Personality-Guided Therapy for Depression (Personality-Guided Psychology)

330 Pages·2006·18.59 MB·English

by  Neil R. Bockian

PERSONALITY^GUIDED
PSYCHOLOGY BOOK SERIES
THEODORE MILLON, Series Editor
Personality-Guided Therapy for Posttraumatic Stress Disorder
George S. Everly Jr. and Jeffrey M. Lating
Personality-Guided Therapy in Behavioral Medicine
Robert G. Harper
Personality-Guided Forensic Psychology
Robert J. Craig
Personality-Guided Relational Psychotherapy: A Unified Approach
Jeffrey J. Magnavita
Personality-Guided Cognitive-Behavioral Therapy
Paul R. Rasmussen
Personality-Guided Behavior Therapy
Richard F. Farmer and Rosemery O. Nelson-Gray
Personality-Guided Therapy for Depression
Neil R. Bockian
Personality-Guided Therapy
for Depression
Neil R. Bockian
Series Editor Theodore Millon
A M E R I C AN P S Y C H O L O G I C AL A S S O C I A T I ON
WAS H I N G T O N, DC
Copyright © 2006 by the American Psychological Association. All rights reserved. Except
as permitted under the United States Copyright Act of 1976, no part of this publication
may be reproduced or distributed in any form or by any means, including, but not limited
to, the process of scanning and digitization, or stored in a database or retrieval system,
without the prior written permission of the publisher.
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Psychological Association.
Library of Congress Cataloging-in-Publication Data
Personality-guided therapy for depression / by Neil R. Bockian.
p. cm. — (Personality-guided psychology)
Includes bibliographical references and index.
ISBN 1-59147-410-8 (alk. paper)
1. Depression, Mental—Treatment. 2. Personality disorders—Treatment.
I. Title. II. Series.
RC537.B58 2006
616.85'2706—dc22 2005037362
British Library Cataloguing-in-Publication Data
A CIP record is available from the British Library.
Printed in the United States of America
First Edition
Dedicated with love to my wife Martha—
my personal antidepressant and my favorite personality type.
CONTENTS
Series Foreword ix
Preface xi
Acknowledgments xiii
Chapter 1. Introduction 3
Chapter 2. An Overview of Depression and Theoretical
Models of Its Relationship to Personality
Disorders 13
Chapter 3. Depression in Paranoid Personality Disorder 41
Chapter 4. Depression in Schizoid Personality Disorder 63
Chapter 5. Depression in Schizotypal Personality Disorder .... 91
Chapter 6. Depression in Antisocial Personality Disorder 109
Chapter 7. Depression in Borderline Personality Disorder 135
ChapterS. Depression in Histrionic Personality Disorder 169
Chapter 9. Depression in Narcissistic Personality Disorder .... 187
Chapter 10. Depression in Avoidant Personality Disorder 209
Chapter 11. Depression in Dependent Personality Disorder 227
Chapter 12. Depression in Obsessive-Compulsive Personality
Disorder 247
vu
Appendix A: Emotion List—2 267
Appendix B: Expression of Personality Disorders Across the
Domains of Clinical Science 271
References 273
Author Index 305
Subject Index 313
About the Author 325
viii CONTENTS
SERIES FOREWORD
The turn of the 20th century saw the emergence of psychological inter-
est in the concept of individual differences, the recognition that the many
realms of scientific study then in vogue displayed considerable variability
among "laboratory subjects." Sir Francis Galton in Great Britain and many
of his disciples, notably Charles Spearman in England, Alfred Binet in France,
and James McKeen Cattell in the United States, laid the groundwork for
recognizing that intelligence was a major element of import in what came to
be called differential psychology. Largely through the influence of psychoana-
lytic thought, and then only indirectly, did this new field expand the topic of
individual differences in the direction of character and personality.
And so here we are at the dawn of the 21st century, ready to focus our
attentions ever more seriously on the subject of personality trait differences
and their impact on a wide variety of psychological subjects—how they im-
pinge on behavioral medicine outcomes, alter gerontological and adolescent
treatment, regulate residential care programs, affect the management of pa-
tients with depression and posttraumatic stress disorder, transform the style
of cognitive—behavioral and interpersonal therapies, guide sophisticated fo-
rensic and correctional assessments—a whole bevy of important themes that
typify where psychologists center their scientific and applied efforts today.
It is toward the end of alerting psychologists who work in diverse areas
of study and practice that the present series, entitled Personality-Guided Psy-
chology, has been developed for publication by the American Psychological
Association. The originating concept underlying the series may be traced to
Henry Murray's seminal proposal in his 1938 volume, Explorations in Person-
ality, in which he advanced a new field of study termed personology. It took its
contemporary form in a work of mine, published in 1999 under the title Per-
sonality-Guided Therapy.
The utility and relevance of personality as a variable is spreading in all
directions, and the series sets out to illustrate where things stand today. As
will be evident as the series' publication progresses, the most prominent work
at present is found with creative thinkers whose efforts are directed toward
enhancing a more efficacious treatment of patients. We hope to demonstrate,
further, some of the newer realms of application and research that lie just at
the edge of scientific advances in our field. Thus, we trust that the volumes
included in this series will help us look beyond the threshold of the present
and toward the vast horizon that represents all of psychology. Fortunately,
there is a growing awareness that personality variables can be a guiding fac-
tor in all spheres of study. We trust the series will provide a map of an open
country that encourages innovative ventures and provides a foundation for
investigators who wish to locate directions in which they themselves can
assume leading roles.
Theodore Millon, PhD, DSc
Series Editor
SERIES FORWORD
PREFACE
The science and practice of clinical psychology have undergone a dra-
matic and exciting process of change in the past century. Following Freud's
explorations of the unconscious, the dialectic swung to the antithesis, the
behavioral revolution of Thorndike and Watson and, later on, Skinner. Fill-
ing in the vast space since then have been many approaches. Object-
relations theorists have examined the functioning of the ego, and interper-
sonal theorists have studied how relationships with others impact human
psychology. Client-centered, humanistic, and existential therapists as well
as logotherapists have focused on human experience and questions regarding
life's meaning. Systems-oriented theorists have helped us to understand dyads,
families, groups, and organizations and have developed new and innovative
intervention strategies. Cognitive and rational—emotive therapists have dis-
covered a wealth of techniques designed to help the individual use reasoning
to feel better. With each new theoretical innovation, the discipline of clinical
psychology has found new ways to be helpful and to reach more individuals.
Efforts at integration have become increasingly important. There were
theoretical manuscripts integrating, for example, individual and family ap-
proaches (e.g., Wachtel & Wachtel, 1986) or psychodynamic and behav-
ioral approaches (Arkowitz & Messer, 1984). Millon's (1969/1985)
biopsychosocial model makes the case that biological, psychological, and so-
cial factors contribute to a person's overall adaptation; this approach had a
substantial impact on the field.
Previous efforts at integration focused mostly on the level of theory—
that is, the effort was to find commonalities in different theoretical approaches
or to add the strengths of one to another. With Personality-Guided Therapy
(1999), Millon added the notion that the best way to integrate theories was
to focus at the level of the person. Simply put, psychodynamic, behavioral,
cognitive, family, humanistic, and other theories can all be used to describe
XI