My guest on this episode of Psych Sessions is Daniel J. Fox (PhD). Dr. Fox has been specializing in the treatment and assessment of individuals with personality disorders for over 15 years in the state and federal prison system, universities, and in private practice. He is a licensed psychologist in the state of Texas and has published several articles on personality, ethics, and neurofeedback. He is the author of The Clinician’s Guide to Diagnosis and Treatment of Personality Disorders and the Antisocial, Borderline, Narcissistic and Histrionic Workbook Treatment Strategies for Cluster B Personality Disorders. His specialty areas include personality disorders, ethics, and emotional intelligence. Dr. Fox has been teaching and supervising students for over 15 years at various universities across the country, some of which include West Virginia University, Texas A&M University, University of Houston, Sam Houston State University, and Florida State University. He is currently a staff psychologist at the Federal Detention Center in Houston, Texas, Adjunct Assistant Professor at University of Houston, as well as maintaining a private practice that specializes in working with difficult clients. You can learn more about Dr. Fox at http://www.drdfox.com/
People with Borderline Personality Disorder have a strong sense of abandonment, and they are at greater risk to have a psychotic episode, which can further complicate matters, even if it's a brief psychotic break because of the increased risk of misdiagnosis. During the interview, we discuss how important it is to make an accurate diagnosis and focus on things like: intensive efforts to avoid being alone, pattern of unstable, intense interpersonal relationships, patterns in poor self-identity, recurrent suicidal behavior in response to a stressor, and the paranoia or disassociation which tends to be short lived without hallucinations. Dr. Fox also explains that when it comes to differentiating BPD from bipolar, it's important to look for triggers and behavioral responses. You typically see these triggers in BPD, not bipolar. But, again, it's imperative for a clinician to treat the individual, not a diagnosis. Good intakes, further exploring reporting concerns, and probing deeper are all ways to ensure an accurate diagnosis and effective treatment plan.
People with BPD experience changes in mood and behavior that can last anywhere from minutes to hours. It's a very difficult disorder to live with and manage, so it's critical that a diagnosis only be made by a licensed mental health professional. The good news is that BPD is treatable. And it's important for clinicians to see BPD as a dual construct, that is there is core content and surface content. Surface content being things like depression and anxiety. And core content being what' driving it, like fear of abandonment, empty self, variable self image and intense loneliness. Check out the podcast to learn more about Bipolar Personality Disorder.