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Borderline Clients Tend To Show: The TAT and Borderline, Narcissistic, and Psychotic Patients

The document summarizes characteristics seen in projective tests like the TAT for patients with borderline personality disorder, narcissistic personality disorder, and psychosis. Patients with borderline personality disorder may show affective instability, reality distortions, splitting, poor sense of self, pattern of wearing out relationships, few boundaries, and need for constant reassurance. Their TATs are marked by panic, splitting, extreme superegos, and fragmentation. Narcissistic patients show narcissistic injury, attempts to reinforce a false self, feelings of power/weakness, and tendency to bottom out after 30. Their TATs show difficulty with relationships, low empathy, grandiosity, and overreaction to criticism. TATs from

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134 views2 pages

Borderline Clients Tend To Show: The TAT and Borderline, Narcissistic, and Psychotic Patients

The document summarizes characteristics seen in projective tests like the TAT for patients with borderline personality disorder, narcissistic personality disorder, and psychosis. Patients with borderline personality disorder may show affective instability, reality distortions, splitting, poor sense of self, pattern of wearing out relationships, few boundaries, and need for constant reassurance. Their TATs are marked by panic, splitting, extreme superegos, and fragmentation. Narcissistic patients show narcissistic injury, attempts to reinforce a false self, feelings of power/weakness, and tendency to bottom out after 30. Their TATs show difficulty with relationships, low empathy, grandiosity, and overreaction to criticism. TATs from

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aastha jain
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The TAT and Borderline, Narcissistic, and Psychotic Patients

http://www.psychpage.com/projective/hand_bpd_npd.htm
Richard Niolon, Ph.D.
Borderline clients tend to show
affective instability, meaning tearful scenes and intense emotional periods followed by angry outbursts, and later by
intense feelings of emptiness and boredom
distortions of reality (which can be minor or severe)
splitting, meaning that since they can't conceptualize the whole person they tend to overidealize and then denigrate
people, they change from being "all good" to "all bad" and back again, and there is no "in between" in their life.
They split themselves too, feeling "all good" and entitled to good things in life, and then "all bad" and deserving of
punishment and hatred
a poor sense of self, and even periods when they feel their sense of self fragment; they then can show short
psychotic breaks, intense anxiety, or self-injurious behavior
a pattern of tiring out others and wearing out relationships, but an ability to sustain them with intense fears of
abandonment prompting frantic efforts to secure the relationship again
few boundaries, getting close quickly and taking relationships very seriously
a need to have others to "hold" onto certain concepts about them and remind them of who and what they are, and a
need to be constantly reassured by others, almost as if they can not remember what others said about them when
they are absent
impulsive and strained reasoning, and they often act while stressed, making matters worse

Their TATs are marked by


panic, with stories show wild, sudden, impulsive actions, or characters that become frozen and completely lifeless
splitting, with good/bad splits in the main and side characters
extreme superegos, with harsh punishments for minor infractions, then magical forgiveness and happiness without
and responsibility for the consequences of actions
introjection/projection confusion, including others that can read minds, two people that are identical in every way
fragmentation and disorder, with no self-reflection or recognition of the craziness they explain
primitive content, like ghosts and witches

Narcissistic clients show


a narcissistic injury in which the basic "true" self was rejected and as a result is buried deeply, and a false self that
was developed and is what is shown to the world
attempts to make the false self the real self through constant reinforcement and support, but this ultimately doesn't
work, and they are left feeling dissatisfied, unable to enjoy their "successes"
feelings of power and worthiness alternating with intense feelings of weakness and inadequacy
apparent insight into their personality, but often it is fake too, as it is insight into the false self, not the real self, so
reflecting on it doesn't really lead to any change
a tendency after 30 tend to "bottom out" in life and experience deep depression

Their TATs are marked by


difficulty forming and maintaining relationships, with relations that don't happen in logical manner like in real life
low empathy, low concern or understanding of others' needs
grandiosity and exaggerated self-regard, with high demands for love and attention support
intense envy and overreaction to mild criticism, as the narcissistic injury is re-experienced

TAT's from Psychotic clients are marked by


direct sexual and aggressive themes
themes of persecution and paranoia
characters in stories dramatically change
figures are contams, combinations of things and people, or two different people
juxtaposition of extremes (splitting)
ideas of reference - connect this story to previous one but connection is really strained
disoriented x3 in the story, doesn't fit sometimes
gross deviation from the stimulus

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