Neelam paul

22BPTR140

Sub : psychology

Sarah is a 32-year-old woman who seeks therapy due to difficulties in her relationships and a
pervasive sense of emptiness. Upon evaluation, she exhibits symptoms that suggest a mixed
personality disorder, combining features of borderline personality disorder (BPD) and narcissistic
personality disorder (NPD).

Borderline Personality Disorder (BPD) Traits:

1. Intense Fear of Abandonment: Sarah experiences overwhelming anxiety at the

thought of being left alone. She frequently seeks reassurance from her partner and becomes
distraught when he spends time with friends or works late.

2. Unstable Relationships: Sarah’s relationships are tumultuous, characterized by

idealization followed by devaluation. She alternates between viewing her partner as perfect and then
vilifying him over minor disagreements.

3. Impulsivity: Sarah engages in risky behaviors such as overspending, substance abuse,

and reckless driving, often in response to emotional distress.

4. Identity Disturbance: Sarah struggles to maintain a stable sense of self, frequently

adopting the interests and opinions of those around her. She feels empty and uncertain about her
goals and values.

Narcissistic Personality Disorder (NPD) Traits:

1. Grandiosity: Sarah has an inflated sense of self-importance and expects special

treatment from others. She believes she deserves admiration and feels entitled to privileges and
attention.

2. Lack of Empathy: Sarah struggles to empathize with others’ emotions and needs,
viewing them primarily in terms of how they can benefit or threaten her.

3. Manipulative Behavior: Sarah is skilled at manipulating situations and people to

serve her own interests. She uses charm and flattery to manipulate others into meeting her needs.

4. Fragile Self-Esteem: Beneath her outward confidence, Sarah harbors deep

insecurities. She becomes defensive and hostile when her sense of superiority is challenged.

Treatment Approach:

Given the complexity of Sarah’s presentation, a comprehensive treatment plan is necessary:

 1. Dialectical Behavior Therapy (DBT): This therapy addresses both BPD and NPD
symptoms by teaching emotion regulation, distress tolerance, interpersonal effectiveness, and
mindfulness skills.

2. Schema Therapy: This approach helps Sarah identify and challenge maladaptive
thought patterns and beliefs underlying her behavior, fostering healthier coping mechanisms and
self-concept.

3. Psychodynamic Therapy: Exploring Sarah’s early experiences and unconscious

conflicts can provide insight into the roots of her personality dysfunction and facilitate emotional
healing.

4. Medication: While medication alone is not a primary treatment for personality

disorders, certain symptoms such as depression or anxiety may benefit from pharmacological
intervention.

Overall, Sarah’s treatment requires a multidisciplinary approach tailored to address the complex
interplay of her BPD and NPD traits, with the goal of promoting emotional stability, healthier
relationships, and a more authentic sense of self.