Antisocial Personality Disorder - A Practitioner's Guide... by F. Rotgers, et. al.

By F. Rotgers, et. al.

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Frank also meets the criteria for narcissistic personality disorder. Ignoring the character pathology represented by both sadism and narcissism could be quite detrimental to the therapy (as well as potentially to the therapist). ” He is also quite depressed. It is important to determine if symptoms of depression stem from a mood disorder or from characterological deficits. Case formulation and treatment would be different in each situation. The hallmarks of antisocial personality disorder are chronic criminal behavior and disregard for the feelings of others.

Unfortunately, conventional wisdom indicates that medication tends to be ineffective in treating symptoms which result from a personality disorder. There has been success in using antidepressant medications (the SSRIs) in treating symptoms of PTSD as well as for clients with substance abuse histories. A caveat in prescribing psychotropic medication to a substance abuser is the risk to the liver if the client does not remain sober and the danger of overuse or misuse of the medication. Additionally, use of medication in the treatment of character-disordered clients can reinforce their notion of externalization of control rather than a focus on their own efforts.

In this type of work, it is always the client who determines the timeline for therapy and not the therapist. The critical juncture in long-term therapy occurs as the beginning phase of treatment is approaching its conclusion. The focus of this phase is on establishing and strengthening the therapeutic relationship, improvement of coping skills, affect tolerance, and problem solving, all relating to day-to-day life in the present It typically takes 3 to 4 months of weekly sessions for a client to feel at ease with the therapist and to begin to experience a reduction in symptoms.

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