Grandiosity and Depression
When you pierce someone’s grandiosity you may find depression
When dealing with a Grandiose . . . do this in doses for OPTIMAL Gratification
- gratify “that is great”
- Ask “what do you need from me, why are you sharing this?” (do you need me to affirm you? Can you believe the good before I say it?)
Idealizing Transference:
“you’re the greatest”
BORDERLINE PERSONALITY – brain scans
Activation of insula paradigm ANTERIA INSULA
the healthy volunteers and BPD were scanned as they responded to cues about money and investment
Healthy volunteers’s trust could be anticipated
BPD clients could not perceive bad or good accurately and their ability to trust is injured. BPD were less trusting and see negative intent more. They have no empathy
BPD see all people as “ALL BAD” or “ALL GOOD”, there is no room for mistake making.
As they heal, there is less dissociation and they feel more physical pain.
Children of mothers who have BPD – the parent may be critical or harsh and have memory impairment. They don’t see the child as a seperate human and insist the mother is wrong.
Outsiders see their mom as Charming, which makes the child feel like their reality is unreal.
Could be a “poorness of fit” between mom and child.
Disorganized/disoriented attachment “I hate you- don’t leave me”
FEAR OF ABANDONMENT is triggered into narcissistic rage when a partner says they will leave.
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“Affect storm” when a Boarderline Personality over reacts – it is like they are a baby in a crib feeling terror. . . reminds me of Anne Martini not remembering acting out even when shown videos of herself
they don’t feel the Depressive Pole in bi-polar patients


The Final – do NOT do another ATTACHMENT paper – HALF of your sources have to be from the syllabus… say “it is likely that” – do not diagnose definitively . . . . yes “based on research”…
