March 28th

Grandiosity and Depression

When you pierce someone’s grandiosity you may find depression

When dealing with a Grandiose . . . do this in doses for OPTIMAL Gratification

  1. gratify “that is great”
  2. Ask “what do you need from me, why are you sharing this?” (do you need me to affirm you? Can you believe the good before I say it?)

Idealizing Transference:

“you’re the greatest”


Activation of insula paradigm  ANTERIA INSULA

the healthy volunteers and BPD were scanned as they responded to cues about money and investment

Healthy volunteers’s trust could be anticipated

BPD clients could not perceive bad or good accurately and their ability to trust is injured. BPD were less trusting and see negative intent more. They have no empathy

BPD see all people as “ALL BAD” or “ALL GOOD”, there is no room for mistake making.


As they heal, there is less dissociation and they feel more physical pain.

Children of mothers who have BPD – the parent may be critical or harsh and have memory impairment. They don’t see the child as a seperate human and insist the mother is wrong.

Outsiders see their mom as Charming, which makes the child feel like their reality is unreal.

Could be a “poorness of fit” between mom and child.

Disorganized/disoriented attachment “I hate you- don’t leave me”

FEAR OF ABANDONMENT is triggered into narcissistic rage when a partner says they will leave.


“Affect storm” when a Boarderline Personality over reacts – it is like they are a baby in a crib feeling terror. . .  reminds me of Anne Martini not remembering acting out even when shown videos of herself

they don’t feel the Depressive Pole in bi-polar patients











The Final – do NOT do another ATTACHMENT paper – HALF of your sources have to be from the syllabus… say “it is likely that” – do not diagnose definitively . . . . yes “based on research”…

NO self psychology,  NO mentalization ,
Assignment #2: Application of theory to health and mental health
This is a crossover assignment with SOWK 643. Thus, the topic you choose will be addressed both from a theoretical and a practice application perspective.
Heath/Mental Health Theory:
Choose a symptom (e.g. depression), disorder (e.g. personality disorder), or problem (e.g. family violence, specific health issue) in which you are interested and discuss it from one of the following theoretical perspectives.
            Object Relations theory (other than Bowlby and Mahler)
                        Mentalization theory (Fonagy)
            Self Psychology
            Contemporary Cognitive Behavioral theory (includes neurobiology)
            Trauma theories (integration of psychological and biological theory, includes dissociation)             Social Learning theory (at a more advanced level than 1st year)
Theories you may not use are the following: Ecological, Systems, Erikson, Freud, and any others emphasized in HBSE 1st year. It is strongly suggested that you run the theory by the instructor to make sure it meets the requirements of the assignment.
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