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1. Strengths Based
Biopsychosocial Approach to
Recovery from Narcissistic
Personality Disorder
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
Recovery & Resilience International in partnership with AllCEUs.com
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2. Objectives
 Define Personality Disorders
 List the characteristics of Narcissistic Personality
 Examine the similarities between the behaviors of
certain personality disorders and addictions
 Identify ways to address these behaviors and
thought patterns
 Encourage clinicians to critically examine
behaviors in patients with addiction in order to
effectively differentially diagnose
Recovery & Resilience International in partnership with AllCEUs.com
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3. Why I Care/How It Impacts Recovery
 When personality disorders are viewed as pervasive & perpetual, it
 Provides an “excuse for relapse”
 Often derails treatment because patterns of behavior thought to be
due to the PD are essentially ignored
 Personality Disordered & Addictive Behavior often look the same
 Goals for recovery from both:
 Honesty with self & others about thoughts/feelings/needs/wants
(Mindfulness)
 Distress tolerance and the ability to self-soothe
 Hope and faith in self/future/others through addressing cognitive
errors
 Development of self esteem to eliminate need for external validation
 Development of healthy, supportive relationships
Recovery & Resilience International in partnership with AllCEUs.com
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4. Personality Disorders
 Represent a cluster of behaviors that is pervasive
beginning before the age of 15.
 Addictive behaviors also often begin before 15
 Due to immature cognitive development, children tend
to be more egocentric, overgeneralize and think in
terms of dichotomies
 From a survival perspective, most of these behaviors
make perfect sense when viewed through the eyes of a
child
Recovery & Resilience International in partnership with AllCEUs.com
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5. Personality Disorders
 Treatment
 Since these behaviors formed the foundation for
further development patients must
Understand their function in the past
Identify how these behaviors and beliefs are faulty in the
present
Develop alternative skills
Be empowered to interface with the world with the
strengths, knowledge and tools of the adult
Recovery & Resilience International in partnership with AllCEUs.com
Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89

6. Addictions
 Represent one way to cope with distress
 Can begin early in life
 Have overlapping symptoms with personality
disorders, especially Cluster B
Recovery & Resilience International in partnership with AllCEUs.com
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7. Addictions & Personality Disorders
 Cluster A (Paranoid, Schizoid, Schizotypal)
 Characterized by social awkwardness and withdrawal
 Often co-occur with addictions
 Cluster C (Obsessive-Compulsive; Dependent)
 Characterized as anxious and fearful
 May co-occur with addiction
 Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
 Characterized by dramatic, emotional, erratic behavior
 Behavioral patterns overlap with addiction
Recovery & Resilience International in partnership with AllCEUs.com
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8. Addictions & Personality Disorders
 Cluster B (Borderline, Narcissistic, Histrionic, Antisocial)
 Characterized by
Dramatic, emotional, erratic behavior
All or Nothing thinking
Hostility and Aggression
Hypersensitivity
Manipulative
Low Self-Esteem / Weak Self-Concept
Recovery & Resilience International in partnership with AllCEUs.com
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9. Antisocial Personality Disorder
 CORRUPT (3 criteria)
 C: Conformity to law lacking
 O: Obligations ignored
 R: Reckless disregard for safety of self or others
 R: Remorse lacking
 U: Underhanded (deceitful, lies, cons others)
 P: Planning insufficient (impulsive)
 T: Temper (irritable and aggressive)
Recovery & Resilience International in partnership with AllCEUs.com
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10. Addictions vs. Personality Disorders
 Many behaviors characteristic of active addiction
 Overlap with personality disorders
 Begin in late childhood/early adolescence
 Are pervasive
As people’s experiences and knowledge expanded, their
coping skills and behaviors remained relatively primitive
 Recovery from both requires
 Development of effective coping skills
 Addressing cognitive distortions
Recovery & Resilience International in partnership with AllCEUs.com
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11. Recovery Interventions
 Dramatic, emotional, erratic behavior
 Distress Tolerance
 Mindfulness to identify and process the source of the distress
 Coping skills
 All or Nothing thinking
 Awareness and elimination of cognitive distortions (CBT)
 Hostility and Aggression
 Understanding of the fight or flight response
 Development of anger awareness and management skills
Recovery & Resilience International in partnership with AllCEUs.com
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12. Addictions vs. Personality Disorders
 Hypersensitivity esp. to rejection
 Awareness of and addressing thinking errors
 Awareness and addressing abandonment issues
 Development of self-esteem
 Manipulative
 Interpersonal skill development (boundary setting,
communication skills)
 Low Self-Esteem / Weak Self-Concept
 Development of self-esteem and the ability to
internally validate
Recovery & Resilience International in partnership with AllCEUs.com
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13. Summary
 Most patients with addictions have traits associated with
personality disorders
 These traits can be loosely classified into
 Thinking errors  the perception of a threat
 Behavioral reactivity to escape or eliminate the threat
 Important concepts in early recovery
 Honesty with self and others (Mindfulness and Awareness)
 Hope & faith (Identifying cognitive distortions and thinking errors to
encourage and empower)
 Courage and discipline to remain constantly mindful, accept and
address thoughts and feelings, make conscious choices based on
facts
Recovery & Resilience International in partnership with AllCEUs.com
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14. Summary cont…
 A child growing up in an unstable, neglectful,
emotionally detached environment may develop
 PD traits to survive
 Addictions to numb the pain and escape from the lack of
control.
 Behaviors characteristic of addictions and personality
disorders
 Were learned and reinforced
 Will always be in the recesses of the toolbox
 Must be made less rewarding than alternative, healthy
behaviors
Recovery & Resilience International in partnership with AllCEUs.com
Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89