self, since IDL assumes that all beings are best treated as aspects of self.

• This allows fear of an overly objectified and dissociated self-aspect to subside, increasing the likelihood that a mutually respectful relationship can be established.

What Addictions May Respond to Integral Deep Listening?

• smoking

• sexual addiction

• gambling

• alcohol and drugs

• compulsive eating

• worry and obsessive thoughts

How Does Integral Deep Listening  Help Addiction?

• listens to the needs the addiction is attempting to fill

• activates self-aspect antidotes to the addiction

• supports disidentification with addiction

• supports identification with non-addicted self-aspects

• listens to the resistances to change

• supports other treatment modalities