CBT Counseling Role-Play - Clients with Symptoms of Borderline Personality Disorder
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- Опубликовано: 11 авг 2017
- This video features a cognitive-behavioral therapy counseling role-play session in which CBT techniques are used to address relational and mood instability. The client (played be an actress) has symptoms consistent with Borderline Personality Disorder.
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Something many people in the comments don't seem to realize is that bpd is a VERY wide spectrum and everyone experiences it differently.
The actress did a fantastic job portraying BPD symptoms! Definitely helped when Dr. Grande was demonstrating techniques to work with a BPD client.
Agreed
Yes, she did!!
I don't have BPD but I've been practicing CBT via some workbooks I bought on amazon (I can't actually afford counseling) and it's tough stuff
Actually having to be accountable for your own intrusive thoughts while at the same time dismantling them with logic and acknowledging that what you feel and think aren't always true is something that takes a lot of mental and emotional effort
Dunno how I ended up on these older videos but this is extremely helpful thank you Dr.Grande
Keep the counseling session videos coming! I absolutely love them! they help me to make sense of what I'm reading in my counseling textbooks.
Thank you so much -
Dr. Todd Grande they are SO helpful!
This one was really moving to me.
It made me feel calm and more ok with being bpd. I have overcome many things like trust issues and made progress. Proud of myself
Logical thinking for the win
Andreas Landgren That’s great! I’m really happy for you. It must be very difficult to live with BPD and I know it’s a challenge some days to get out of bed. I’m really glad you’ve made such tremendous progress! I’m always thrilled to find out when therapy helps. Always remember you have value and worth. I’m proud of you too. Take care.
This was a good video. I like how the counselor sets boundaries at the beginning of the session when the client kept trying to call him. The counselor reminded the client that she was supposed to call her brother or a couple of other friends so they could spend their time in session. The counselor wants the client to pay attention to her thoughts so he gives her an assignment to document what she is thinking. Two techniques used in this video are homework and specifying automatic thoughts
I agree. He also identified the automatic thought she was having when she jumped to conclusions about the husband cheating on her without specifying the evidence to support. She assumed this was happening because of her negative past patterns of dating men. Additionally, she had lots of self-blame, guilt, and doubts that she was unlovable.
Her mood seems more stable than I would expect. I'd have trouble saying any of this with out crying or raising my voice. But I know everyone is different.
This is fantastic work. I appreciate that you're sharing these videos free of charge: it speaks to your character. Keep it up.
I like that I can see the smooth progression of the counseling session from discussion of boundaries to homework and encouragement. The counselor empathized with her distress, pointed out inconsistencies, suggested jumping to conclusions, and clarified goals of recording thoughts prior to actions.
You should do a video about quiet borderline.
Thank you for the idea. I will plan to make a video on quiet borderline.
Yeah I agree. Maybe he has? For myself, talk therapy is great :)
Please do this...or have you? 😢🙏
Dr. Todd Grande please do a video on quiet PD 😢🙏 or have you? 😳? I’m isolated and sad.
Yes, quiet bpd gets talked about so little that most people don't even believe it exists.
Dr. Grande asking really tough questions for a therapist to ask. This comes with a good rapport especially with a borderline. He's a total boss when it comes to his knowledge.
Well done! I found this to be a well-written and acted portrayal. The part about the client feeling rejected by not being able to reach the counselor outside of the therapy hour was realistic and the counselor's handling of it was a helpful demonstration. Not only was he maintaining his own appropriate boundaries, he explained to her that they were part of her treatment and for her good. The video also shows a simple and seemingly natural use of CBT, assigning the client homework to help her identify her negative thoughts that precede the behavior she wishes to extinguish.
It’s interesting I find that more women have BPD and more men have Narcissism and Psychopathy. It’s interesting.
BPD: I love you....go away....don’t leave me...go away. It’s interesting to see all the different ways this behavior can manifest. There’s so many facets of BPD. It must be very difficult to have and live with. It’s a lot of self blame and fear of abandonment. It must be very painful and frightening. If you’re living with BPD I am so sorry for all the pain you endure. Just know there are many people out there who love you and value you. There is help out there and people who are willing to listen.
that's so nice thank you
I've heard that BPD in women is to antisocial personality disorder in men
This helped me understand what helpful dialogue sounds like with this personality type. Thanks.
i’ve been doing CBT for three years already, got diagnosed with BPD in 2018 and ,,, man she was so on spot. the way i speak to my therapist whenever i feel that *switch* turning on. this is a really good video.
Dual LPC/LMFT Student here. Love the videos, very informative. Even within the context of role-playing, your care and compassion shine through.
I love this!! I am going to watch more of your role plays. She played a very good bpd client.
I just discovered this series and I always get so engrossed in each episode because they're SO convincing. Well done.
I am in my internship for L.P.C. and have been watching your videos for extra training. These are a great help, thank you.
Dr. Grande, I really enjoy your videos. I use them often when teaching other counselors. You provide great examples of technique through these role plays. Thank you.
I could feel her. This lady is me. I've been dealing with BPD for over 6 years' now and it is terrible
her posture and expressions are actually surprisingly accurate... i think for someone with BPD the character is very strong to talk about her boyfriend leaving or accusing her without exalt herself
My sister is like this, she is very hard to handle but the antidepressants have made everything for me much easier to deal with. This was very helpful, thank you for sharing this.
Wow, this is spot on. I have a few clients with bpd and she is bringing up all the issues my clients present with including being frustrated that I I'm not available at their convenience.
Crazy Lovatic you are so defensive. How do you know what the commenter feels towards her clients? She simply stated her experience with her clients. There was no mention of their pain. Try and look past your borderline assumptions and calm down. For YOUR sake, no one else’s.
Dr Grande, your videos are so helpful and so very well explained. I watched many of your videos on a whim. Thank you for them so much 🙏
Dr. Grande, You are a terrific therapist and sound so much like my own therapist. I have BPD and have said many of the things Marcy did in this role playing session lol. But the way you responded to her couldn't have been any better in my opinion. I didn't sense one hint of criticism or judgement and I hear them everywhere so easily! And since I'm currently dealing with an unanswered text about cancelling a session due to an emergency, the timing of hearing you discuss the same thing was incredible. It was very helpful to hear you tell Marcy you weren't rejecting her. And I'm sure my therapist is not rejecting me either but it does feel that way. I really enjoyed this role playing session! 👍💖
Reminds me of someone always vilifying me calling me evil, no matter what I do. Thank you for your insightful video Dr. Todd Grande. I wish you and your patients the best from Philadelphia, continue doing Gods work.
I swear there are a lot of people who look like that patient. I feel like I have met her before.
This is exactly how my thoughts race. It’s an exhausting way to live for me and the people around me. Thanks for this educational video, I am going to try to find ways to alter my unhealthy thought processes.
Wow is an understatement for the insight you have given me..wish I saw this video along with your other videos 25 years ago... seriously this is like dying and going to heaven and all your answers are answered. I hope that there would be some way that you would receive an award from your fellow Psychological Association but if you don't I just want to let you know that you've given me so much from this video and from all your other videos and I want to thank you so super much for making these and informing us about this disorder
You are quite welcome!
Thank you so much for doing this. The description for BPD is so broad but this helped a lot. Someone close to me came out with BPD recently and the descriptions just weren’t enough for me to understand but watching this example helps so much. This behavior would drive me nuts. I can’t thank you enough. Sorry your RUclips analysis gets more views- I’m part of that problem as that’s how I found you but with that, I looked to you specifically for this and sure enough, you did this video that describes it best.
I have BPD and I've come to realize through some counseling that family and friends run instead of trying to understand and/or be supportive. They don't have enough time/energy etc. to try. I get that and it leaves alot of patients going into introversive patterns. No one wants to even be around them. I've admitted to family/friends as to what's going on with me and immediately contact was broken. This is a reality for so many people. It's not easy at all to recover some part of your life that was there before.
These videos are so helpful!! I really struggle with these clients. Thank you for posting.
These are amazing videos love this entire serious. I am on my way to becoming a psychologist and seeing this is really helpful. Thanks Dr. Grande
Thank you for all this vidos as a grad student it is helping me so much
Great example of CBT counseling, very interesting to watch.
It's DBT
Good work !!!!wow it takes a lot work to listen to people.She said no not on her side wow I will
See how she could call This Doct all the time he is calm of her peace
This was so interesting and very helpful. Thank you!
In many ways, this is very close to what one could expect from any Borderline. Needy, demanding, extremely reactive when judged or faced with disapproval or rejected, perpetually disappointed either with herself or others, with moments of extreme but short lived enthusiasm, and a very ambivalent relationship with the therapist.
But one thing that strikes me as very particular of this case is the presence of more or less reliable sources of support. And the lack of an evident emotional disorder, such as depression and suicidal ideas. This is a very ideal scenario for a BPD, at least in my experience. Setting clear boundaries with a BPD is secondary to establishing a trusting therapeutic relationship.
I also noticed he only tried to help her develop some kind of insight into how her demands and patterns of controlling behavior may drive significant others away, but did not use his own relationship with the patient to help with that analysis. I have no problem with being very straightforward in that analysis with a BPD client once the therapeutic relationship is consolidated. They most certainly need to understand and benefit from understanding how they foster the judgment or disapproval or rejection the so desperately fear.
Great job on this !
Thank you!
I really appreciated this presentation. Thank you.
This is excellent.
Well watching this has taught me I probably don’t have the required patience or temperament to ever be a good councillor - I’ll have to stick with Engineering Lol 😂
This was excellent.
Hi Doctor Grande. Great insight. I am currently working towards an eventual LMHC license. I have a question for you. In session, do you typically sit this close to the client, or is this just to fill the camera frame?
Even though I understand the "client" is an actress, I feel genuinely sorry for this girl! Thank you for sharing!
This session was very interesting. The clients issues with illogical thinking was causing irrational mood and emotional behavior. The counselors suggestion of focusing on what could be leading to these thought by documenting anything that precedes the behavior should be very effective. However, as stated in the video, for this client it will definitely be a process.
Sounds almost exactly like what happened to me before with my BPD. Minus the excessive calling my therapist. Excellent job acting for both of them.
The acting was sure good in this valuable for everyone to watch in the caregiving professiopresentation. So good that maybe 1 too many ? was asked which could have left a real client with a little more self doubt for about a day or so.
Good stuff love it
Is there a different condition which has symptoms that are more mild than this or would it still be BPD?
im more quiet about it but yes i would be at least thinking everything she says. i unfortunately jump to these conclusions when i think people are dodging me or that they are fake if they are nice to me one day and too busy to talk the next.
I have bpd and have been seeing a psychologist for over a year every week. I've made some good process. Some of this video rings true for me but her emotions do not change once the whole way through which is not accurate for bpd.
I can get through a whole session without my emotions changing. Everyone experiences bpd differently.
I think this video works well in context with Dr. Grande's video describing the symptoms of BPD and how people who have it tend to behave. I wouldn't really see as much without that as a context. I've also read various things about BPD, but it helps having a very basic context. I also give full credit to the actress cause yeah, she does well showing how people with this seem to act, as far as I can tell.
I think someone I know may have BPD, but he's against getting any mental health aid cause he doesn't want to be committed. However, for that same reason, he also can't work a typical job with people cause he's afraid he'll flip out and look crazy... I'm not sure if those with BPD have such localized outbursts but think they can.
If anyone is reading this, I'd like to ask: how far can you go trying to help/be friends with and/or romantic partners with someone with this condition? In my case, I felt I had to leave because I was being outright verbally and emotionally abused, as well as going through my own physical/mental health issues. I had to cut out the bad things I had control over, and that included stressful relationships. I was literally having a mental breakdown in front of my other friends because he'd convinced me I was the worst person ever. So yeah, how far do we go? I do want to help people, but there's always a limit...
Thanks in advance!
What do you say to a client who, when receiving the homework, instead of saying they'll try it, they say "How? How do I not follow him? I don't know how to stop." ??
My ex got bpd she always manipulates me and leaves me gives me hot and cold dr todd can you suggest me any idea what should i do to convince my girlfriend to go theraphy without attacking i told her about bpd she gets defensive and tells me she doesnt need theraphy and end up getting blocked in social media i want to help her
What do you feel is the best method of reality checking a client with BPD?
Get to the wounds. Breathe. DO the Presence process. Feel the emotions that come up with the breath. This is going in absolute circles and you aren't even beginning to touch on the root of her wounds that are triggered. If you keep talking about the problems how is she going to heal the rage, fear of abandonment, lack of self love. The problems aren't the problem. The problems are triggers for initial wounding and the feelings those brought about which keeps coming up.
What you just described would be so much more validating and healing. Do you have any videos or a youtube channel? I feel like you could provide some good information on how to treat bpd
It's sort of like reliving the childhood trauma
I can relate to a lot of this
Very accurate 👌 👏
That was a very interesting interview! Her paranoia and distrust of other people are only serving to perpetuate her fears.
Do people in the comments realize that this is role-play? This is just to show what a CBT-session with a borderline client could look like. There is no way to simulate a real therapy situation by acting because the therapeutic relationship cannot fully be acted as role-play. Also, therapists have different styles and different approaches and might use different approach with different clients, this video is just to showcase a common CBT-approach to BPD. There is no way to evaluate Dr Grane's skills based on this video (or to evaluate anyones skills based on any role-play video) because this is just a video intended for educational purposes and I would speculate that he picked the approach that he uses in this video because this is the basic CBT-approach (CBT varies a lot in approaches and CBT as a whole covers a whole range of other therapy approaches like DBT and ACT, this is just the most basic one). I have to note also that an inexperienced actor will have to use a lot of his/her attention on the acting itself, and that normal body language is not captured well on camera (trained performers always exaggerate their body language on screen), so if Dr Grande seems distant and cold in terms of body language and posture, this is probably just because of the fact that they are acting and because this is a video.
Brilliant
Dr. Grande - where have you been? I've never seen an actual therapy session of yours in previous years. I agree with other commenters. People need help, and viewing 'actual' sessions could remove the fear element involved in not knowing what therapy looks like.
Thanks, very CBT
You're welcome!
Damn!!!I love Dr.Grande! Man!…You are that deal.
Oh, man. The little jabs, the sweeping statements,… So familiar. That’s how she was. Definitely how she was. Nobody cares, nobody understands, everything sucks, yada yada yada. And all the while, there’s this pull at you to want to contradict, to reassure and to let her know that she is wrong, that people do care, that people do want to help, etc. etc. Oh, man. Flashback! and, don’t you dare fall into the trap. If you do, you may turn her around once or twice. Eventually though, the more you reassure the more it agitates her because, now, you are contradicting her and implying that her assessment of things is wrong so, eventually she explodes and rages at you. And then you become the target. And everything bad in her life centers on you. And then the devaluation takes off in earnest followed by the discard, of course. Leaves you a hot mess.
@3:05
I've always needed to see what "splitting" was. I'm assuming this is what it is?
Black and White thinking. There's no grey areas. That's not reality.
Anything on being borderline and then having a stroke
This is only what 'borderline' looks like for this person. Cause it's not even close to my experience.
There are exceptions to everything and not everyone is the same, so Borderline Personality Disorder is not always going to be expressed the same way. I know from experience, as I have Borderline Personality Disorder myself. There were things (behavioral patterns) I could relate with in the role play.
@@beyondbeauty6921 No that's actually a minority, and it typically happens with people who have comorbid personality disorders rather than just bpd.
What most people don't seem to realize about bpd is it's actually a very wide spectrum with many different ways that the symptoms can be expressed. No 2 borderlines are exactly the same.
also, someone might not act the same way in their therapy like they do in their social or family life.
@@beyondbeauty6921 the person that hurt you is not a clone of everyone else with BPD.
😁 Retro Dr T.
Where the old school fandom come to hang out & reminisce 😁
The decor is missing something 🤔...
🌵 A cactus. 😉
Is that ok if I put your videos on a Chinese video website?
The never ending self pity and emotional turmoil is an emotional black hole. They expect us to be on call and focused only on them and we’re always being tested to see not if but when we will fail them.
I have a family member like this but I’ve checked out. His trauma is not mine to fix.
I feel like Im actually watching my BPD friend
5:32 how to respond when the person is - sadly - partially correct. I'm not saying a person is unlovable, like undeserving of basic respect- but isn't it possible a person could be very hard to be around? Do you deny it knowing she's actually somewhat right about herself, do you agree and watch her flip out and jump off a building? Is the third option- just nodding along with why she feels that way without actually agreeing or disagreeing?
11:43 again, what if it's true? Do we just kind of nod and not address the facts of that?
Have you done a video about GAD?
What if you're like this but only right around your period... PMDD? Minus reaching out to others because I go all avoidant, like the silent treatment on angry hormones
Sounds like me when I was younger...now at 63 alone, I find I don't like or trust ppl. I used to have friends...
CPTSD in childhood, finding I couldn't trust my own narcissist parent.
I don't know if she can be mindful enough to be aware of her thoughts in the moment. I think that's a good homework assignment in the future.
I think this video is just a book example of BPD, but from my experience lots of us experience BPD on much more complex and deeper level.
Maybe because I did lots of work on myself and had many many obstacles and seen and been through. I also see traits of different personality disorder in her rather then only BPD.
The woman deserves an Oscar.
Thank you can you please do a borderline splitting??
4:36 someone or something is all good or all bad. He is great and I am bad, etc.
What’s the relationship between vulnerable narcissism and BPD?
There seems to be overlap. I can’t tell the difference.
Ive learned if i dont have a relationship with another person whether it be significant other, sister, "friend", grocer, landlord, coworker, etc. Anyone i deal with for more than a few minutes or recurring, than my BPD isnt an issue. I simply have no care about what a stranger does. No relationship means no love/hate, no needing to learn to trust, no problems. I isolate as much as possible so i cant be hurt and cant hurt another. It seems to be the loneliest place in the world but im not in horrific pain all the time. It works for me, unfortunately i have no money or insurance. Just a NP that likes to push meds on me once every 6 weeks. It's my "norm". Mostly i feel happy to be alone, numb. It's for the best for my family. When you have no resources for good honest help, its all i can do to try and get or learn to get better. I dont think i will ever have anything more. I know i will never trust again.
Self deprecating is a such a sad aspect. I understand why it happens but still.
I may be wrong, but I think many of the things that she says in response, such as staying with her boyfriend because she is afraid to be alone, are things that someone with BPD would THINK but do everything in their power not to SAY.
Lol I think I have borderline but the quiet type hahah
Wow!
I recognize certain behaviors in this role play. I had a friend who was a narc and had bpd.
The playing victim all the time, always focused on traumatic or percieved traumatic experiences from the past, some of which may or may not be accurate.
The splitting, where a person is considered to be either all good or all bad.
The inability to be alone, there can be an overly romanticized mentality that relationships will give them everything to make them whole which we know logically that doesn't happen.
I remember being in the car with the bpd, and a Whitney Houston song came on.
He said, I wish a woman would sing to me like that. I said well she technically is, she's singing to whomever is listening lol.
Does anyone know what this means: having met a guy only a few days earlier,I quit my job. I would sleep all day then get up around 4pm and get ready. Then I would take a two hour bus ride to see him. Then I would feel tired after only a couple of hours and spend the night in the dark just hugging him tight.
The chairs are way too close and I’d probably start scooting back 😂
She said it’s gona be hard to not confront him. I feel rejected wow.
This isnt a critique of the video, rather the closed captioning. I have mine on as my hearing isnt great and its a noisy house, however thw text was really far off the actual spoken word. Only 90 seconds into the video and I have lost count. It all started with "Hello, this is doctor Bronte." I just thought you might want to be aware of that fact.
I think it was auto generated captioning.
Some therapists brainwash you BPD and after you"ve been there you experience a nasty influence that effects your mood for days and can get such traits of that. Sloppy messy therapists and are immature ambitious and unexperienced and impersonal. Very negative influence and are not interested it does not matter and they don"t care about you and make you feel bad. They make you therapy addict for years. Some therapist have a high sexdrive and that trait can infiltrate also in to you. So be careful and do any investigation before you go to a ambitious and unexperienced therapist. Also the choice of the GP is important and some are dominant solitairy.. They want always the last word.
Sounds like Jodie Arias story😬Thank you Dr Grande for the insight of this frightening disorder.
She seems very mild mannered for a bpd person. Everyone has some moments of insecurity and trust issues at different times in their life. The only thing I can detect is her impulsiveness and bothering the therapist. Maybe I don't understand bpd!
Bpd is a very wide spectrum and actually the majority of us are this mild mannered if not more so. My therapist says even though I have bpd I'm more cooperative than most NON borderlines!
@@nicorizzo5402 Have you ever been told that your too negative? I have been told that by my family.
My house mate had borderline and it's exusting.
Borderlines are abusive and love playing the victims!! Leave ...dont stand for their shit let them own their own shit like all adults do!!!
@@beyondbeauty6921 Actually many borderlines are not abusive. If you're with someone who is abusing you then yes, get out asap, but don't just assume that just because someone has bpd that they're automatically abusive. It's actually a minority that are. Most borderlines aren't abusive which is why they're the ones that don't often get talked about.
Borderline strikes me initially as extreme covert narcissism (extreme focus on herself, her feelings, her experience, zero awareness of others’ realities). Also strikes me as extreme victim mentality, having dealt with a friend and family member just like this.
Hi how are you doing been better what ever
I would think no one wants a person that needs you to fix them. That is a drowning job and puts too much of a burden on one partner. That's what my husband expected of me. The reason how I found this out was observing and him being a jerk and the more I gave the more he became a little boy. It's some sh-t to witness I will tell you that. I am still pissed in talking about this. What an assh-le. His reality is not my reality and not your reality. Put it that way.