* Discuss the treatments or interventions that have been shown to be the most effective for your selected disorder.

Select one of the following personality disorders; borderline, antisocial, or narcisistic personality disorder SEE ATTACHED NOTES

 

Use the Research Analysis to complete this assignment.

 

Prepare at least 1,100 word paper that discusses research-based interventions to treat psychopathology.

 

Review the characteristics of the selected disorder and discuss the research about intervention strategies for the disorder by completing the following:

 

* Evaluate three peer-reviewed research studies using the University of Phoenix Material: Research Analysis.

 

* Conceptualize the disorder using the DSM-5, diathesis stress or biopsychosocial model. ( link to explain these models https://en.wikipedia.org/wiki/Diathesis%E2%80%93stress_model)

 

* Discuss the treatments or interventions that have been shown to be the most effective for your selected disorder.

 

Cite at least five peer-reviewed sources.

Select one of the following personality disorders; borderline, antisocial, or narcisistic personality disorder SEE ATTACHED NOTES

Use the Research Analysis to complete this assignment.

Prepare at least 1,100 word paper that discusses research-based interventions to treat psychopathology.

Review the characteristics of the selected disorder and discuss the research about intervention strategies for the disorder by completing the following:

* Evaluate three peer-reviewed research studies using the University of Phoenix Material: Research Analysis.

* Conceptualize the disorder using the DSM-5, diathesis stress or biopsychosocial model. ( link to explain these models https://en.wikipedia.org/wiki/Diathesis%E2%80%93stress_model)

* Discuss the treatments or interventions that have been shown to be the most effective for your selected disorder.

Cite at least five peer-reviewed sources.

 

 

 

TRANSCRIPT of Video

Video Link http://fod.infobase.com/p_ViewVideo.aspx?xtid=41359

 

Cite Information: Should I live, should I die? Understanding borderline personality disorder [Video file]. (2004). Retrieved November 19, 2016, from http://fod.infobase.com/PortalPlaylists.aspx?wID=18566&xtid=41359

>> Narrator: RACHAEL KAVANAGH IS PREPARING FOR AN EVENT SHE NEVER DREAMED WOULD HAPPEN. ON SATURDAY SHE’S GETTING MARRIED. IT’S BEEN A DIFFICULT ADJUSTMENT BECAUSE SHE HAD SOMETHING ELSE IN MIND.

>> THE PLAN WAS TO BE DEAD BY THIRTY. I GAVE MYSELF NO MORE TIME THAN THAT. I WAS ENTIRELY SICK OF DISAPPOINTMENT, I WAS SICK OF LETTING MYSELF DOWN AND I WAS TIRED OF TRYING TO IMPRESS OTHER PEOPLE, UNDERSTAND THESE EMOTIONS. I WAS JUST TIRED AND IT’S SO, IT’S LONELY HAVING THIS DISORDER. IT’S JUST INCREDIBLY LONELY.

>> Narrator: SINCE HER TEENS, RACHAEL HAS BEEN BATTLING WITH BORDERLINE PERSONALITY DISORDER, AN EMOTIONAL BEHAVIOR OR PROBLEM THAT CAN BE SO DIFFICULT TO LIVE WITH LIFE CAN SEEM LIKE IT SIMPLY ISN’T WORTH LIVING. WHILE RACHAEL’S PLANS TO BE DEAD BY THIRTY DIDN’T COME OFF, FOR ANOTHER WOMAN THE PAIN OF LIVING WITH THE SAME CONDITION PROVED TOO MUCH. ON A COLD, MID-WINTER NIGHT, JULY 2003, 53 YEAR OLD MARIA DE SILVA TOOK HER LIFE IN A DRAMATIC AND SHOCKING WAY IN AOTEA SQUARE.

>> (DISPATCHER): WAITING FOR A REPORT TO COME OF A PERSON ON FIRE.

>> Narrator: EMERGENCY SERVICES RACED TO SAVE THE WOMAN WHO SET FIRE TO HERSELF, BUT IT WAS TOO LATE. THIS IS THE STORY OF TWO WOMEN’S STRUGGLE WITH A TERRIBLE CHOICE. MARIA DE SILVA WAS A GIFTED OPERA SINGER, FORMER ATHLETE, AND TIRELESS CAMPAIGNER FOR GOOD CAUSES. ONE OF THOSE CAMPAIGNS WAS TO HIGHLIGHT THE SUFFERING OF THOSE WITH BORDERLINE PERSONALITY DISORDER, THE CONDITION THAT LED HER TO TAKE HER OWN LIFE. THAT’S HOW RACHAEL KAVANAGH FIRST CAME TO HEAR OF HER.

>> I WAS READING A WOMAN’S WEEKLY AND SAW IN THE HIDDEN BORD-LINE, AND THAT WAS SHORTLY AFTER I THINK I’D BEEN DIAGNOSED, AND IT WAS REALLY QUITE LOVELY TO SEE SOMEBODY TALKING OPENLY ABOUT THE DISORDER BECAUSE UP UNTIL THEN I’D REALLY SAID NOTHING ABOUT IT. SO I CONTACTED HER, AND SHE WAS PRETTY MUCH RIGHT FROM THE START A WEALTH OF INFORMATION, BUT SHE MADE ME FEEL QUITE NORMAL FOR A TIME BEING.

>> Narrator: SHARING THEIR EXPERIENCES OF THE ILLNESS BROUGHT RACHAEL AND MARIA TOGETHER. THROUGH MARIA, RACHAEL BECAME AWARE OF JUST HOW MANY OTHER PEOPLE HAD THE DISORDER. IT’S ESTIMATED THAT AROUND THIRTY THOUSAND PEOPLE IN NEW ZEALAND HAVE BORDERLINE PERSONALITIES.

>> HELLO, DAVID SPEAKING. OK, OK, SLOW IT DOWN A LITTLE BIT. SO IT SOUNDS LIKE YOU’RE FEELING REALLY UPSET AT THE MOMENT. TELL ME WHAT’S HAPPENED. OK, OK.

>> Narrator: DAVID SEMP IS A PSYCHOLOGIST AT SAINT LUKES MENTAL HEALTH CENTER IN AUCKLAND. HE SPECIALIZES IN TREATING PEOPLE WITH THIS DIAGNOSIS.

>> THE KEY THING WITH BORDERLINE PERSONALITY DISORDER IS A PROBLEM WITH EMOTIONS, WITH EXTREME EMOTIONS, AND MUCH MORE EXTREME THAN THE AVERAGE PERSON AND WITHIN ANY GIVEN DAY SOMEONE WITH THIS DISORDER CAN GO FROM FEELING OK TO SUDDENLY SOMETHING WILL HAPPEN AND THEY’LL FEEL TERRIBLE, THEY’LL FELL REALLY ANGRY, OR THEY’LL FEEL REALLY ABANDONED, OR THEY’LL FEEL REALLY SAD OR LONELY OR HOPELESS, ANY NUMBER OF THINGS. AND IT CAN BE TRIGGERED BY MANY, MANY DIFFERENT AREAS OF THEIR LIVES. BECAUSE THEY RESPOND SO STRONGLY TO IT, THAT OFTEN MAKES WHATEVER HAPPENED IN THE FIRST PLACE MUCH WORSE. SO IF IT WAS IN THE CONTEXT OF A RELATIONSHIP, IS THAT GOING TO FEEL LIKE THEY’RE ABOUT TO BE ABANDONED, OR THAT SOMEBODY HATES THEM, WHEN IT FACT THEY’RE JUST A LITTLE BIT ANNOYED WITH THEM.

>> I SABOTAGED RELATIONSHIPS, FRIENDSHIPS. I WOULD FIND BOUNDARIES WITHIN RELATIONSHIPS, TO SAY THAT WERE UNBEARABLY PAINFUL, OF COURSE WE GET KIND OF SICK OF THAT AND END UP GOING AWAY FROM YOU, WHICH IS THE OPPOSITE OF WHAT YOU WANT.

>> Narrator: RACHAEL HAS BEEN WITH SY FOR OVER TWO YEARS NOW. AS IT IS FOR OTHERS IN THIS POSITION, COPING WITH THE DISORDER HAS BEEN A CHALLENGE FOR THEM BOTH.

>> WE’LL HAVE AN ARGUMENT AND I WOULD JUST COMPLETELY GO OFF THE DEEP END, AND HE’LL BE THINKING, WELL, HELL, I JUST CHANGED THE CHANNEL AT THE WRONG TIME, YOU KNOW, WHERE AS I’M THINKING HE DOESN’T CARE WHAT I’M LOOKING AT AND JUST GO THROUGH ALL THOSE, DEALING WITH IT. YOU’VE GOT TO BE SO AWARE, AWARE YOUR EMOTIONS ARE SOMERSAULTING TOO.

>> IT’S VERY DISTRESSING TO LIVE LIKE THIS, AND SO TO DEAL WITH THE DISTRESS OF THESE EXTREMES OF EMOTION PEOPLE WITH BORDERLINE PERSONALITY DISORDER OFTER SELF HARM AS A WAY OF COPING WITH THAT, SO THEY MIGHT BURN OR THEY MIGHT CUT.

>> Narrator: RACHAEL HAS BEEN CUTTING HERSELF FOR FIFTEEN YEARS. NOW SHE HAS OVER TWO HUNDRED SCARS ON HER BODY.

>> WHEN I WOULD CUT AND THEN BLEED, THE BLEEDING WAS ALMOST LIKE A FORM OF CRYING. IT WAS PROVING TO ME THAT I WAS STUPID, I WAS UGLY, I WAS ALL THOSE THINGS AND THE MARKS WERE THERE TO KIND OF PROVE THAT POINT, AND SO IT WAS KIND OF REFLECTING WHAT I FELT ON THE INSIDE AND PUTTING IT ON THE OUTSIDE.

>> Narrator: WHILE CUTTING WAS RACHAEL’S WAY OF COPING, MARIA DE SILVA CHOSE ANOTHER WAY. LIKE MANY OTHERS WITH THIS DISORDER SHE CHOSE SUICIDE AS A WAY OF EXPRESSING HOW SHE FELT.

>> IT WOULD JUST POP UP IN ORDINARY CONVERSATION. YOU’D BE TALKING AWAY AND SHE WOULD SAY “I TOOK A HUNDRED IMOVANE YESTERDAY, I’M DOING PRETTY WELL”, OR TWENTY IMOVANE OR SHE JUST, IT WAS A PART OF LIFE FOR HER.

>> Narrator: RACHAEL ALSO THINKS MARIA USED SUICIDE AS A WAY OF GETTING ATTENTION NOT JUST FOR HERSELF, BUT ALSO FOR THE DISORDER.

>> MARIA DIDN’T DO ANYTHING WITHOUT AN AIM, WITHOUT A PURPOSE. SHE USED HER DEATH, SHE GOT A LOT OF ATTENTION. SHE GOT A LOT OF ATTENTION FOR THE DISORDER AND I’M QUITE SURE SHE DID THAT PURPOSELY, QUITE SURE.

>> Narrator: A REPORT ON BORDERLINE PERSONALITY DISORDER BY THE MENTAL HEALTH COMMISSION IN 1999 SHOWS THREE TIMES AS MANY WOMEN ARE DIAGNOSED WITH THE DISORDER AS MEN. IT USUALLY EMERGES IN ADOLESCENCE OR EARLY ADULTHOOD.

>> I WAS FOURTEEN WHEN I FIRST FIGURED THAT THERE WAS JUST A BIG DIFFERENCE BETWEEN MY REACTIONS AND MY FRIENDS REACTIONS. YEAH, SOMETHING JUST DIDN’T FIT, I WAS TOO EMOTIONAL AND I DIDN’T SEEM TO HAVE AS MUCH CONTROL. I FELT TOO MUCH. I WAS PROBABLY WHAT THEY WOULD CALL A REALLY SENSITIVE ADOLESCENT.

>> Narrator: IT WAS AROUND THIS TIME SHE FIRST STARTED TO HARM HERSELF.

>> FIRST TIME I CUT WAS WHEN I WAS FOURTEEN, AND IT WAS MY FACE, AND AFTER IT I CAN REMEMBER THINKING GOD, THAT WAS STUPID, BUT ALSO RELIEF, A CERTAIN RELIEF THAT I HAD NEVER FELT. OF COURSE AS TIME PROGRESSED I HAD A BAD HABIT, AND IT BECAME VERY MUCH A COPING MECHANISM, NOT A GOOD ONE, BUT IT WAS A COPING MECHANISM.

>> Narrator: BY HER TWENTIES, RACHAEL WAS CAUGHT UP IN A CYCLE OF RITUAL SELF HARM AND ALCOHOL ABUSE. HER LIFE WAS OUT OF CONTROL AND SHE WAS HEADING FOR TROUBLE. BORDERLINE PERSONALITY DISORDER EMERGES IN ADOLESCENCE AND EARLY ADULTHOOD. BY HER TWENTIES RACHAEL KAVANAGH WAS SHOWING CLEAR SIGNS OF THE DISORDER.

>> MY EARLY, EARLY TWENTIES I GUESS MY BEHAVIOR STARTED COMING OUT, UNREASONABLE ARGUMENTS TOO. THERE WASN’T A TIME REALLY WHEN I WASN’T DRINKING. SELF IMAGE WAS JUST IN THE TOILET BY THAT STAGE. IF I SAT IN FRONT OF THE TV AND I CAUGHT THE REFLECTION OF MYSELF IN THE TV I WOULD MOVE. YEAH, JUST UTTER SELF HATE. I LEFT A BAD TASTE IN MY OWN MOUTH.

>> Narrator: DESPITE HER CONFUSED MENTAL STATE RACHAEL WAS ABLE TO PULL OFF A CONFIDENT FACADE. SO MUCH SO, AT THE AGE OF TWENTY FIVE SHE GOT A JOB AS A CASE WORKER AT WORKINGIN COM NEW ZEALAND.

>> IT’S FUNNY BECAUSE WITH THE DISORDER YOU CAN OFTEN SEPARATE SELF FROM JOB, AND BE INVOLVED IN QUITE STRESSFUL POSITIONS AND HOLD THEM DOWN QUITE NICELY, BUT THEN OF COURSE GO HOME AND FALL TO BITS.

>> Narrator: BY HER LATE TWENTIES RACHAEL WAS FINDING IT INCREASINGLY HARD TO COPE WITH HER ILLNESS. IN 2001 SHE DECIDED SUICIDE WAS THE ONLY WAY OUT.

>> I TOOK TIME OFF WORK. I DISCONNECTED MY PHONE, PUT DOG FOOD OUTSIDE SO MY DOG WOULD BE OK. I BOUGHT ALCOHOL. I HAD STORED MEDICATION, DOWNED THEM AND WENT TO BED.

>> Narrator: SHE WAS DISCOVERED BY A NEIGHBOR AND TAKEN TO HOSPITAL. WHEN SHE CAME TO SHE FELT FRUSTRATED AND ANGRY.

>> DAMN. I’M NOT EVEN GOOD AT THIS. I’M NOT EVEN GOOD AT KILLING MYSELF. YOU’RE BE KIDDING ME, YOU KNOW, ALL THAT PLANNING AND I’M STILL HERE, I’M STILL ALIVE. I THINK I FELT GUILTY FOR BEING ALIVE.

>> Narrator: LIKE RACHAEL, MARIA DE SILVA WAS ALSO ABLE TO PROJECT AN OUTWARDLY SUCCESSFUL PERSONA. AFTER TRAINING IN LONDON SHE TOURED EUROPE AS AN OPERA SINGER. ?

>> Narrator: THEN, WHILE STUDYING OPERA IN ITALY, SHE BECAME INVOLVED IN LAUNCHING AN AID PROGRAM TO HELP BOSNIAN REFUGEES. IT WAS A HUGE PROJECT THAT DEMANDED ALL HER COMMITMENT. IN 1995 SHE EVEN APPEARED ON TELEVISION APPEALING FOR NEW ZEALANDERS TO HELP OUT IN ANY WAY THEY COULD.

>> I’M SURE THE SUPPORT IS THERE, I’M SURE THAT A LOT OF NEW ZEALANDERS WOULD LIKE TO DO SOMETHING AND REALLY ARE SCRATCHING THEIR HEADS AND WONDERING WHAT THEY CAN DO.

>> Narrator: BUT THE BOSNIAN MISSION PROVED TOO MUCH. SHE COULDN’T HOLD IT TOGETHER ANY LONGER. PHYSICALLY AND MENTALLY EXHAUSTED, SHE RETURNED TO NEW ZEALAND. IT WAS THEN THAT SHE STARTED TO REALIZE SHE WAS SUFFERING FROM MORE THAN JUST DEPRESSION.

>> MY HEART ACHES, MY SOUL BURNS. I CRAVE RELEASE. THE PAIN AT TIMES IS SO UNBEARABLE. WHEN I’M ALONE SUICIDAL THOUGHTS CONSUME ME.

>> Narrator: EVENTUALLY, JUST AS IT HAD BEEN FOR RACHAEL, SUICIDE SEEMED THE ONLY WAY TO PUT AN END TO THE CONSTANT MENTAL ANGUISH SHE WAS IN. IN 1998 MARIA MADE HER FIRST SUICIDE ATTEMPT.

>> I REMEMBER IT QUITE CLEARLY BECAUSE I WAS WATCHING TV WHEN ALL OF A SUDDEN I JUST COULDN’T STAND THE PAIN ANYMORE. SO I GOT A BOTTLE OF WHISKEY I’D PUT AWAY AND GATHERED A BOTTLE OF SLEEPING TABLETS. DAD FOUND ME SIX HOURS LATER.

>> Narrator: LIKE MARIA, RACHAEL WAS ALSO STRUGGLING TO COPE. IN BETWEEN BOUTS OF SELF HARM SHE WAS STILL CONTEMPLATING SUICIDE. FRIEND AND WORK COLLEAGUE NETA LEILUA REMEMBERS WHAT A TRAUMATIC TIME IT WAS.

>> I GUESS I COULD ALWAYS GUARANTEE EVERY TIME RACHAEL WOULD FIND HERSELF IN A HOLE SHE’D END UP SLITTING HER WRISTS OR DOING SOMETHING. SHE HAD SO MANY TIMES, I’VE LOST COUNT OF HOW MANY TIMES.

>> SOMETHING BAD WOULD GENERALLY HAVE TO HAVE HAPPENED FOR ME TO CUT. WHEN I SAY BIG, A BIG FALLING OUT IN A RELATIONSHIP, OR ANYTHING THAT WOULD MAKE ME FEEL TRAPPED OR AFRAID.

>> Narrator: BY THIS TIME, RACHAEL WAS ON MEDICATION FOR DEPRESSION AND ANXIETY. EACH TIME SHE WAS IN A CRISIS SHE CALLED NETA.

>> I DON’T KNOW IF THIS WILL MAKE SENSE BUT AFTER A WHILE YOU JUST SWITCH OFF. I GUESS IN THE BEGINNING IT WAS VERY EMOTIONAL, AND USUALLY THE EMOTION TURNED INTO ANGER, AND I STARTED TO GET ANGRY.

>> Narrator: THEN, IN NOVEMBER 2001, RACHAEL CUT HERSELF SO BADLY NETA DECIDED IT WAS TIME TO TAKE LEGAL ACTION AND COMMIT RACHAEL AS A PSYCHIATRIC PATIENT.

>> I WAS VERY NUMB ABOUT IT ALL, SO TO ACTUALLY SIGN THE PAPERS I SORT OF DIDN’T HAVE ANY FEELINGS, I JUST WANTED TO DO IT. BUT THE HARDEST PART FOR ME WAS JUST WAITING AROUND FOR THEM TO TURN UP. SO RACHAEL WAS RESTING IN THE ROOM AND WE WERE WATCHING TV AND THAT’S ALL SHE THOUGHT WAS HAPPENING. SHE WAS REALLY SHOCKED WHEN THEY DID TURN UP BECAUSE THEY JUST SORT OF BARGED IN THE HOUSE, WENT AND GOT HER AND SORT OF GRABBED HER AND WE’RE TAKING YOU TO HOSPITAL INSTEAD OF THAT SORT OF STUFF. SO I FELT LIKE I HAD BETRAYED HER, AND THAT IF ANYTHING WAS PROBABLY THE HARDEST FOR ME.

>> Narrator: TODAY, NETA AND RACHAEL HAVE COME BACK TO HOSPITAL TO TALK ABOUT WHAT HAPPENED.

>> I THINK THE WORST TIME FOR ME WAS ACTUALLY SEEING THEM TAKE YOU AWAY KNOWING THAT IT WAS BECAUSE OF ME, THAT I HAD RUNG THEM.

>> I’M GLAD YOU DID IT.

>> ARE YOU?

>> YUP. YEAH, I AM, ABSOLUTELY. I OFTEN WONDER WHAT WOULD HAVE HAPPENED IF YOU DIDN’T ACTUALLY HAVE THE GUTS TO COMMIT ME. WHAT DO YOU RECKON?

>> YOU WOULDN’T BE HERE.

>> THAT’S PRETTY CLEAR, EH?

>> Narrator: THERE ARE MANY CAUSES OF BORDERLINE PERSONALITY DISORDER, ONE OF WHICH IS SEXUAL ABUSE. BOTH MARIA AND RACHAEL CLAIM TO HAVE BEEN SEXUALLY ABUSED AS CHILDREN.

>> I WAS ABUSED BY A WELL-KNOWN ENTITY. HE WAS STEREOTYPICAL OF A CHILD ABUSER IN THAT PEOPLE TRUSTED HIM AND THEY TRUSTED THEIR KIDS WITH HIM, AND HE REALLY FOOLED PEOPLE INTO THINKING HE WAS JUST A REALLY NICE GUY. BUT A BUNCH OF US KIDS KNEW QUITE DIFFERENTLY, IT WASN’T JUST ME. I REMEMBER IT WAS BAD, I REMEMBER IT. I HAD NO POWER. ANYONE THAT’S BEEN ABUSED WOULD PROBABLY TELL YOU THE SAME THING, IT’S JUST, IT’S SO OVERWHELMING. YOU DON’T WANT TO BREATHE, YOU DON’T WANT TO MOVE. YOU JUST WANT IT ALL TO GO AWAY, WANT THAT PERSON TO GO AWAY.

>> Narrator: AS MANY AS SEVENTY PERCENT OF PEOPLE WITH BORDERLINE PERSONALITY DISORDER HAVE BEEN SEXUALLY ABUSED AS CHILDREN. FOR MARIA DE SILVA IT HAD A DEEP AND LASTING EFFECT, DISRUPTING RELATIONSHIPS WITH MEN AND CAUSING INTERNAL TURMOIL. ?

>> Narrator: SEVENTY PERCENT OF WOMEN WITH BORDERLINE PERSONALITY DISORDER HAVE BEEN SEXUALLY ABUSED AS CHILDREN. MARIA DE SILVA CLAIMED SHE WAS ABUSED WHEN SHE WAS SEVEN BY AN OLDER SCHOOL BOY. IN DIARIES FOUND AFTER HER DEATH SHE WRITES:

>> I REALIZED HE MUST HAVE WATCHED ME BEFORE HE SET HIS TRAP. OH GOD, HE HAS GOOD AS EXTINGUISHED THE INNOCENT FRESH CHILD IN ME. HE CRUSHED THE BLOSSOMING BRIGHT FUTURE. I FEEL SO GUILTY, SO ASHAMED. IT WAS MY FAULT. IT HAD TO BE MY FAULT. I WENT WITH HIM, I DIDN’T REFUSE.

>> WHEN PEOPLE ARE ABUSED AS CHILDREN OFTEN WHAT HAPPENS IS THE ABUSER IS TELLING THE CHILD THINGS ABOUT THE CHILD’S EXPERIENCE THAT JUST AREN’T TRUE. FOR INSTANCE, THE ABUSER WILL BE TELLING THE CHILD THIS IS OK, YOU’RE ENJOYING THIS, THIS ISN’T A PROBLEM AND THIS IS FINE. ALL THINGS THAT ARE NOT TRUE. SO WHAT THE CHILD IS LEARNING THERE IS TO NOT RELY ON THEIR OWN EXPERIENCE, TO NOT TRUST THEIR EMOTIONS AND SO THEY END UP VERY VERY CONFUSED ABOUT THEIR OWN EMOTIONAL STATE AND THEIR OWN FEELINGS AND THEIR OWN THOUGHTS. AND THAT CONFUSION AND UNCERTAINTY AROUND EMOTIONS IS ONE OF THE KEY PROBLEMS IN BORDERLINE PERSONALITY DISORDER.

>> Narrator: TO THIS DAY RACHAEL KAVANAGH STILL HAS VIVID NIGHTMARES OF BEING SEXUALLY ABUSED AS A CHILD. IT’S SO BAD SHE TAKES SLEEPING PILLS EVERY NIGHT.

>> I HAVE POST-TRAUMATIC STRESS DISORDER FROM ABUSE, AND WITH THAT COMES INABILITY TO SLEEP, OR GO TO SLEEP AND NOT STAY ASLEEP, AND THEN ONCE YOU ARE ASLEEP THE NIGHTMARES, THAT WOULD FOLLOW.

>> Narrator: IT’S NOT JUST SEXUAL ABUSE THAT LEADS TO BORDERLINE PERSONALITY DISORDER. THE PERSONS TEMPERAMENT AND THEIR FAMILY ENVIRONMENT ARE ALSO IMPORTANT.

>> AS BEST AS WE CAN TELL THERE ARE TWO MAIN CAUSES OF BORDERLINE PERSONALITY DISORDER. THE FIRST ONE IS THE PERSON NEEDS TO HAVE A SENSITIVE TEMPERAMENT. THAT ON IT’S OWN IS NOT A BAD THING. IT JUST MEANS THAT THEY HAVE A CAPACITY FOR A WIDE RANGE OF EMOTIONS WHICH CAN LEAD TO A VERY KIND OF INTERESTING AND OFTEN CREATIVE LIFE. ON IT’S OWN IT’S NOT A PROBLEM, HOWEVER IF THAT’S COUPLED WITH AND ENVIRONMENT WHERE THE PERSON DOESN’T LEARN HOW TO APPRECIATE AND ADEQUATELY CONTROL THEIR EMOTIONS THEN THAT’S A REAL PROBLEM. A FAMILY ENVIRONMENT SAY WHERE THERE’S A LOT OF CONFLICT AND LOTS AND LOTS OF ARGUMENTS, WHICH IS OFTEN VERY DISTRESSING FOR YOUNG CHILDREN. SO A YOUNG CHILD IN THAT SITUATION MIGHT SAY TO THE PARENTS I’M FEELING BAD OR I’M UPSET. NOW, IF THE PARENTS RESPONSE IS TO TELL THE CHILD THAT EVERYTHING’S FINE AND THERE’S NOTHING TO BE UPSET ABOUT, WHAT THE PARENTS ARE TELLING THE CHILDREN IS APPARENTLY WRONG AND IT’S A VERY VERY CONFUSING THING FOR THE CHILD TO LEARN SO THEY DON’T LEARN TO VALUE THEIR OWN EMOTIONAL RESPONSES AND TO LEARN FROM THEM AND TO CONTROL THEM.

>> Narrator: AS WELL AS BEING SEXUALLY ABUSED, RACHAEL FEELS THERE WERE ALSO PROBLEMS AT HOME THAT CONTRIBUTED TO HER DISORDER. TODAY SHE’S GOING TO VISIT HER MOM, JOY. TOGETHER THEY’RE STILL TRYING TO WORK OUT WHAT WENT WRONG IN HER CHILDHOOD. RACHAEL IS THE YOUNGEST OF FOUR DAUGHTERS. HER FATHER LEFT WHEN SHE WAS A BABY SO JOY BROUGHT RACHAEL UP ON HER OWN.

>> RACHAEL HAD THIS FEAR OF BEING ABANDONED. YOU HAD TO THINK HOW YOU WERE GOING TO WORD A SENTENCE IN CASE SHE FELT REJECTED. ANY SIGN OF BEING PUSHED AWAY AT ALL WOULD START ON A, START HER DOWN A TRACK ACTUALLY OF, WELL YOU WOULD SAY MISBEHAVING, PLAYING UP, MANIPULATING.

>> THE REASON FOR THE MANIPULATION, THE REASON FOR THE CUNNING, IT WASN’T JUST BECAUSE I FELT LIKE IT. IT WAS OUT OF FEAR, IT WAS SPAWNED OUT OF FEAR. MOM WAS REALLY ALL I HAD AND THE FEAR OF LOSING HER WAS JUST, IT WAS HUGE.

>> Narrator: AS TIME WENT ON RACHAEL BECAME MORE AND MORE INSECURE.

>> I THINK AT THE TIME I WAS AMIST A LOT OF CONFUSION, THERE WASN’T REALLY ANYWHERE THAT I FELT SAFE TO GO, AND AT THAT POINT THAT COULD HAVE JUST BEEN ME AS I KNEW IT, OR AS A CHILD OR WHATEVER JUST GAVE UP TO A DISORDER, AND I BECAME VERY DISSOCIATIVE, DEPRESSIVE, VERY MOODY PRETTY MUCH FROM THERE.

>> I WAS NOT A PERFECT MOTHER, WHO IS? I MEAN YOU’RE NOT BORN A MOTHER, YOU LEARN AS YOU GO ALONG, AND THERE WERE MISTAKES. BUT I REALLY CANNOT SEE, OR COULDN’T SEE, THAT WHERE ANYTHING I HAD DONE COULD CAUSE SUCH A TRAUMATIC SICKNESS.

>> Narrator: WHILE FOR RACHAEL CHILDHOOD INSTABILITY SEEMS TO HAVE CONTRIBUTED TO HER DISORDER, FOR MARIA DE SILVA IT WAS A DIFFERENT SET OF PARENTAL CIRCUMSTANCES THAT LED TO HER ILLNESS. LIKE RACHAEL, SHE WAS THE YOUNGEST OF FOUR CHILDREN. HER BROTHER DENNY REMEMBERS THE JOY OF HIS ONLY SISTER BEING BORN.

>> WELL, WE WERE THREE HAPPY BROTHERS GROWING UP IN A LOVELY AREA. IT WAS A TYPICAL RURAL SITUATION OF NEW ZEALAND. SHE WAS IN A LOVELY FAMILY ENVIRONMENT, AND CARING AND LOVING PARENTS, AND CERTAINLY HAD THREE DOTING BROTHERS. SHE DIDN’T WANT FOR ANYTHING.

>> Narrator: IN FACT, SHE WAS CHERISHED AND SPOILED.

>> WELL BECAUSE OF MY PARENTS UNCONDITIONAL LOVE SHE DID TEND TO GET HER OWN WAY OVER MOST THINGS. THERE WERE TIMES WHEN SHE HAD MORE FREEDOM AND GOT AWAY WITH MORE THAN PERHAPS WE DID AS BROTHERS AND I DARE SAY THAT AT THE END OF THE DAY THAT DOESN’T HELP.

>> Narrator: WHAT MARIA’S PARENTS DIDN’T REALIZE WAS THAT BY SPOILING THEIR DAUGHTER THEY WERE LAYING THE SEEDS OF WHAT WOULD LATER ON BECOME A PSYCHOLOGICAL ILLNESS.

>> WHERE IT WOULD BE POSSIBLE FOR SPOILING TO CONTRIBUTE TO BORDERLINE PERSONALITY DISORDER IS, LET’S SAY FOR AN EXAMPLE, EVERY SINGLE TIME A CHILD HAD A STRONG EMOTIONAL RESPONSE, AND LETS’ SAY INITIALLY THE PARENTS SAYS NO, AND SO THE CHILD INCREASES THEIR EMOTIONAL RESPONSE, HAS A STRONGER AND STRONGER EMOTION UNTIL THE PARENT GIVES IN. SO WHAT’S ACTUALLY HAPPENING THERE IS THE CHILD IS BEING TAUGHT TO GET WHAT YOU WANT YOU HAVE TO HAVE STRONGER AND STRONGER AND STRONGER EMOTIONS. IF THAT HAPPENS AS A PATTERN OVER A CHILD’S LIFE THEY LEARN THAT THE ONLY WAY TO GET WHAT THEY WANT IS TO HAVE REALLY REALLY STRONG EMOTIONS. SOMETIMES PEOPLE CAN BEAR THAT WITH CHILDREN BUT WHEN ADULTS START TO BEHAVE LIKE THAT IT’S A REAL PROBLEM. HI JANEY, DO YOU HAVE YOUR DIARY CARD WITH YOU TODAY?

>> YEP, YOU MIGHT LIKE IT.

>> Narrator: PSYCHOLOGISTS LIKE DAVID SEMP BELIEVE THE ONLY WAY TO UNDO THESE UNDESIRABLE PATTERNS SET IN CHILDHOOD IS TO TEACH PEOPLE HOW TO REGAIN CONTROL OF THEIR EMOTIONS. HE DOES THIS THROUGH DIALECTICAL BEHAVIOR THERAPY, WHICH ORIGINATED IN AMERICA.

>> A TYPICAL EXAMPLE OF WHAT WE WOULD DO IN A THERAPY SESSION IS A CLIENT WOULD COME IN, THEY WOULD HAVE A RECORD WHICH THEY KEEP OF THEIR EMOTIONS DURING THE WEEK AND OF ANY TIMES DURING THE WEEK WHERE THEY SELF-HARMED OR USED DRUGS OR ANYTHING LIKE THAT. AND LET’S SAY, FOR EXAMPLE, SOMEONE HAD SELF-HARMED ONCE DURING THE WEEK, WE NEED TO LOOK AT HOW THAT HAPPENED, WHAT WERE YOU FEELING? WHAT LED UP TO THAT SELF-HARM? WHAT COULD YOU DO DIFFERENTLY?

>> Narrator: RACHAEL KAVANAGH IS ABOUT TO TRY DIALECTICAL BEHAVIOR THERAPY. SHE’S KEEN TO WORK ON HER FEARS OF ABANDONMENT AND FIND OUT WHY IT IS SHE’S SO JEALOUS EVERY TIME PARTNER SY LOOKS AT ANOTHER WOMAN. ?

>> Narrator: AFTER YEARS OF SELF-HARM AND TWO SUICIDE ATTEMPTS, RACHAEL IS GOING TO HER FIRST DIALECTICAL BEHAVIOR THERAPY SESSION WITH PRIVATE PSYCHOLOGIST SUE HARDING.

>> HI RACHAEL, NICE TO SEE YOU.

>> Narrator: TODAY, THEY’RE LOOKING AT WHY RACHAEL FEELS SO JEALOUS OF HER PARTNER SY EVEN GLANCES AT ANOTHER WOMAN.

>> A GOOD EXAMPLE WOULD PROBABLY BE WE WERE IN COWTON AND A WOMAN WALKED TOWARDS HIM AND I WAS JUST IN FRONT OF HIM, AND I LOOKED AROUND AND I COULD SEE HIM LOOKING AT HER, AND IT WAS JUST FROM ZERO TO, YOU KNOW, A HUNDRED MY EMOTIONS JUST CAME, YOU KNOW, UP. I FELT MYSELF STARTING TO DISSOCIATE AND RAGE AT THE SAME TIME.

>> SO YOU TURN AROUND AND YOU SAW THE WOMAN, AND WHAT WENT THROUGH YOUR MIND THEN?

>> DOES HE KNOW HER? ARE THEY SEEING EACH OTHER? HE DOESN’T LOVE ME. HE’S GOING TO LEAVE ME.

>> AND DID YOU DO ANYTHING AT THAT POINT?

>> I LOOKED AT HIM AND GAVE HIM AN AWFUL LOOK.

>> AND WHAT WAS THE FEELING THAT WENT WITH THAT?

>> ANGER WENT WITH THAT ONE.

>> Narrator: SUE HELPS RACHAEL TO UNDERSTAND HER EMOTIONAL RESPONSE TO THE SITUATION, AND TOGETHER THEY EXPLORE NEW WAYS IN WHICH RACHAEL CAN DEAL WITH HER EMOTIONS. IT WILL TAKE TIME TO LEARN HOW TO DO THIS.

>> WHAT’S SOMETHING THAT YOU COULD HAVE DONE DIFFERENT? WHAT’S SOMETHING THAT WOULD HAVE HELPED YOU AT EACH POINT ALONG THE WAY?

>> FROM A PHYSICAL PERSPECTIVE I THINK THAT I COULD HAVE DONE, BECAUSE AS SOON AS I SAW THE TWO PEOPLE LOOKING AT EACH OTHER, YOU KNOW, I STOPPED BREATHING. AND MY WHOLE BODY TENSED, AND THE BREATHING KIND OF WENT FROM STOPPING TO JUST VERY, VERY SHALLOW.

>> RIGHT.

>> SO I THINK THAT I COULD HAVE DONE MYSELF A FAVOR THERE IN BEING MINDFUL OF HOW MUCH BREATH I WAS TAKING IN IN ORDER TO HELP MYSELF SETTLE DOWN. I THINK THAT MODEL OF THERAPY, IT GIVES YOU LONG TERM STRATEGIES. I THINK, I JUST, IT’S SO MUCH MORE HELPFUL THAN JUST MASKING THE BEHAVIORS WITH, WITH COMMUNICATIONS.

>> Narrator: ALTHOUGH DBT, OR DIALECTICAL BEHAVIORAL THERAPY IS A POSITIVE EXPERIENCE FOR RACHAEL, FOR MARIA DE SILVA IT SIMPLY DIDN’T MAKE SENSE.

>> DBT IS A HEAP OF SHIT. ANY THERAPY THAT REQUIRES THAT MUCH EXPLANATION AND LEAVES THE POOR PERSON SUBJECTED TO IT IN TOTAL CONFUSION HAS TO BE SUSPECT. I DON’T NECESSARILY WANT A LABEL ATTACHED TO ME, I JUST WANT SOMEBODY SOMEWHERE TO UNDERSTAND WHAT’S GOING ON WITH ME.

>> BREATH IN TOO, PUSH YOUR TUM UP, PUSH YOUR TUM UP.

>> Narrator: TAKING ON SUE HARDING’S ADVISE, RACHAEL HAS DECIDED SHE NEEDS TO LEARN NEW SKILLS TO DEAL WITH HER EMOTIONS, ONE OF WHICH IS TO LEARN TO BREATH PROPERLY SO SHE CAN CALM HERSELF IN MOMENTS OF PANIC. SHE’S COME TO SEE TANYA CLIFTON SMITH AT BREATHING WORKS. HERE, TANYA IS TEACHING RACHAEL HOW TO BREATH CORRECTLY. BUT WHILE LYING ON THE BED RACHAEL HAS A PANIC ATTACK ABOUT HER CHIN BEING FILMED FROM AN UNFLATTERING POSITION.

>> OH GOD, I DON’T LIKE THE CAMERA AT THAT ANGLE.

>> ARE YOU OK?

>> BECAUSE OF MY SELF IMAGE I HAD A VISION, IF YOU LIKE, OF HOW I MUST LOOK RIGHT NOW AND ALL I COULD SEE WAS THIS DOUBLE CHIN ALMOST COVERING UP TO MY NOSE, AND I JUST KEEP SEEING IT AND THE PANIC AND THE BREATHING STOP FIRST, AND THE PANIC CEDED AND THE EYES WELL UP.

>> ARE YOU ALRIGHT? OH, I KNOW, I KNOW. LET IT GO, JUST LET IT GO. THAT IS COMMON. HOW DO YOU FEEL?

>> BETTER. PANIC ATTACKS WITH ME HAPPEN VERY VERY QUICKLY.

>> Narrator: MARIA DE SILVA WAS ALSO SUFFERING FROM PANIC ATTACKS AND ANXIETY AFTER HER MOTHER DIED. IN SEPTEMBER 2000 SHE MADE THIS ENTRY IN HER DIARY.

>> I WENT TO VISIT MOM THIS AFTERNOON. I WANT SO BADLY TO BE WITH HER. I MISS HER TERRIBLY. I HAD A STRONG COMPULSION TO CRAWL INSIDE THE GRAVE TO BE WITH HER.

>> Narrator: THEN, ANOTHER BLOW. SHE WAS DEVASTATED TO READ A REPORT OF HER CONDUCT AT FRIENDSHIP HOUSE, A PLACE SHE WORKED AS A VOLUNTEER AS PART OF A MENTAL HEALTH CERTIFICATE SHE WAS TAKING.

>> MARIA IS CLEARLY UNABLE TO MAINTAIN HER PERSONAL BOUNDARIES. SHE DEMONSTRATES POOR IMPULSE CONTROL AND ANGER MANAGEMENT. HER TIME MANAGEMENT AND ABILITY TO PRIORITIZE ARE ALSO UNSATISFACTORY.

>> Narrator: AT HOME, RACHAEL IS WAITING FOR THE RESULTS OF HER BUSINESS COMMUNICATION PAPER, PART OF A FOUR YEAR PSYCHOLOGY DEGREE SHE’S DOING BY CORRESPONDENCE.

>> I FEEL AS THOUGH I FAILED IT MISERABLY, SO I’M JUST HAVING A LOOK TO SEE IF IN FACT I DID. OH, HOLD ON, HERE WE GO. WELL, IT WASN’T TOO BAD. I THOUGH I WOULD GET A ROUND ABOUT FORTY PERCENT IF I WAS LUCKY, BUT I’VE GOT SIXTY OUT OF A HUNDRED, SO IT WASN’T TOO BIG A FAILURE.

>> Narrator: RACHAEL’S LOW SELF-ESTEEM IS ALSO APPARENT IN THE WAY SHE PERCEIVES HERSELF PHYSICALLY. SHE HATES HER CHIN AND WANTS TO HAVE IT SURGICALLY ALTERED. TODAY SHE’S PREPARING TO SEE PLASTIC SURGEON TRISTAN DE CHALAIN.

>> I’M GOING TO GO GET A QUOTE FROM HIM TO SEE HOW MUCH IT’S GOING TO COST TO GET LIPOSUCTION IN MY CHIN. I’D LIKE TO KNOW WHAT IT FEELS LIKE TO HAVE A JAW LINE FOR A START. IT’S JUST SOMETHING THAT HAS BEEN, SOMETHING I’VE JUST REALLY HATED ABOUT MY FACE, AND JUST THE LONGEST TIME.

>> RACHAEL KAVANAGH. HI RACHAEL. TRISTAN DE CHALAIN, I’M VERY PLEASED TO MEET YOU. COME THROUGH WITH ME. SORRY WE’RE STILL DECORATING. IT’S BEEN THREE WEEKS SINCE THEY BUILT IT BUT THEY HAVEN’T FINISHED. OK, LET’S SEE WHAT WE HAVE. WHAT I’D LIKE YOU TO DO IS TAKE THAT MIRROR, PICK IT UP, AND YOU SHOW ME WHERE THE AREA OF CONCERN IS.

>> ALRIGHT, IF I’M LIKE THAT, IT’S THAT PART THERE THAT HANGS DOWN. FROM THE SIDE, IT’S FROM THERE DOWN, THIS HANGING PART HERE. WHEN I GO LIKE THAT I LIKE IT CONSIDERABLY BETTER THEN IT JUST SORT OF HANGING. IT’S JUST SORT OF, I’VE PROBABLY GOT A NICE JAW LINE UNDER THERE SOMEWHERE.

>> SURE. SO WHAT I NEED TO DO IS MAKE A LITTLE INCISION JUST UNDER THERE, GET ONTO THE MUSCLE, AND YOU TIGHTEN THE MUSCLE ACROSS THE MIDDLE LINE, TAKE OUT SOME OF THE FAT BOTH ABOVE AND BELOW THE MUSCLE, AND THEN TAKE SOME OF THIS SKIN UP THIS WAY.

>> IT SOUNDS WONDERFUL.

>> I COULD PROBABLY SHOW YOU A PICTURE OF SOMEBODY WHO’S HAD SOMETHING SIMILAR.

>> WOW!

>> SO THAT’S A NECK LIFT ONLY. THAT’S THE SORT OF THING THAT I WOULD SUGGEST FOR YOU. OK, COME ON. I’LL TAKE YOU THROUGH TO MEET WENDY, AND WE’LL MAKE A DAY TO SEE YOU AGAIN SHOULD YOU DECIDE TO PROCEED.

>> OH I THINK I WILL BE.

>> OK, GOOD.

>> AWESOME! THANK YOU SO MUCH.

>> IT WAS NICE MEETING YOU.

>> OK, YOU TOO.

>> HI RACHAEL. IF YOU’D LIKE TO FILL THAT OUT FOR ME.

>> Narrator: BACK IN RECEPTION, RACHAEL’S WAITING TO FIND OUT HOW MUCH IT WILL COST. IT’S A TENSE MOMENT. SHE’S DESPERATE TO GO AHEAD WITH IT, BUT IT’S ALL DOWN TO COST. IF IT’S TOO EXPENSIVE SHE’LL BE BITTERLY DISAPPOINTED. RACHAEL KAVANAGH HAS JUST BEEN FOR A CONSULTATION WITH PLASTIC SURGEON TRISTAN DE CHALAIN. SHE WANTS TO SURGICALLY ALTER HER NECK AND CHIN. THE ONLY PROBLEM IS CAN SHE AFFORD IT?

>> THE ENTIRE COST FOR EVERYTHING THAT YOU SAW ME IS SIXTEEN THOUSAND TWO HUNDRED DOLLARS. THERE IS JUST ABSOLUTELY NO WAY I CAN AFFORD SIXTEEN THOUSAND DOLLARS ON MY FACE. IT’S A HUGE BLOW. IT IS JUST, THAT’S A HUGE BLOW. I WAS JUST SO LOOKING FORWARD TO IT, BUT THESE, I GUESS I’VE JUST GOT TO STICK WITH THE SAME FACE.

>> Narrator: RACHAEL’S DISAPPOINTMENT IS GOING TO BE HARD TO COME TO TERMS WITH. MARIA DE SILVA WAS ALSO ABOUT TO FACE A MAJOR SETBACK THAT WAS TO PROVE A TURNING POINT IN HER LIFE. IN 2001, SHE SET UP A TRUST TO RAISE AWARENESS ABOUT PEOPLE WITH BORDERLINE PERSONALITY DISORDER. CHRISTINE WHITTLE, AFTER WHOM SHE NAMED THE TRUST, HAD BPD AND HAD KILLED HERSELF A YEAR BEFORE. MARIA WAS ORGANIZING A CHARITY BALL TO RAISE MONEY FOR THE DISORDER. SHE HAD WRITTEN A SONG ABOUT THE ILLNESS WHICH SHE WANTED TO SING TO A HOST OF CELEBRITIES. WHEN SHE FAILED TO SELL ANY TICKETS THE TRUSTEES BECAME CONCERNED AND PUT THE PROJECT ON HOLD. THE DELAY PUT THE PROJECT IN JEOPARDY. THEN, ON THE FIFTEENTH OF JULY, 2003, MARIA GOT A PHONE CALL FROM THE CARLTON HOTEL SAYING THEY WERE PULLING OUT. SHE WAS FURIOUS. SHE PHONED HER CASE WORKER TWICE. THE CALLS WERE RECORDED IN MARIA’S CASE NOTES.

>> I GOT A PHONE CALL AT FIVE-THIRTY FROM MARIA, YELLING AND SCREAMING. SHE TOLD ME SHE WOULDN’T BE HERE TOMORROW. I SAID VERY LITTLE, AS I LEARNED FROM PAST EPISODES IT JUST MAKES MATTERS WORSE.

>> Narrator: BUT THIS WASN’T JUST A CRY FOR HELP. MARIA MADE TWO MORE PHONE CALLS SAYING SHE WOULDN’T BE AROUND THE NEXT DAY. THEN SHE PUT HER DRASTIC PLAN INTO ACTION.

>> FROM NINE P.M. TO ELEVEN TWENTY, THIRY-FIVE P.M. WHEN SHE WROTE HER LAST WILL AND TESTAMENT AND LEFT IT ON THE COMPUTER THERE WAS TWO AND A HALF HOURS WHEN SOMEONE COULD HAVE GONE AND RAN AND CHECKED ON HER.

>> Narrator: AT ELEVEN-O-CLOCK, MARIA DE SILVA LEFT THE HOUSE AND DROVE TO AOTEA SQUARE. SHE LEFT THE CAR OUTSIDE THE POLICE STATION AND MADE HER WAY DOWN TO THE SQUARE. AFTER HER SETBACK AT THE PLASTIC SURGEONS, RACHAEL’S BOUNCED BACK. SHE’S GOT EVERY REASON TO BE HAPPY. ON SATURDAY SHE’S GETTING MARRIED TO SY. ALTHOUGH SHE’S LOOKING FORWARD TO THE WEDDING, SHE’S APPREHENSIVE TOO. MANY OF THE RELATIVES DON’T KNOW ABOUT HER DISORDER.

>> THE REASON I CHOSE THIS DRESS WAS BECAUSE IT COVERED MY SCARS QUITE NICELY. I HAVE ABOUT TWO HUNDRED ON MYSELF, AND I DIDN’T WANT FOR THE NEW RELATIVES AND PEOPLE TO KNOW THAT ABOUT ME.

>> Narrator: FOR RACHAEL, THE BIG DAY IS HERE. SY IS WAITING FOR HER TO ARRIVE.

>> I MET MY PARTNER, AND I LET MY GUARD DOWN, WHETHER IT BE BECAUSE HE’S JUST GOT AN AWESOME PERSONALITY, OR QUITE WHAT IT WAS, AND I ALLOWED MYSELF TO BE LOVED. AND WHEN I WAS, IT WAS JUST A COMPLETELY ENTIRELY NEW EXPERIENCE AND SUCH A POSITIVE ONE THAT I STARTED TO SLOWLY REBUILD, AND THE EMOTION, I STARTED TO WANT TO LOVE. SO IT WAS ALMOST LIKE A REBIRTH.

>> TODAY SY, I JOIN MY LIFE TO YOURS.

>> TODAY SY, I JOIN MY LIFE TO YOURS.

>> LET ME BE THE SHOULDER YOU LEAN ON.

>> LET ME BE THE SHOULDER YOU LEAN ON.

>> THE ROCK ON WHICH YOU REST.

>> THE ROCK ON WHICH YOU REST.

>> THE COMPANION OF YOUR LIFE.

>> THE COMPANION OF YOUR LIFE.

>> WITH YOU I WILL WALK MY PATH.

>> WITH YOU I WILL WALK MY PATH.

>> FROM THIS DAY FORWARD.

>> FROM THIS DAY FORWARD.

>> UNTIL WE ARE PARTED BY DEATH.

>> UNTIL WE ARE PARTED BY DEATH.

(applause).

>> Narrator: MARIA DE SILVA’S LAST MOMENTS ARE CAUGHT ON CCTV. AT ONE THIRTY-FIVE SHE SET FIRE TO HERSELF. AMBULANCES RACED TO SAVE HER, BUT IT WAS TOO LATE. SHE DIED LATER IN HOSPITAL. MARIA’S BROTHER, DENNY, IS DEVASTATED BY HIS SISTER’S DEATH. HE DOESN’T ACCEPT AS OTHERS DO THAT SHE MEANT TO KILL HERSELF, NOT LEAST BECAUSE SHE CALLED THREE PEOPLE, INCLUDING HER CASE WORKER, THE NIGHT SHE DIED, WARNING THEM SHE WOULDN’T BE THERE THE NEXT DAY.

>> IF SOMEBODY HAD REACTED TO HER LAST CALLS IN THAT LAST TWENTY-FOUR HOURS, CERTAINLY THE EVENING BEFORE SHE DIED, SHE’D BE STILL ALIVE, WOULDN’T SHE, OR SHE MIGHT HAVE LIVED ANOTHER DAY, OR SHE MIGHT HAVE LIVED ANOTHER WEEK. SHE MIGHT HAVE LIVED ANOTHER MONTH. SHE MIGHT STLL BE ALIVE TODAY.

>> Narrator: HE’S ESPECIALLY QUESTIONING WHY THOSE IN CHARGE OF HER CARE AND WHO KNEW OF HER DISTRESS DIDN’T DO MORE.

>> HOW MUCH MORE GRAPHIC DETAIL DID THEY NEED TO UNDERSTAND THAT THIS WOMAN WAS REALLY CLOSE TO ACTUALLY JUMPING OVER THE CLIFF? THAT’S WHAT I DON’T UNDERSTAND.

>> Narrator: COUNTIES MANUKAU DISTRICT HEALTH BOARDS SAY ALL THE CORRECT PROCEDURES TO HELP MARIA WERE IN PLACE THAT NIGHT, AND MARIA WAS AWARE OF THEM. BEST FRIEND AND COMMUNITY CARER RAEWYN BIEL WAS ANOTHER PERSON MARIA RANG ON THE NIGHT SHE DIED. COULD SHE HAVE DONE MORE?

>> I THINK WE COULD ONLY STOP IT FOR SO LONG. YOU SORT OF KNOW THAT ONE DAY IT’S GOING TO HAPPEN, AND YOU’RE JUST NOT GOING TO BE THERE. I GUESS THIS WAS THE TIME.

>> Narrator: FOR RACHAEL, IT’S TIME TO MAKE AMENDS FOR THE HURT SHE’S CAUSED HER MOTHER IN THE PAST, AND LOOK TO A BRIGHTER FUTURE TOGETHER.

>> I AM FOREVER THANKFUL FOR WHAT MY MOM DID AND WHAT SHE SAW, AND WHAT SHE PUT UP WITH.

>> WE CAN SYMPATHIZE…

>> I’M SORRY.

>> YOU DON’T HAVE TO BE SORRY BECAUSE I JUST WANT YOU TO KNOW THAT I AM SO PROUD OF YOU. I SAW THE FIGHT AND I SAW THE BATTLE, AND I KNEW IT WAS HARD, AND I KNEW YOU WERE GOING THROUGH HELL, BUT YOU STILL KEPT ON FIGHTING. AND YOU WON, YOU WON. AND YES, I WOULD LIKE PEOPLE OUT THERE TO KNOW THAT THERE IS LIGHT AT THE END OF THE TUNNEL. IT’S JUST THE COMING THROUGH THAT’S THE HARD PART. AND IT’S WORTH IT, IT’S WORTH IT, BECAUSE YOU GET YOUR DAUGHTER, YOU GET YOUR CHILD BACK AGAIN. ?

 

Full Program

Operant conditioning emphasizes the __________ of behavior.

Question

Question 1 Which is least likely to be considered an indication of problem behavior in youth?

A.A behavior is excessively intense.

B.A behavior is qualitatively atypical.

C.A behavior is unusual but of no harm to anyone.

D.A behavior is exhibited in inappropriate settings.

Question 2 Alicia’s mother is worried because although Alicia’s behavior seems much like that of her peers, Alicia misbehaves relative to the setting she is in. Alicia’s mother is concerned that her daughter is not meeting

A. gender norms.

B. situational norms.

C. regression norms.

D. developmental norms.

Question 3 Human development is best viewed as

A. always occurring in stages.

B. changes in individuals due to environmental influences.

C. change in persons over time due to the interactions of many variables.

D. quantitative rather than qualitative growth.

Question 4

________________is another term for cause.

A. Effect

B. Theory

C. Paradigm

D. Etiology

Question 5 Risk factors

A. can be biological, psychological, or social.

B. are best conceptualized as being mostly biological.

C. are best conceptualized as characteristics of the individual.

D. are best viewed as independent factors that do not affect each other.

Question 6 Resilience is best defined as

A. a person’s characteristics that protect him or her from negative outcomes.

B. characteristics of the environment that protect a person from negative outcomes.

C. one or more factors that work with risk factors to produce a disorder.

D. one or more factors that protect a person in the presence of risk factors for a disorder.

Question 7

______________ refers to the processes that facilitate or hinder reactivity.

A. Goodness of fit

B. Self-regulation

C. Inhibition

D. Emotion

Question 8 Norepinephrine, serotonin, and dopamine are all examples of

A. bodily humors.

B. synaptic clefts.

C. neurotransmitters.

D. growth hormones.

Question 9 A toxic substance that may cause damage to the developing fetus is known as a

A. placenta.

B. barrier.

C. teratogen.

D. diathesis.

Question 10 Operant conditioning emphasizes the __________ of behavior.

A. unconscious aspects

B. consequences

C. interpretation

D. symbolism

Question 11 A depressed child views herself as less capable than her peers, whereas others do not view her this way. This is an example of

A. cognitive deficiency.

B. cognitive distortion.

C. thought disorder.

D. protective cognition.

Question 12 The most common form of child maltreatment is

A. emotional maltreatment.

B. neglect.

C. physical abuse.

D. sexual abuse.

Question 13 Why is it valuable to randomly select persons from the population of interest to participate in a research study?

A. Participants will feel they have been treated fairly, which can positively affect the study.

B. It increases the chance that the participants will represent the population.

C. It ensures that the participants will be of the same age.

D. It ensures reliability of measurement.

Question 14 ______________ assumes that participants have the right to control the degree to which personal information can be disclosed.

A. Informed consent

B. Beneficence

C. Non maleficence

D. Confidentiality

Question 15 If an individual is given a global assessment of functioning score of 30, which of the following is likely true?

A. The individual is exhibiting superior functioning.

B. The individual has some impairment in almost all areas.

C. The individual has generally good functioning with difficulty in only a couple of areas.

D. The individual is uncooperative and functioning cannot be determined.

Question 16 The term comorbidity refers to

A. a child meeting the criteria for more than one disorder.

B. two children in a family having the same disorder.

C. a child and parent having the same disorder.

D. two disorders having some of the same cause.

Question 17 _______________ refers to groups of disorders that are thought to share certain psychological and biological qualities.

A. Dimension

B. Classification

C. Spectrum

D. Syndrome

Question 18 A ________________ describes behaviors that tend to occur together.

A. diagnosis

B. syndrome

C. dimension

D. spectrum

Question 19 Which of the following statements regarding diagnostic labels is part of the concern with the impact of such labeling?

A. Diagnostic labels have a social impact as well as a clinical and scientific purpose.

B. Diagnostic labels do not influence observer expectations regarding the child who is labeled.

C. Diagnostic labels do not help to provide adults with an explanation or understanding of the child’s behavior.

D. Diagnostic labels do not lead to generalizations about the characteristics of all children receiving a particular label.

Question 20 Which of the following is accurate regarding the diagnosis of social phobia in an adolescent?

A. The adolescent will not recognize that the fear is excessive or unreasonable.

B. The distinction between normal and abnormal social anxiety may be particularly difficult.

C. The disorder is likely overdiagnosed in adolescents diagnosed in this age group.

D. Young people with social anxiety are typically on anxious in one or two social situations (e.g., meeting new people or performing in front a group).

Question 21

Heather is a 13-year-old who has been diagnosed with generalized anxiety disorder. It is likely that Heather

A. exhibits anxiety concerning one particular kind of situation.

B. has excessive concerns with her competence and performance.

C. has symptoms that are likely to be transitory (short term).

D. does not show other signs of significant impairment in her functioning.

Question 22 A(n) __________ is a discrete period of intense fear or terror that has a sudden onset and reaches a peak quickly.

A. anxiety attack

B. compulsion

C. panic attack

D. parathesia

Question 23 A(n) _______ is usually defined as an event outside of everyday experience that would be distressing to almost anyone.

A. panic attack

B. obsession

C. trauma

D. parathesia

Question 24 In order to diagnose OCD:

A. obsessions must be related to dirt and germs.

B. the obsessions and compulsions must be highly time consuming and interfere with life.

C. a child must have both obsessions and compulsions.

D. parents and children must agree that there is a problem.

Question 25 The most prevalent form of affective disorder among children and adolescents is

A. bipolar disorder.

B. cyclothymia.

C. dysthymia.

D. major depressive disorder.

Question 26 Depression with onset in ______ is most similar to adult forms of the disorder.

A. preschool

B. early school age

C. preadolescence

D. later adolescence

Question 27 The ____________ perspective attributes depression to low social competence, cognitive distortions, and low self-esteem.

A. psychoanalytic

B. cognitive behavioral

C. biological

D. family systems

Question 28 Susie’s mother abandoned her when she was 5 years old. Now at age 8, Susie thinks that she has little control over her environment. This is an example of:

A. anaclitic depression

B. learned helplessness

C. hopelessness

D. projection

Question 29 Regarding pharmacotherapy for childhood depression,

A. research supports the superiority of antidepressant medications in prepubertal children and adolescents.

B. antidepressant medications have well-established guidelines for administration with youngsters.

C. antidepressant medications are established as being safe for youngsters.

D. selective serotonin reuptake inhibitors are the medications most likely to be recommended.

Question 30 Ana is 17 years old and experiencing a persistent elevated mood. She feels like her thoughts are racing. Ana reports that she needs less sleep than she did before. She has been buying an extensive new wardrobe and has been involved in sexual relations with several older men. She is doing poorly in school and is in conflict with her family and friends. Ana would most likely be diagnosed, according to DSM-V, as experiencing a

A. major depressive episode.

B. manic episode.

C. dysthymic episode.

D. masked depressive episode.

Question 31 The term delinquency is primarily employed to refer to

A. a juvenile who has committed an act that would be illegal for adults as well.

B. a juvenile who has committed an act that is illegal only for juveniles.

C. a juvenile who has committed an act that would be illegal for adults as well or an act that is illegal only for juveniles.

D. a psychological condition – it refers only to a juvenile who has committed an illegal act because of emotional problems.

Question 32 An 11-year-old youngster has, for about a period of one year, frequently exhibited the following behaviors: loses temper, refuses to follow requests or rules, deliberately annoys others, and easily annoyed. He would likely receive a DSM-IV diagnosis of

A. attention-deficit disorder.

B. oppositional-defiant disorder.

C. overt conduct disorder.

D. early-onset conduct disorder.

Question 33 Bobby, a 13-year-old boy is seen at a clinic. He displays the following behaviors: deliberate destruction of others’ property, lying to obtain favors, staying out at night without permission, and frequent truancy from school. These behaviors have all been present during the past year and are ongoing. His parents report that this pattern began when Bobby was 9 years old. Bobby would likely receive a DSM-V diagnosis of

A. oppositional-defiant disorder.

B. conduct disorder, childhood-onset.

C. conduct disorder, adolescent-onset.

D. oppositional-conduct disorder.

Question 34 Which of the following is an example of relational aggression?

A. Purposefully leaving a child out of some activity

B. Spitting on a another child

C. Threatening to beat up another child

D. Shoving a child into a locker

Question 35 The adolescent-onset pattern of conduct-disordered behavior

A. is a less common developmental path than the childhood-onset pattern.

B. is less likely to result in arrest than someone the same age with a childhood-onset pattern.

C. is characterized by less aggressive behavior than the childhood-onset pattern.

D. has a larger proportion of males than the childhood-onset pathway.

Question 36 Executive functions include

A. planning and organizing.

B. respiration.

C. heart rate.

D. hunger and thirst.

Question 37 Which subtype of ADHD is characterized by lethargic, daydreamy behavior?

A. Predominantly inattentive

B. Predominantly hyperactive

C. Predominantly impulsive

D. Combined type

Question 38 Which class of medications is most commonly used in treating attention-deficit hyperactivity disorder?

A. Antidepressants

B. Antipsychotics

C. Tranquilizers

D. Stimulants

Question 39 Jimmy has been diagnosed with expressive language disorder. We would thus expect Jimmy

A. to have problems in understanding what others say to him.

B. to speak in simplified, sometimes incorrect, sentences.

C. to have age-appropriate vocabulary.

D. to respond atypically to the speech of others, almost as if he were deaf.

Question 40 Which of the following is an example of a receptive language skill?

A. Babbling

B. Combining vowel sounds

C. Using pronouns

D. Following commands

Question 41 The most appropriate time for identifying writing disorder probably is

A. when the child begins to try to draw and color.

B. when the child enters school, that is, about five years of age.

C. about 8 years of age.

D. about 14 years of age.

Question 42 Assessment of learning disabilities

A. usually occurs in mental health clinics and hospitals.

B. usually occurs by preschool age.

C. requires a battery of tests to evaluate general intelligence and specific academic skills and achievements.

D. typically has placed the most emphasis on evaluating the child’s motivation and social environment.

Question 43 Danny displays mild intellectual disability. Thus, Danny

A. has an IQ in the 35-40 to 50-55 range.

B. will probably achieve no more than second grade academic skills.

C. will probably attend a residential school.

D. will probably achieve adult vocational and social skills for self support.

Question 44 Project Head Start is an example of a(n)

A. direct instruction program.

B. genetic mapping project.

C. early intervention program.

D. job placement program.

Question 45 Research on the developmental course of autism has revealed that

A. for most children the symptoms of autism are not evident until about age 6.

B. regression occurs in less than 5% of cases.

C. symptoms rarely persist into adulthood and most individuals with autism live independently.

D. higher intellectual ability is associated with better outcomes.

Question 46 Asperger’s disorder is characterized by:

A. significant language delay.

B. deficits in intelligence.

C. problems in social interaction.

D. adaptive behavior deficits in all areas.

Question 47 An example of a positive symptom of schizophrenia is

A. lack of emotion.

B. lack of goal-directed behavior.

C. disorganized speech.

D. language that contains little information.

Question 48 Obstructive sleep apnea is

A. rare in children in adolescents.

B. treated with stimulant medication.

C. easily recognizable by parents and professionals.

D. characterized by loud snoring, pauses and difficulty breathing, restlessness and sweating during sleep.

Question 49 Which of the following interventions for the problems of bedtime refusal, difficulty falling asleep, and nighttime wakenings are supported by research?

A. Punishment

B. Bedtime routines.

C. Scheduled awakenings

D. Pharmacological treatments.

Question 50 Current knowledge regarding the etiology of obesity suggests that

A. psychological factors are primary.

B. biological factors are primary.

C. social factors are primary.

D. the causes are probably multiple and complex.

 

 

Was it ethical to do the prison study in the way that Zimbardo conducted it?

Each week assignment most be between 300 and 400 words.

 

Week 5 Memory
A great deal of controversy has surrounded the phenomenon of “false memory syndrome” and the implications that it has had in our society, particularly in the legal realm. One of the most influential psychologists in the area of memory and eye witness testimony is Dr. Elizabeth Loftus, who has spent three decades as a research psychologist and memory expert in legal cases. To learn more about the controversy surrounding “false memory syndrome,” visit the online LA Weekly website at
http://www.laweekly.com/2004-08-19/news/memory-and-manipulation/ to read the article, “Memory and Manipulation.”

Based on the points that the Loftus article brings up and our textbook readings this week respond to the following:
What kind of implications do particular limitations of human memory have on the use of eye-witness testimony in criminal and civil court cases?

 

 

 

Week 6
The Stanford Prison Experiment ( 5 messages – 5 unread ) New messages Hide Full Description

Below are the Week 6 Forum Topic instructions.  General posting requirements can be viewed by clicking the Week 6 Forum “View Full Description” link on the Forums screen under the heading “Forum General Posting Requirements”.
Our textbook discusses one of the most famous psychological experiments of all time, conducted by Dr. Philip Zimbardo and his colleagues at Stanford University. To read more of the details of this experiment, visit http://www.prisonexp.org. Take some time to watch the video on the Zimbardo Prison Experiment by clicking here. After reading about the experiment, exploring the website and watching the video, answer the following:

1. Was it ethical to do the prison study in the way that Zimbardo conducted it?  Why or why not?  Explain your position substantively.

In responding to the above, keep in mind that morals and ethics aren’t the same thing.  Morals are right vs. wrong behavior internal compasses that guide personal life decisions and are grounded in family beliefs, faith traditions, etc.  Ethics are standards of behavior established by a professional organization, such as the American Psychological Association.  You may have very strong feelings about whether the Zimbardo study was moral, but here we are discussing ethics.

2. How do the social psychology concepts of conformity and the power of the social situation that we are studying this week relate to what happened during the brief period of time that the prison study ran.  Where in the description of how the study unfolded did we see evidence of these concepts?

Ground your answer to the questions in #2 in our assigned readings for this week and think social psychology.  For example, the guards were given power over the prisoners and having power  may affect others’ obedience to one’s rules, but one can affect obedience one-on-one as we see in the Milgram study.  What we mean when we say “the power of the social situation” is the impact that being with others in a group setting, whether public or private, has on people’s behavior, such as the degree to which they conform to perceived norms.
Be sure to check before posting that you have answered all of the questions, that you are basing your statements on concepts from textbook readings where required and that your post meets the general posting requirements located under the “View Full Description” link below the main Forum heading.

Week 7
Psychological Disorders

This week we studied psychological disorders.  Which of the disorders covered in our textbook do you think would be the most challenging to have and why?  Which of its symptoms would prove the most difficult for you.  What what you most need from society if you had the disorder you selected?

Although any psychological disorder has challenges, here you must choose only one.  You don’t have to be a trained professional to answer this question; just think about what you believe would be challenging in general and particularly difficult about a particular disorder.

Because one never knows who might have a disorder (people with psychological disorders are in society, around us all the time), we always want to use respectful language and avoid words like “crazy” or “insane” or statements like, “That would be horrific to have” or “I would want society to put me away if I had that…”.  These are all words that have been used in past posts used with no intent to hurt others but which still can sting.

In preparation for this portion of the Week 8 Forum topic, you are encouraged to visit the site, Lost Among Us at http://lang.sbsun.com/projects/lostamongus/displayarticle.asp?part=6&article=art02_saida03
and learn about the case of Saida Dugally, a real-life woman who suffered from bipolar disorder until her tragic death in 2003. On this web resource you will find videos of her story and the time-line of her decline into mental illness, as well as journal excerpts and photos from her life.

Saida’s story is but one among many. According to the National Institutes of Mental Health (NIMH), an estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.

Assignment 1: LASA 2: Integrating Theories

Dropbox AssignmentAssignment 1: LASA 2: Integrating Theories

In this course, we have studied various approaches to therapy and explored the utility of each orientation with reference to the client.  For this assignment, take the perspective of a therapist working with clients. This will help you honestly assess your own development and more objectively evaluate the advantages and disadvantages of using an integrative approach to counseling. Answer each of the following questions thoroughly and provide examples where requested to substantiate your points.

  1. Do you think therapists should focus on becoming an expert in one particular counseling approach or should they try to become proficient in more than one approach? Provide an explanation for your answer and illustrate them with examples.
  2. Identify what the three most important characteristics of a successful counselor you consider to be. Describe how these characteristics can be developed or strengthened?
  3. Identify and describe some of the characteristics (from question 2) that are best developed in the counseling process with clients?  Support your points with examples? Identify and describe some areas of personal or professional development that would potentially be unethical for the counselor to develop in the counseling process with clients? Explain your rationale in detail and give examples.
  4. What are some of your own personal motivations and characteristics that may help or hinder you as a counselor (identify at least two)?
  5. What areas of your own personal and professional development need the most development before you will feel prepared to be an effective counselor (identify at least three)?
  6. What are two advantages and two disadvantages of practicing within the framework of one specific theory as opposed to developing a more integrative approach consisting of several therapies? Give a detailed description and rationale for both sides.
  7. What are the advantages and disadvantages of practicing within an integrated framework?
  8. Explain at least two techniques you would use in your treatment and describe how you would integrate these techniques in a therapy session.

Your paper should be double-spaced and in 12 point, Times New Roman font with normal one-inch margins, written in APA style, and free of typographical and grammatical errors. It should include a title page with a running head, an abstract and a reference page. The body of the paper should be no less than 5 and no longer than 8 pages in length. Submit your response to the M5: Assignment 1 Dropbox by Monday, February 13, 2017.

Assignment 1 Grading Criteria
Maximum
Points
Explained whether it is preferable to have an expertise in one counseling approach vs. multiple approaches with supporting examples.
24
Described at least three important characteristics of a successful counselor with suggestions of how each could be developed?
32
Described at least one characteristic that could be developed in the counseling process with clients and at least one that would be potentially unethical to develop in therapy with clients with supporting examples for each.
40
Identifies at least two personal motivations and characteristics and explained benefit or hindrance for each.
24
Identified and explained at least three areas of personal or professional development for being an effective counselor.
24
Described advantages and disadvantages of practicing from one specific theory vs. developing a more integrative approach.
40
Described advantages/disadvantages of practicing from an integrative framework
24
Identified the therapeutic approaches student would use as a therapist and described the techniques that would be integrated as a treatment approach
28
Style (8 points):  Tone, Audience, Word Choice
Organization (16 points):  Introduction, Transitions, Conclusion
Usage and Mechanics (16 points): Grammar, Spelling, Sentence structure
APA Elements (24 points): Attribution, Paraphrasing, Quotations
64
Total:
300