Controllers, Abusers, Manipulators and Users: Treating Trauma in Survivors of Pathological Relationship Abuse

Credit

Handouts

Speaker

Peter Salerno, PsyD Related seminars and products

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Peter Salerno, PsyD, LMFT, is a licensed psychotherapist and author of The Nature and Nurture of Narcissism (a #1 new release on Amazon in its category) and his latest book, Traumatic Cognitive Dissonance: Healing from an Abusive Relationship with a Disordered Personality.

Dr. Salerno has treated mental health conditions in a variety of clinical settings and works in private practice in California and consults internationally. He’s trained in EMDR and Accelerated Resolution Therapy (ART) and is certified in family trauma and complex trauma through the International Association of Trauma Professionals. He also holds certifications in psychoanalytic psychotherapy and personality disorder treatment (C-PD) and is trained and qualified to administer and score the Hare Psychopathy Checklist-Revised (PCL-R). Dr. Salerno earned his doctor of psychology degree (PsyD) from California Southern University.

 

Speaker Disclosures:
Financial: Peter Salerno maintains a private practice and receives royalties as a published author. He receives a speaking honorarium and book royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Peter Salerno is a member of the American Psychological Association and the California Association of Marriage and Family Therapists.

 

Additional Info

Program Information

Access never expires for this product.

For a more detailed outline that includes times or durations of time, if needed, please contact cepesi@pesi.com.

Objectives

1. Identify which DSM-5-TR disorders are typically involved pathological relationship abuse. 
2. Examine the etiology of personality disorder pathology based on current research.   
3. Examine Cluster B personality pathology and diagnostic criteria. 
4. Identify Cluster B personality dynamics in interpersonal relationships. 
5. Identify pathological relationship abuse when the abusive partner is not part of the treatment process. 
6. Identify common indicators of intimate partner violence to assess client physical safety. 
7. Define traumatic cognitive dissonance and identify unique symptom indicators in clients. 
8. Identify common misconceptions applied to the traumatic cognitive dissonance client population. 
9. Choose effective interventions for the traumatic cognitive dissonance client population. 
10. Determine the benefits of using a multimodal treatment approach rather than a one-size-fits-all approach.   
11. Identify difficulties and treatment pitfalls which may arise in treating traumatized survivors of relationship abuse.
12. Utilize self-regulation techniques to manage clinician self-care.   

Outline

Pathological Relationship Abuse 101

• Defining pathological relationship abuse in all of its manifestations
• Differentiate between pathological relationship abuse and non-pathological forms
• DSM-5-TR™ disorders and pathological relational abuse
• Case study: Patterns of abuse vs. singular instances of abuse

Abusers, Personality Disorders, and Personality Pathology

• Where the etiology of personality disorder pathology has been inadequate
• New research findings
• Probing our prejudices around personality disorders and trauma
• Errors in popular psychology related to personality disorders
• Case study: Relational conflicts related to trauma vs. Personality Disorder Pathology

Understand Cluster B Personality Disorders

• Dimensional and categorical models of DSM-5-TR Cluster B personality disorders
• When features of Cluster B personalities overlap
• What pathological personality traits predict abuse and how to identify them
• How comorbidities complicate assessment

The Relational Dynamics of Cluster B Personalities

• Identify the main culprits: controllers, abusers, manipulators, and users
• How do detachment patterns manifest neurobiologically in Cluster Bs?
• The most pervasive mentalization impairments in Cluster B personality disorders
• How intimacy plays a role in deficiencies and impairments in Cluster B relationships
• How deficiencies reduce the capacity for empathy in Cluster B relationships
• Case study featuring a Cluster B personality

 How to Screen for Pathological Relationship Abuse

• Identify pathological relationship abuse through a client’s recounting of relational dynamics
• Specific questions that get to the heart of the pathological relationship abuse dynamic
• When and why couple and family therapy is NOT indicated
• Case study: how to separate objective information from subjective experience

Assess for the Physical Safety of Clients

• Potential for violence in Cluster B personalities
• Identify common indicators of intimate partner violence
• Psychoeducation on the domestic violence cycle of abuse
• Collaborative safety plan development
• Duty to warn – Mandated reporting protocol when a client’s life is at risk

Traumatic Cognitive Dissonance: The Key to Why Victims Blame Themselves

• Recognize and define traumatic cognitive dissonance
• Differences and similarities between chronic and subtle psychological abuse
• Covert manipulation, deceit, and coercion
• When the core belief system of a client has been distorted
• The impact of abuse on the autonomic nervous system
• Checklist: the most notable symptoms of traumatic cognitive dissonance
• Case study: A client with traumatic cognitive dissonance

When Initial Treatment Proves Ineffective

• Why multiple initial treatment attempts can be ineffective
• Psychoeducation for clients who are being abused by a Cluster B personality
• Five traditional therapy interventions to avoid
• Why life story gathering with these clients should be initially avoided
• Redefine a client’s mental images and for shifting core beliefs
• Case study: where traditional therapeutic methods failed

Interventions from EMDR, PE, CPT, and Other Approaches: Reshape Cognitive Distortions, Improve Emotional Regulation, and Rebuild the Self

• How EMDR can rebuild healthier beliefs – “I deserve respect” or “I can trust myself”
• Accelerated Resolution Therapy (ART) to target traumatic cognitive dissonance
• Prolonged Exposure to improve emotional regulation
• Stress inoculation for anxiety and overwhelm
• Cognitive Processing therapy to reshape cognitive distortions
• The best ways to create and conduct a support group for reality testing
• Research, risks, and limitations

Using a Multimodal Therapeutic Approach

• Why a one-size-fits-all therapy modality is doomed to failure
• Use a neuroscientific understanding of emotion and trauma as the basis of treatment plans
• The conscious and the unconscious in breaking free from traumatic cognitive dissonance
• Case study of two separate therapeutic models and results

Troubleshooting: Working with Countertransference, Help Rejecting Clients, and More

• Assess for authenticity in clients who describe/report pathological relationship abuse
• Countertransference “tells”
• How to get “help-rejecting” clients engaged
• Assess the collaborative capacity in clients

Manage Clinician Self-Care

• Set appropriate clinical expectations
• Typical barriers to self-care with this client population
• Consultation and professional collaboration/support
• Mindfulness and grounding techniques for self-regulation

Target Audience

• Counsellors
• Social Workers
• Psychologists
• Marriage and Family Therapists
• Addiction Counsellors
• Psychiatric Nurses
• Other Mental Health Professionals