The Dance of Power…Frustrating
the DRAMA!
Presented by:
Josh Smith, LMSW, BCD
Co-Owner of The DBT Center of Michigan
Owner of The DBT Center of Western Kentucky
[email protected]
Outline
• Characteristics of Normal vs. Disordered
Personality
• Review Cluster B Personality Disorders
• The Drama Triangle
• Drama Switches
• What to do to avoid getting stuck in the
Drama Triangle
• Wrap Up
Normal Personality vs. Disordered Personality
Primary Characteristics of Normal Personality
Problem solving process:
1) Problem is defined “operationally” (all the things that
lead to this happening)
2) Possible solutions are thought about
3) Solution(s) selected
4) Implement solution
5) Results are evaluated
6) Adjustments are made
Process called: Problem Solving
Goal of process: Create solutions and adaptations
Normal Personality vs. Disordered Personality
Primary Characteristics of Disordered Personality
Problem Solving Process
1) Problem is defined “personally”
2) Agreement and disagreement is generated
3) Responses and behaviors are justified
4) Problem remains unaddressed, enhanced or multiple
problems occur
5) Identity is validated and gains additional agreement
Process called: DRAMA
Goals of process: Validate position (identity)
The Drama Triangle
Persecutor
Rescuer
Victim
Primary Traits of DRAMA
A) Overt (what they want others see) purpose:
– To show you that my behaviors are justifiable,
reasonable and understandable
B) Covert (what I want to see in myself) purpose:
– To validate or verify my own position/identity
rather than reach a workable outcome
Primary Traits of DRAMA, cont.
C) We enter into the drama triangle through one
of the positions and will “switch” to get back to or
end up in our “home” (covert) position
D) This creates stimulation in order to substantiate
their identity (existential position)
E) This produces new problems or to intensify
current problems
Primary Traits of DRAMA, cont.
F) To resist being exposed to intervention or
exposed to change
G) Designed to propagate itself and to get others
to participate in the DRAMA
The severity of a personality disorder is
identified by the intensity of the DRAMA
3 degrees of drama
1st degree: Socially acceptable
– Traits
2nd degree: Socially unacceptable
– Breaks social rules
– Hides, sneaks, denies or rationalizes
– No self-observational capacity
3rd degree: Life-Threatening
– Breaks survival rules
Antisocial Personality Disorder
• Published in DSM-II (replaced “psychopath”)
• 1% -3% of general population
• 3% - 30% of clinical population (obviously higher
in forensic settings)
• Violates agreements which violates society
• Do not keep commitments/agreements
• Functional trait: EXPLOITATION
**A pervasive pattern of disregard for and violation
of the rights of others**
More stats on APD
• 94% have a history of trouble with employment
and jobs
• 85% have history of some violence
• 72% have multiple moving violations
• 67% have severe marital problems
• 47% have a significant arrest record
Psychotherapy outcomes:
Only helps when they are able to be made to feel
guilty
Drama Pattern of APD
• Drama entry point: RESCUER or VICTIM
• Drama switch: RESCUER to PERSECUTOR
VICTIM to PERSECUTOR
• Home position: PERSECUTOR
Example: “I’m smart. I didn’t sign the bottom line.
He should of known better. He made the mistake
and he got what he deserved.”
The Drama Triangle
Persecutor
Rescuer
Victim
Deception of trustworthiness (RESCUER) or neediness (VICTIM)
Opens the door for exploitation and take advantage of (PERSECUTOR)
Borderline Personality Disorder
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.4% - 5.5% of general population
10% of outpatient clients
20% of inpatient clients
9 – 11% will die by completed suicide
A disorder of the emotion regulation system
Functional trait: INTENSE changeability/instability
in moods
***A pervasive pattern of instability of mood,
affect, impulsivity, interpersonal relationships and
self-image***
Drama pattern of BPD
• Drama entry point: VICTIM or RESCUER
• Drama switch: VICTIM to PERSECUTOR
RESCUER to PERSECUTOR
• Home position: VICTIM
Ex: “I hurt myself because you didn’t return my
phone call.”
The Drama Triangle
Persecutor
Rescuer
Victim
Feeling attacked and victimized of self (VICTIM) or others (RESCUER)
Have the right to get even with or back at (PERSECUTOR)
Histrionic Personality Disorder
• Most common Cluster B disorder
• 1.6% - 3.9% of general population
• 10% - 15% of clinical population
• No long-term studies
• Functional trait: EXPRESSIVENESS
***A pervasive pattern of excessive emotionality
and attention seeking”
Drama Pattern of HPD
• Drama entry point: VICTIM
• Drama switch: VICTIM to PERSECUTOR
PERSECUTOR to VICTIM
• Home position: VICTIM
Ex: “Are you kidding me!?!?” “WOW! I don’t
believe it!” “I just can’t do that. It’s too much.”
The Drama Triangle
Persecutor
Rescuer
Victim
Immature/Childlike neediness (VICTIM)
Over-the-top/Excessive demands (PERSECUTOR)
Whiny complaints (VICTIM)
Narcissistic Personality Disorder
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Least common of the Cluster B PDs
.4% - 5.5% of the general population
2% - 16% of clinical population
“Arrogant, haughty behaviors” are the most reliable
diagnostic criteria
• Deficient in equality and empathy
• Norway twin study found 77% of traits appear to
biological
• Functional trait: Self-Exaggeration
***A pervasive pattern of grandiosity in behavior or
fantasy***
Drama Pattern of NPD
• Drama entry point: RESCUER
• Drama switch: RESCUER to PERSECUTOR
• Home position: PERSECUTOR
Ex: “I’m everything and untouchable; you’re
nothing.”
The Drama Triangle
Persecutor
Rescuer
Victim
Being important and held in high regards (RESCUER)
Others are less than and belittled (PERSECUTOR)
Wrap-Up
• Review
• Q&A
Contact Information:
Josh Smith
[email protected]
517-214-7964
www.dbtcentermi.org