John, That's a great question...what are the symptoms we can treat, in a time limited way, in patients who have personality disorders? For me, the answer in part depends on what setting I am seeing the patient and also is based on my efforts to try to identify an important but focal purpose for an intervention. In a primary care setting, I mostly limit my focus to a personailty variable(s) that is interfering in the delivery of medical care. For example, I would focus on a patient's suspiciousness that is interfering with my doing the necessary lab tests. In a brief psychotherapy, I focus on a problem that either brought the patient to see me or alternatively a personailty trait that the patient identifies might be a problems. For example a patient who comes to me after being fired because of a work problem with a boss...I will focus on his/her issues with authority figures as the entire brief treatment. If a patient is avoidant of others and lonely I will focus on his interpersonal skills. I usually go for skills training, problems solving, but have also been impressed how a focal psychodynamic understanding can help many patients. Rob Feinstein
What do you do ?
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