Personality Theory and Psych Assessment
Personality Theory and Psych Assessment

Why integrate a personality theory into your work? Well…
  • it helps organize the large amount of information testing can offer
  • it helps "flesh out" the "skeleton" explaining why the person is this way
  • it helps you go from conceptualization to plans for intervention
This isn't comprehensive by any stretch of the imagination… BUT… it might give you some starting ideas for what to do with a theory to integrate it into your work.
Psychodynamic Theory
This is helpful in explaining how problems interact, and how others can be helpful to the client. Basic ideas include:
  • multideterminism or multiple reasons for everything
  • making the unconscious conscious, freeing ego energy
  • analyzing projections for transference and counter-transference
  • the corrective emotional experience
  • soothing anxiety over forbidden desires and thoughts
  • internalizing an understanding therapist to replace the irrational superego
Adler's Individual Psychology
This offers some ways to explain pathology without pathologizing. We all begin life with a sense of inferiority and try to develop a sense of superiority
  • strive for mutual cooperation/interdependence, you are healthy and have social interest
    • dwell upon inferiority and you overcompensate, trying to dominate and overpower, leading to an unhealthy or mistaken style of life and neurosis
    • a fictional finalism is our unconscious goal which we think will make us happy
  • Karen Horney
    This model offers some good descriptions of how people cope. Emotional coldness toward children creates basic anxiety, a feeling of being isolated and helpless. Horney offers 10 resulting neurotic strategies in 3 basic trends to cope:

    The Compliant Types -- move towards, seek love and protection with a neurotic need:
    1) for affection and approval, but can't express wishes and say "No"
    2) for a partner who will take over their life
    3) to restrict their life within narrow borders, sometimes to avoid rejection
    The Aggressive Types -- move against, seek control and prestige with a neurotic need:
    4) for power, perhaps for a worthy cause, but it's tied to anxiety and inferiority
    5) to exploit others to feel safe… "do unto others before they can do unto you"
    6) for recognition and prestige, evaluating all things in terms of their prestige
    7) for personal admiration to compensate for self contempt
    8) for personal achievement
    The Detached Types -- move away, with a neurotic need:
    9) for self-sufficiency and independence
    10) for perfection
    Horney described 7 defenses:
    1) blind spots--ignores obvious contradictions and becomes numb to experiences
    2) compartmentalization
    3) rationalization
    4) excessive self control--suppression leads to greater resentment and control
    5) arbitrary rightness--doubt is intolerable, and a dogmatic and selfish style develops
    6) elusiveness--cannot be pinned down to anything to avoid being wrong
    7) cynicism--denies and devalues moral beliefs, projects this and suffers
    Object Relations
    This model is good for describing how a client's relationships work. OR deals with our internalized representations of others which we use to build a self. Examine a client's understanding of:
    1) various feelings
    2) conflicting and changing feelings
    3) different possible resolutions with understanding of impact to self and others

    Cognitive, Behavioral, and Learning Theory
    These models explain how a person organizes the information they gather about their world. Here's a few ideas:
    Rational Emotive Therapy - Albert Ellis
    A Something happens, B We think terrible things ("mustabatory fantasies"), C We get upset
    D We reconsider, E We are more rational about matters
    Depression and the Cognitive Triad - Aaron Beck
    • Global, Stable and Internal - "I can always get an A because I'm hardworking and smart"
    • External, Unstable, Specific - "It was an easy test; I got lucky and it won't happen again"
    Schema Theory
    • for People Like Us and People Unlike Us

      Higgins and others wrote about self-schemas like
    • the Ideal Me (who you want to be)
    • the Real Me (who you think you are)
    • the Ought Me (what you ought to be-depression if you fall short)
    • the Should Me (what you should be-anxiety if you fall short)
    • the Not Me (what you reject about yourself)
    Social Learning Theory
    • we learn by being reinforced but also by watching others (Bobo)
    • we can define our own reinforcers and direct our behavior (self-efficacy)
    • 2ndary gain and what maintains it, but also where was/is this useful?
    • confirmatory search strategies
    • what environment is the client trying to create

    Erickson and Psychosocial Development
    This model is nice for explaining life stages and struggles.
    Basic Trust Vs. Mistrust -- 1 basic trust with consistent nurturing care and hope, but basic mistrust with abuse or neglect (depression and even paranoia)

    Autonomy Vs. Shame -- 2 to 3 autonomy and will, but if too permissive or demanding parents, shame and doubt, with neurotic striving for competency (narcissistic injury, histrionic)

    Initiative Vs. Guilt -- 4 to 5 initiative and purpose if supportive home, otherwise guilt and inhibition, with a constricted life (too much purpose and no guilt leads to ruthlessness - ASP)

    Industry Vs. Inferiority -- 6 to 12 industry and competence or inferiority and inertia, like in self-efficacy, coping skills, success experiences to shape expectations

    Identity Vs. Role Confusion -- 13 to 19 identity and fidelity, "the ability to sustain loyalties freely pledged in spite of the inevitable contradictions." Marcia offers 4 resolutions:
    Identity Achievement - commitment and crises, healthy and flexible
    Moratorium - crises w/o commitment, may stay in crises and never develop identity
    Foreclosure - commitment w/o crises, buy parents'; resists growth, rigid and authoritarian
    Identity Diffusion - no commitment or crises, may never develop, pessimistic and bored with unfocused anger
    If this fails, identity diffusion; may join cults or hate groups and repudiate values, or the military and show fanaticism… may become psychotic and fragmented

    Intimacy Vs. Isolation -- 20 to 24 ability to be close, gaining love. Orlofky offers 6 resolutions:
    Intimate - forms relationships
    Preintimate - able but scared
    Stereotyped - superficially able/doesn't
    Pseudointimate - superficially able/does
    Isolated - unable and avoids
    Merger - enmeshed and sacrifices identity
    Failure leads to promiscuity, short mergers, or exclusion (reject relationships)

    Generativity Vs. Stagnation -25 to 64 a strong ego identity, creativity, and success leads to generativity and care, failure to stagnation or self-absorption and lack of meaning

    Ego Integrity Vs. Despair - 65 to death ego integrity and wisdom or despair and dread of death; maybe false integrity or presumption, or disdain for life

    New Theories
    Kohut and Self-Psychology
    Kohut offers a nice way to explain how someone became the way they are now:
    • a child needs 1) accurate mirroring from the parents that the child is good, 2) to idealize the parents and internalize protective and loving objects to sooth and calm, and 3) kinship
    • if lacking adequate care and empathy, the child is traumatized and develops a grandiose self with an intense need for admiration and praise
    • the parents must allow idealization first and later show how to love yourself with faults, providing optimal frustration to show the child is not all powerful but can still cope
    • failure will lead to arrest at a psychosexual stage for fear of re-experiencing rejection

      Disturbances to the Self
      Psychosis--protracted damage, few defenses, disorganized, chaotic, constantly threatened self
      Borderline States--self is in chaos, but has some defenses sometimes available
      Schizoid Personality--emotional distance through coldness, protecting from distortion of self
      Paranoid Personality--distance through hostility/suspiciousness, constantly fear exposure
      Narcissistic Personality Disorders--severe damage to self including subtypes:
    Understimulated Self--prolonged lack of stimulating responsiveness from parents, experiences self as boring and apathetic, and seeks stimulation to relieve their deadness
    Fragmenting Self--received little parental responsiveness, but the parent's empathic failure focused on a single aspect of the child's total self
    Overstimulated Self--excessive responsiveness to grandiose and idealizing needs, no optimal frustration, moves into adulthood with a weak separation between the fantasy/reality of the self
    Overburdened Self--views the world as hostile and dangerous, responds irrationally because lacked the opportunity as a child to merge with a calm powerful self object
    Narcissistic Behavior Disorders--less severe harm, with a tendency toward grandiosity and pretentiousness at times, but self-criticalness and minimization at others.
    Mirror-Hungry Personalities--seeks self objects who will provide mirroring
    Ideal-Hungry Personalities--seeks idealized partners to make them feel worthwhile
    Alter-Ego-Hungry Personalities--seeks others to conform to their beliefs and validate self
    Merger-Hungry Personalities--seeks idealized attachment to repair seriously defective self with primitive self-objects and primitive needs
    Contact-Shuning Personalities--seeks all encompassing idealized union, but fears rejection
    Carl Rogers and Person-Centered Therapy (Kohut-Lite)
    This theory is easy to understand and implement. The social self is an organized self based on others' perceptions, while the true self is based upon our actual feelings and experiences. Conditions of worth activate the social self, repress the true self, and produce incongruence. Unconditional positive regard places social and true self in harmony, and congruence results.
    Three Conditions are necessary and sufficient for therapeutic change.
    • therapist shows unconditional positive regard for the client
    • therapist shows empathy for the patient through empathic listening
    • patient perceives 1 and 2

      Rogers thought that there were six characteristics of a healthy marriage
    • difficulties are always present in the partnership but are brought into the open
    • communication is more open and more real, with mutual listening
    • the partners will come to recognize the value of separateness
    • the woman's growing independence is recognized and valued
    • role expectations drop away, people choose their own way of behaving
    • either partner may form satellite relationships which ultimately enrich the relationship

      Rogers argues that the fully functioning person is open to experience, focuses on their experiences in the present, trusts their organism and does what feels right, is creative and lives a richer life, taking challenges, risks, and hurts as they come. They are honest and open, and opposed to highly structured, inflexible bureaucracies. They are indifferent to material comforts and rewards, but have a deep distrust of technology that exploits people and relies on authority.
    Maslow and the Hierarchy of Needs
    This theory is nice to incorporate systemic, community, and social views. Maslow posited the existence of a biologically based goodness that, if fostered by society, would develop into a drive benefitting man. Needs were arranged in a hierarchy:
    self-actualization (being able to reach our potential, facing Deficiency-Cognitions or judgmental, condemning, and black-and-white thinking and developing B-Cognitions, or non-judgmental, validating, and clear thinking. Peak moments define someone capable of clear B-Cognitions. You can still be petty, unreasonable, and uncertain, but you live life in the moment and experience self and world clearly and consistently)
    esteem (based both on our own and upon others' views of us)
    belonging and love (Deficiency-Love and Being-Love, or love only to meet one's own needs versus love to meet another's needs)
    safety (physical safety, stability, law and order - where threatened, panic, emotional distress, and turmoil can result)
    physiological (food, clothing, shelter- where threatened, the others can not be addressed)

    Family Therapy
    Bowenian Family Therapy
    This model is good for understanding relationship problems, how they start, and their context in family systems. It understands multi-generational patterns in families and includes culture, ethnicity, religion, and more regarding expressing emotions, dealing with death and life, loyalty to the family… Key ideas:
    • Differentiation of Self - undifferentiated people can't separate feeling and thinking, and become anxious; differentiation may come after freeing self from family
    • Triangles - when stressed, dyads become distanced and triangulate a third party to decrease anxiety; the least differentiated person will be triangulated
    • Family Projection Process - emotional processes are passed on from one generation to the next through the least differentiated
    • Emotional Cutoff - cutoff by emotional or physical distance may feel like independence, but is not (remember Superman and Kryptonite)
    • Societal Emotional Process - social expectations re: class, ethnicity, gender, orientation

      Problems result from emotional fusion, increase in level of anxiety, or upset to a fused relationship. "Vertical" probs span generations and interact with "horizontal" probs caused by environment or transition. Most people choose spouse with equal level of differentiation

      Keys to Effective Therapy
    • lower anxiety as it breeds fusion, increase understanding, return to the family of origin
    • remain neutral and detriangulated, halt open conflict, but address power differentials
    • teach communication, teach them to state their needs and thoughts without over-reacting
    • uses stories or films to provide safe areas to explore
    • use labels like "pursuer-distancer" and teach about emotional systems (genograms)
    Structural Therapy
    The Structural and Strategic models can help in families, as well as systems like a company, social service agency, and referral source. Minuchin argues that there are good (adaptive and coping) and bad (rigid and stuck) families. You unstick them by getting the family to realign and do something different. Key ideas:
    • Structure or patterns for how they behave
    • Subsystems or subunits in the family
    • Boundaries demark subunits, too rigid and disengagement, too soft and enmeshment
    • Hierarchy is the "thickness" of the boundaries or how much they bend

      Problems are part of life, but some come from boundaries that are too hard or too soft

      Keys to Effective Therapy
    • joining - get into the family,
    • accommodate and bend to their definitions of problems, solutions, and ways of coping
    • accept some of the family's views, but avoid blame for the IP, and reframe
    • reinforce boundaries, meet with the parents separate, reinforce their authority
    Strategic Therapy
    Main concern is with the presenting problem and changing it through different behaviors to break feedback loops; desires for power/love cause dysfunctional patterns to emerge. Key points:
    • Analyzing the function of the symptom and seeing what purpose it serves
    • Develop a unique Strategy to resolve it (e.g., an Ordeal or a Ritual, or a "dirty game")
    • Improve the hierarchy of the family (looks like Structural Therapists in this way)
    Techniques of Structural and Strategic Therapy
    The difference between the schools is sometimes not what they do, but why they do it.

    Paradoxical Techniques - highlight the paradox they create but won't name
    Resistance Techniques- tell them not to change and engage their resistance
    Prescribing the Symptom - tell them keep doing it, but do it more
    Affect Shocking - like "Dad's going to die within a year if he keeps drinking like this"
    Empty Chair Techniques
    Session Limits - like 10 and no more
    Outpositioning - helpless mom is now fully in charge
    Final Family Notes
    Mix and Match is not OK
    You are not an expert
    Beware of coming across as manipulative using paradoxical techniques
    Know research
    Be aware of professional boundaries
    Consider the system

    Gottman's Sound Marital House Method
    Three concerns
    1) delay between realizing marriage has problems and seeking help is six years
    2) relapse - 30-50% of improved couples relapse in two years
    3) 55% of couples improved after therapy, only 35% were in the non-distressed range

    Dysfunction is marked by:
    • more negativity than positivity
    • 4 Horsemen
    • harsh argument startups
    • failed repair attempts
    • demand and withdraw patterns
    • failure to accept influence
    • negative perceptions
    • diffuse physiological arousal
    The Sound Marital House
    Fondness and admiration - or the dailyness of positive events. Work on
    • Love Maps and increasing positivity (money in the "emotional bank"); positivity in happy is 20 to 1, conflicted 5 to 1, soon-to-divorce .8 to 1
    • process failed bids for affection
    • Stress Reducing Conversation
    • decreasing negativity in conflict resolution (behavioral techs - tabling) and increase effective repair (insight techs)
    • teach communication and compromise skills
    • support dreams
    The Four Horsemen
    • Criticism ("What kind of person are you?") -- change to complaint
    • Defensiveness ("Well what about what you did?") -- change to taking responsibility
    • Contempt (indignation and superiority) -- build culture of positive appreciation
    • Stonewalling (shutting down) -- self-soothing and give 20-30 minutes time outs
    Help regulate conflict (69% of issues don't get solved, they get managed)
    • softer startups
    • de-escalation and soothing
    • accepting influence
    • reframes with Dan Wile
  • effective repair attempts
    • managing stress spillover
    • show videos ("Wow, I was nasty there")
    • teach about "crazy buttons," life transitions
  • Create Rituals of Connection (marriages end at 5-7 years due to high conflict or 10-12 years due to the loss of intimacy and connection)

    • Cognitive - answer question about each other, finish sentences
    • Physical - touch, closeness on the couch, smiles
    • We-ness - finish sentences, wait for each other to say their part (Writing to Zest)
    • Gender roles, relationships with kin, philosophy on conflict (engage or avoid)
    • Disappointment - expectations for relationship
    • Expansion - add details and emotions
    • Chaos - voice confusion, unpredictability
    • Philosophy of the marriage -"glorified struggle" or "couple efficacy"
    • Meta-emotion - good turned gray
    • Parenthood transition
    • Negativity - bad first impressions, criticism