RESUMEN
The outsider phenomenon is an existential pathology interrelated with the need to belong. It is a group related experience that has developmental foundations. W. R. D. Fairbairn (1952), was one of the first psychoanalysts who systematically challenged Freudian theory, and located the human experience within social relationships. Fairbairn (1935) suggested that the family is the first social group, leading to affiliations with important groups external to the family. This paper extrapolates from Fairbairn's ideas about schizoid character, which is an interpersonal experience, to group experiences in a family and with identity groups. Fairbairn's notions about the unavoidable activation of schizoid processes may help us understand what makes the outsider experience so pervasive.
Asunto(s)
Apego a Objetos , Teoría Psicoanalítica , Humanos , Teoría Freudiana , Relaciones InterpersonalesRESUMEN
Borderline personality disorder (BPD) is often viewed in negative terms by mental health practitioners and the public. The disorder may have a stigma associated with it that goes beyond those associated with other mental illnesses. The stigma associated with BPD may affect how practitioners tolerate the actions, thoughts, and emotional reactions of these individuals. It may also lead to minimizing symptoms and overlooking strengths. In society, people tend to distance themselves from stigmatized populations, and there is evidence that some clinicians may emotionally distance themselves from individuals with BPD. This distancing may be especially problematic in treating patients with BPD; in addition to being unusually sensitive to rejection and abandonment, they may react negatively (e.g., by harming themselves or withdrawing from treatment) if they perceive such distancing and rejection. Clinicians' reactivity may be self-protective in response to actual behavior associated with the pathology. As a consequence, however, the very behaviors that make it difficult to work with these individuals contribute to the stigma of BPD. In a dialectical relationship, that stigma can influence the clinician's reactivity, thereby exacerbating those same negative behaviors. The result is a self-fulfilling prophecy and a cycle of stigmatization to which both patient and therapist contribute. The extent to which therapist distancing is influenced by stigma is an important question that highlights the possibility that the stigma associated with BPD can have an independent contribution to poor outcome with this population. A final issue concerns the available means for identifying and limiting the impact of stigmatization on the treatment of individuals with BPD.
Asunto(s)
Trastorno de Personalidad Limítrofe/tratamiento farmacológico , Trastorno de Personalidad Limítrofe/psicología , Estereotipo , Trastorno de Personalidad Limítrofe/epidemiología , Contratransferencia , Humanos , Relaciones Interpersonales , Conducta Autodestructiva/epidemiología , Conducta Autodestructiva/psicología , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricosRESUMEN
Stigma associated with alcohol misuse can have serious consequences for adolescents, who may be at risk of developing abuse and dependence disorders. Adolescence is a period that involves wide use of psychoactive substances. During this developmental phase, adolescents are strongly influenced by peer group norms, which do not necessarily stigmatize alcohol use. Unintentionally, a significant subgroup of adolescents may develop problems that are a result of alcohol misuse. The stigma about alcohol problems may keep adolescents from admitting that their difficulties are exacerbated by misuse of alcohol. When their behavior crosses the line from norm to inappropriate, the label of alcoholic may be applied and the stigma that is attached to the label will have additional consequences. This includes withdrawal of social supports and even access to treatment. Adolescents with alcohol use problems may be reluctant to identify themselves with these difficulties, because of their concern about being rejected. These adolescents may present with emotional or behavioral problems, rather than alcohol concerns. Clinicians may avoid inquiring about alcohol use, because of their own negative and pessimistic perceptions of this disorder. Clinicians can be important resources for these adolescents, but this requires that clinicians examine their own prejudgments about alcohol abuse and dependence. This can facilitate meaningful inquiry about alcohol use and begin to offset the stigma and negative self-worth of these adolescents.
Asunto(s)
Alcoholismo , Estereotipo , Adolescente , Alcoholismo/complicaciones , Alcoholismo/terapia , Humanos , Estados UnidosRESUMEN
We have utilized supportive therapy (ST) with an outpatient population with borderline personality disorder (BPD) who also engage in nonsuicidal self-injurious and suicidal behavior. In recent years, ST has been described as an active psychotherapeutic approach that may have efficacy comparable to other psychotherapies. ST emphasizes the mobilization of strengths to enhance self-esteem and utilize adaptive defenses and positive coping skills. Patients with BPD who self-injure and attempt suicide require integration of tangible solution-focused approaches with standard ST in order to address negative thinking patterns, impulsive behavior, and affective dysregulation, along with crisis intervention during periodic crisis states. ST appears to be well tolerated by patients with BPD who have self-injurious behavior and may be efficacious in engaging BPD patients in treatment and in minimizing the frequency and intensity of self-injurious and suicidal behavior.
Asunto(s)
Trastorno de Personalidad Limítrofe/psicología , Trastorno de Personalidad Limítrofe/terapia , Psicoterapia/métodos , Conducta Autodestructiva/terapia , Apoyo Social , Afecto , Trastorno de Personalidad Limítrofe/complicaciones , Humanos , Selección de Paciente , Autoimagen , Intento de Suicidio/prevención & control , Resultado del TratamientoRESUMEN
Social identity theory was applied in group therapy for adults with mild mental retardation. Social identity theory suggests that social group membership, also called collective identity, has an impact on self-esteem. Individuals will try to maintain self-esteem by viewing their social groups positively. This may not be possible for individuals who are members of a stigmatized group. However, it may be possible to enhance self-esteem by broadening one's awareness of collective identity. Furthermore, being able to positively view other individuals who are co-members of one's own stigmatized group can also have positive consequences for self-esteem. A clinical vignette demonstrates this process in group therapy. Results are discussed as being applicable to members of various stigmatized groups.