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  • Q&A with Australian Health Practitioners

    What are Cluster B personality disorders?

    Both my daughters have serious anxiety disorders one with features of OCD. The younger has been told by her therapist that in all likelihood she has BPD. Apparently they are related disorders (B).

    While the older daughter is well supported medically the younger believes that medication and counselling are of limited value with BPD. She has improved a little on some anti-depressants though she has tried many and appears to be quite sensitive to them in terms of side effects. She vomited for about 6 hours the first and only time she tried Zoloft for example.

    She is moving to a capital city and I am concerned that she will not cope.

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    Thanks

    Damien Haines

    Clinical Psychologist, Psychologist

    Damien Haines is a registered Clinical Psychologist who brings a warm and empathetic approach to therapy. He emphasises engagement in the world and encourages clients … View Profile

    To your first question, there are three “Clusters” of personality disorders. Cluster A is sometimes called the “odd type”, Cluster B is sometimes called the “dramatic” typeand Cluster C is sometimes called the “anxious” type. The are “clustered” as these three groups tend to have similar traits. Within the B Cluster are the diagnoses of Borderline, Antisocial, Histrionic and Narcissistic. The main overlapping trait is around emotional dysregulation and poor boundaries which leads to poor interpersonal skills and therefore relationships.

    Medication for personality disorders is used to treat the symptoms rather than the disorder. Most people who experience personality disorders also experience significant depression and anxiety, but they are sometimes secondary to the dysfunction caused by their personality traits.

    Medication does not treat personality.

    I would suggest that you encourage your daughter to seek out psychological help to improve her emotion regulation and relationships (I'm assuming that they are poor if BPD is an accurate diagnosis). The evidence suggests that DBT (Dialectical Behavioural Therapy) or SFCT (Schema Therapy or Schema Focussed Cognitive Therapy) are best placed for treating personality disorders. You can look on the APS site here http://www.psychology.org.au/FindaPsychologist or look into private and public hospitals that may offer these treatments in a group format. They exist in all capital cities.

    I hope that this information is a good place to begin. Please respond if you would like some more specific information

  • 2

    Thanks

    Michael Guy

    Clinical Psychologist, Psychologist

    I am a clinical and coaching psychologist (www.lifeaftertrauma.com.au) with over 15 years of professional experience. Recognized qualifications and lots of experience to give me skills … View Profile

    I would recommend a book by Kiera Van Gelder, The Buddha and the Borderline - a memoir.  This is the story of a woman's experiences with Borderline Personality Disorder and her treatment.  I would suggest you and your daughter read it.  

    Treatment of Personality Disorders requires longer term therapy and can involve periods of not much change and sometimes one step forward and two back.  If there are feelings of hopelessness then these can be associated with the therapy whereas they are part of the problem.  She may need to change therapist although only after giving her therapist a chance to respond to the feelings of hopelessness.

    In the past BPD was poorly understood and treatments were often ineffective.  Over the last twenty years research has shown Dialectic Behaviour Therapy, Schema Therapy and Psychodynamic Therapy can be effective.  I would suggest finding a therapist  who has experience using one of these with BPD.

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