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Psychologist Post-Test

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Questions:

1. What are three anger myths held by BPD clients?
2. What are three sources of anger in BPD clients?
3. What are three aspects that contribute to an angry BPD client’s sense of helplessness?
4. What are three activities used in the "Anger Journal"?
5. What are three types of should trigger thoughts?
6. What are three types of blaming trigger thoughts?
7. What are two techniques for reducing stress in the BPD client?
8. What are three steps that are beneficial in helping BPD clients prevent angry outbursts as a result of stress and underlying causes?
9. What are three techniques to avoid trigger escalation with BPD clients?
10. What are three characteristics of assuming behavior in BPD clients?
11. What are four stages of anger arousal that can be coped with using self-talk slogans?
12. What are three triggers of defensive anger?
13. What are three active response choices?
14. What are three passive response choices?

Answers:

A. thought process; low self-esteem; and isolation.
B. basic entry; four questions; and specific incidents.
C. finding a pattern; self time out; and self-inquiry.
D. "Scanning the Body" and "Stop and Breathe".
E. reassurance; triggering; physiological tension; and digressing.
F. learned responses in the amygdala; stress; and trigger thoughts.
G. ambiguous gestures; parataxic distortion; and warning signs.
H. anger is biochemical; anger is an instinct; and ventilation is healthy
I. black and white thinking; mind reading; and labeling.
J. identifying the problems; clarifying goals; and coping strategies.
K. predetermined rules; conditional assumptions; and punishment fallacy.
L. criticism; fear of unworthiness; and helplessness.
M. getting information; acknowledging; and withdrawal
N. expressing a specific need; negotiating; and ultimatums.


Questions

15. According to Gregory, what is the most common trap for therapists with a borderline client?
16. Why do some psychiatrists refuse to see borderline patients?
17. According to Chessick, what technique may easily be used with a borderline client by an untrained therapist as an excuse to permit a flattering kind of worship and massage for the narcissism of the therapist? 
18. What is the difference between aggressive and assertive behavior?
19. What is temperament? 
20. According to McKay, what is the difference between anger cycle one and anger cycle two? 
21. What are the three clusters that provide a framework for deciding on the appropriateness of couple therapy and the approach to utilize?
22. What are the four types of support for an anger management client?  
23. According to Bleiberg, what are the four triggers of self-mutilation and suicidal gestures in a BPD client?
24. What are two imagery techniques used with anger management clients?
25. What are the positive effects of anger? 
26. What is self-mutilation associated with, that causes self-mutilating borderline clients to manifest more primary process aggression?
27. What are some things to remember when working with someone who has co-occurring BPD and SUDs?

Answers

A. impulsive cluster, identity cluster, and affective cluster
B. 1. Anger gives you energy. 2. Anger helps you talk with others. 3. Anger gives you information. 4. Anger can motivate you to take control of your life 5. Anger can motivate you to take action toward resolving a problem.
C. The most common trap for therapists with a borderline client to infantilize patients by assuming they are helpless and totally incompetent and by giving excessive advice or reassurance. The therapist thereby creates a traumatic reenactment of loss of autonomy. Patients react to this approach with either an infantile regression or a passive- aggressive rebellion, e.g. sabotaging efforts to gain employment.
D. Borderlines are seen as provocateurs and expert manipulators that are "notorious for late-night irrelevant 'emergency' phone calls, no common sense, no redeeming qualities, no income, and no health insurance."
E. (1) attempts to restore the capacity to experience feelings in children haunted by emotional numbness; (2) efforts to escape unbearable anxiety and depression; (3) desires to punish previously idealized partners; or (4) maneuvers to evoke guilt and involvement.
F. The technique of Kohut, in which the idealization of the therapist is permitted over a long period of time so that the full transference involving the search for the idealized can develop. 
G. In cycle one, stress begets trigger thoughts. In cycle two, the trigger thoughts create a stress.
H. (a) emotional concern, (b) instrumental aid, (c) information, and/or (d) appraisal."
I. intense, unmodulated aggressive affects
J. ". . . for aggressive behavior, accomplishment of end goals is usually at the expense of others; while for assertive behaviors, neither person is hurt… unless their goal achievement is mutually exclusive, both may succeed."
K. Image stopping and image substitution
L. a set of inherited traits that define the style of our emotional and behavioral responses—the tone and direction of our emotions.
M. strong but not rigid professional boundaries; commitment to self-care; awareness of how BPD may affect any kind of work with the individual; and knowledge about what skills the individual who has BPD is learning in therapy

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Additional post test questions for Psychologists, Ohio Counselors, and Ohio MFT’s