by SMH » Sun Jan 03, 2016 3:29 am
IMHO, I believe that a therapist needs to know about Cluster B's specifically in order to identify them in their practice. If it is not a therapist that is knowledgable, they will not know what to look for, and will get pulled into the N's charm & manipulation tactics. There are very smart clinicians out there, that do not specialize, that will report to a supervisor, who will also know.Ultimately, even a non-specializing clinician will see that the treatment is going nowhere, and they are possibly being disrespected, in overt or covert ways. I, treat this population, and their families. For me, because, it's a serious diagnosis, that shapes the way I decide to direct treatment, I will take a good 3 months. Patterns emerge, enactments occur, and it can all been seen thru money transactions, cancelations, sexualizing treatment and the transference. Transference, meaning my gut, the feeling I get from the patient. Because I was raised by N's, it's a visceral thing for me. My body reacts when I'm in the presence of a Cluster B. I will go through the protocol, but, typically, I suspect fairly early in the game that there is someone high in N' traits, but, remember, it's a spectrum disorder too, and not everyone is hopeless, I have found. It's important not to diagnose immediately as I have experienced personally and professionally, temporary Narcissistic episodes depending on life circumstances. If you see a BPD, when they are in their depressive state, it may take a while to see the rage, to see the split, to diagnose BPD. Sometimes, like with self harm, cutters, Eating disorders, we only see the depressive state, and the rage that is turned inward against their body, is not interpreted as rage for a long time. So, they are not seen as "Split". As of late they are saying that PSTD has been presenting as BPD, and it's not BPD. So, it's complicated. But the answer is Yes & No. The trained therapist can see the traits fairly early on, but the N can fool the untrained Clinician. My formal specialty training gave me the information I need to treat Cluster B's and the effect they have on the people around them, but, it's only my personal life experience, that gives me the real knowledge, of the depth of the complexities of these disorders. SMH