okay so we're going to talk about abnormal psychology part of the problem with abnormal is is what is abnormal each society has their own different idea of what's abnormal you know way back when for someone to believe in witches was considered normal for somebody to faint a woman especially too faint when she heard profanity was abnormal in some cultures committing suicide is abnormal is normal not abnormal in our society it's abnormal so what is considered abnormal is tied to the culture tied to it's affected by the culture the values of that culture the scientific knowledge that we have and so therefore it changes with time it's changed within our within our own culture what we considered to be abnormal you know 50 years a hundred years ago is not necessarily what we consider to be abnormal today for example we used to homosexuality used to be diagnosis we don't have that as a diagnosis anymore because we no longer consider that to be abnormal so when we look at what is abnormal we look at different criteria that it meets does it cause the person distress are they uncomfortable do are they having trouble with you know day-to-day functioning that might be one of the reasons for something to be abnormal is the behavior rare is it uncommon not normal in you know in the in the population would then of course be considered abnormal if it's rare and uncommon if it again impairs day to day functioning if it's dangerous if somebody is danger to themselves or others then that would be considered abnormal if they are out of touch with reality we talked a little bit about this in in previous lectures on psychosis it's like oh cuz this is psychosis is out of touch with reality and so if one is out of touch with reality meaning they don't know what day it is they're hearing things seeing things that aren't there and that would be considered abnormal so if it's different from the acceptable norms causing distress impairs day-to-day functioning danger to self or others rare or unusual a psychotic out of touch with reality all of those things can lead to a diagnosis of something that is abnormal now when we talk about diagnosing somebody we use this book okay we Bri v8 at DSM right now it's dsm-5 it stands for Diagnostic and Statistical Manual of Mental Disorders okay DSM for short the very first DSM was just like a little pamphlet and then it went to two and three and three revised and four and four and we just been revised and revise and revise this is the latest edition of the DSM you can see how thick it is and this book the DSM is the first one was published in 1952 and like I said it was just a little pamphlet and because it's changed over the you know because again abnormal is tied to the society the culture the scientific information then I use the beliefs that we have of course it's going to keep changing because we as a society changes and so as we change then what we consider to be abnormal changes the DSM is not based on any theory we we've talked about several theories here we talked about some of the theories in personality theory you know the psychodynamic the humanistic and we're going to talk about more theories here today as well but the DSM the purpose of the DSM is that it's not tied to any theory so it's not tied to any cause of what causes the the behavior they have normal behavior when we look up a diagnosis in the DSM we just have a list it gives us like if I open this up and disruptive mood dysregulation disorder okay and then it gives one two three four five six eleven possible symptoms hey you don't have to have all 11 to make the diagnosis but so it's just a list of symptoms and sometimes it'll say you know 5 out of the following symptoms if you have five of those symptoms you meet the criteria to make that diagnosis okay so there's no we don't talk about cause the what caused the diagnosis we don't relate it to any theory it's just if you have these symptoms then you meet the criteria for that diagnosis then you have the diagnosis and of course when people are coming into my office and you know they're telling me what their symptoms are it's it's self-reported you know I don't often see these symptoms when they tell me that they're having trouble sleeping I don't see them having trouble sleeping I have to rely on their information to make the diagnosis and the diagnosis again we don't have blood tests like doctors do we don't have x-rays we don't have any of that to make the diagnosis the only thing we have to make the diagnosis is the information that the patient or sometimes loved ones give us if the patient isn't going to speak for themselves or like often with kids they'll come in and I don't think they have any problems you know life is good I'm good and then the parents have all this list of symptoms that the child has and then we make the diagnosis based on that so that's how that's done so we're going to start we're gonna talk a little bit about different theories and what different theories believe causes the diagnosis so each theory has a different idea of what causes the diagnosis and then in a couple of lectures we'll talk about treatment and the treatment is tied to the cause which make sense right if you if you think X causes a diagnosis then you need to treat X you need to treat what the cause is okay so the first theory is the medical or biological theory the medical or biological theory states that the cause of the disorder the cause of the abnormal the diagnosis is biological something's biologically going wrong with a person okay so let's say in biological causes there's all different kinds it could be it could be a brain tumor a brain tumor can look like schizophrenia it can be a thyroid condition thyroid condition is the thyroid is a gland in your throat it regulates your hormones in one type of thyroid condition you mimic anxiety looks just like anxiety disorder in another thyroid condition it looks exactly like depression okay when we look at biological factors in fact with every diagnosis that we have in the DSM there is a medical diagnosis with the exact same symptoms so you can have depression and you're actually you could have all the criteria for depression but you could have mononucleosis or thyroid condition you can have all the criteria for an anxiety disorder but you have a thyroid condition you could have all the criteria first gets of running out but you really have a brain tumor so everything so sometimes you know when a patient comes in we you know they list all their symptoms sometimes we'll send them to the medical doctor to make sure it's not a medical condition because if you'll if it looks like you have anxiety and you actually have a thyroid condition all the therapy and anti-anxiety medication they're gonna give you is gonna work because that's not the cause of it so we have to look for those biological causes we can also look to genetics some disorders have a stronger genetic component and by genetic we mean that you were born with the predisposition to have the disorder the diagnosis with the most genetic component to it is schizophrenia what that means is that when we look at identical twins remember identical twins have the exact same genetic makeup because they come from one egg and one sperm so they have the exact genetics they start with the exact same genetics from the mother and the father if one identical twin has schizophrenia there's about a 80% chance the other twin will have it now it's not a hundred percent so does that mean that sometimes schizophrenia is genetic and sometimes it isn't does it mean that sometimes you can be born with the genetic predisposition to have schizophrenia but the environment just doesn't trigger it so you don't got schizophrenia we're not exactly sure the other thing and we talked about this towards the beginning of the semester is the chemical imbalance now remember what the chemical imbalance is sure you don't so let's see if we have the dendrite if we have the axon here sending if we have the axon remember the axon from the nerve cell sends the message out it goes here into the synapse or the cleft and is supposed to be picked up by the dendrite which is connected of course to this neuron over here so remember the neurotransmitters are the chemicals how one neuron communicates with another neuron how our body communicates with our brain and our brain communicates with our body so if you remember from that from that lecture way back when we talked about biology we have the axon sending its neurotransmitters out here right and these neurotransmitters are supposed to be picked up by this dendrite but sometimes remember the neurotransmitters are out here floating around and they get back in here so they don't go where they're supposed to go so now we have a chemical imbalance this chemical this neurotransmitter didn't go where it was supposed to go so now it's imbalanced and that chemical imbalance according to many biological theories is can what can cause anxiety depression schizophrenia all kinds of mental disorders so when we look at treatment we'll look at the medical side how medications treat the chemical imbalance that can occur and that can cause some of the mental disorders that we have the next theory so we have the medical or biological theories the first theory the next theory is the psychodynamic theory now we just talked a lot about the psychodynamic theory and hopefully you'll remember that the theorists most well-known or popular in and under the psychodynamic theory is Freud and Freud's theory is called the psychoanalytic theory but but the psyche of the basis of the cycle dynamic theories are that they're unconscious aware unconscious conflict is what causes abnormal behavior most of the time most psychodynamic theorists believe that this unconscious conflict it happens during childhood we keep it in our unconscious mind and then remember the unconscious mind is the bigger part of the mind the bigger part of the iceberg and it controls the behavior controls what happens so we're unaware of it but it controls or affects a lot of our behavior so that unconscious unresolved conflict can be causing the abnormal behavior that's what the psychodynamic theorists would believe so when we get to again two therapies we'll talk about how the psychoanalytic Oh dynamic theorists but try to get to that unconscious because if that's where all the problems are that's where the causes of the abnormal behavior are that we need to take care of those and fix those in the unconscious mind the third theory is the behavioral theories now does anybody remember anything about the behavioral theories the behavioral theories believe that what we are who we are our intelligence our personality our abnormal behaviors are all caused by learning remember the three three types of learning we have learning by association this is that two things are connected together we learn to associate one with another so that when one happens we anticipate or expect the other to follow that's learning by association that's classical conditioning operant conditioning remember operant conditioning has to do with learning from the consequences of your behavior and this is where we talked about reinforcement and Punishment if behavior is reinforced it gets repeated if a behavior is punished it doesn't get repeated so the learning theorist would say that abnormal behaviors depression anxiety schizophrenia bipolar disorder all of those are learned that everything is learned and so therefore if everything is learned then when we get to treatment we talk about the unlearning the relearning of information so that you don't have the abnormal behavior again that's what the behaviorist believe the humanistic remember the humanistic theories with Rogers and unconditional positive regard talked about that in personality theory and Maslow's theory of trying to reach self-actualization remember the humanistic theorists believe that we are all born with this potential to do good that we all have this inborn need and ability to be good people to be the best we can be and it's society or environment that prevents that from happening and so we need to fix that so then we can go and reach our full potential and again for Rogers he talked about unconditional positive regard if we all had just unconditional positive regard from our whole environment we wouldn't have any abnormal behavior with Maslow if we can get those lower needs met remember the physiological needs the safety needs the love and belonging the self esteem and then we can reach self-actualization and if we were all self actualized we wouldn't have any abnormal behavior so that's what the humanistic believe that it's something per what causes abnormal behavior is something preventing us from achieving our personal growth or self-actualization the next theory is the cognitive theories excuse me we didn't talk a lot about the cognitive theories in personality theory but the continent if there is believed that all abnormal behavior is caused by irrational thoughts remember cognition is your thinking your intelligence your decision making problem solving all of your those thoughts thinking things that's what cognitive therapist or cognitive theorists believe is causing the abnormal behavior so it excuse me if you have anxiety then it's those anxious thoughts that are causing you to behave and let's say an obsessive way so everything is caused by irrational distorted thinking and so again when we get to therapies we'll talk about how to fix that or how the cognitive therapist believe they can fix it by changing their thoughts and the last theory is the biopsychosocial it's all one-word bio then psycho then social all one-word biopsychosocial the P the biopsychosocial model believes that it's an interaction of our biology our environment and our society or our culture so it believes that what causes abnormal behavior is all of that combined then it's not necessarily just one thing but several things that happen that cause us to have an abnormal behavior or a diagnosis so this is the most comprehensive theory and as we go along and definitely when we get to treatment we'll talk about how different theories different theories of what causes abnormal go best and work best with treatment of specific disorders like behaviorism works very well with a lot of childhood disorders a lot of phobias and feared behaviorism works well with that cognitive works very well with depression so we'll talk about different theories and how they work well with different types of therapy or different disorders different diagnoses okay so we're going to talk about different diagnoses now there are different categories of diagnoses so in the DSM we have category of depression and then we have these disorders under depression we have a category of ends disorders and then we have several diagnoses under that category so the first category that we're going to start with is a psychosis the psychotic disorders and I'm gonna read you a little vignette a vignette is like a story about somebody that's been diagnosed him so okay let me see where the symptoms started to appear when the patient was about 19 years old she started a college student and he started becoming very suspicious of his friends his classmates he thought they were developing a special language so that they could destroy him and so in the heat of summer he would wear several sweaters and things over him he felt he needed to protect himself from the poisonous rays of the Sun because the Sun could poison him he thought his friends sometimes found him in the library he would be mumbling to himself one time he refused to eat for a whole week because he thought that the food that they were trying to feed him was poisonous and they were trying to poison him because he was blaming himself for his grandmother's die he went on he just got more and more bizarre he would stand at the window and yell out screaming at people people would be walking by and he would yell things at them like wrangle my strangle and dwop in the soup he complained that Nate Annette neighbours had powers over him he thought he had enormous powers he wrote a president letter to the President of the United States giving him solutions to you know all the world's problems but eventually he was hospitalized he wasn't making any sense by that time um once in the hospital he climbed into the toilet and he asked the nurse to flush him away he once he the doctors were coming in and he said he ordered them all to leave his room because he said he was attending an important meeting with George Washington God and IBM so you can see that he is psychotic he's out of touch with reality that's what psychosis meant means his diagnosis is a friend of young there are several different types of schizophrenia you don't need to know all the different types of schizophrenia but just the general diagnosis of schizophrenia and the symptoms that schizophrenia excuse me people have about 40% of people that are in mental institutions are schizophrenic because it's it's a very difficult disorder to deal with day to day functioning when you're out of touch with reality so there are several different you know symptoms that you need to have to be diagnosed with schizophrenia it's not just being out of touch with reality so you may not know what day it is what week it is you know where you're at where you're living on what year it is who the President of the United States is you don't know any of that normal just day-to-day stuff that people know they often have incoherent speech like I said you know he said things like glop in the soup and brain go my strangle these things don't make sense this isn't normal English people don't understand what you're talking about they can have what we call word salad it's where they just sang a bunch of words just normal English words but they're not put in correct order so you have no idea what they're talking about they often have emotional disturbances and what that means is that you can be talking to them about why it's really hot outside it's you know that this really hot spell you know it's weird cuz it was rainin for so long and now it's you know really hot outside and they'll just burst out laughing so it's inappropriate with what you're talking about even what they're talking about and the emotion that they're experiencing or expressing isn't is incongruent it doesn't make sense it doesn't go with the conversation the emotion and the conversation so again you can be talking about the weather and they can be laughing you can tell them you know that your dog just died and they'll laugh or you can tell them a very funny story and they'll start crying their emotions you know if disturbance of emotion that just doesn't go with what the conversation is they often have hallucinations and delusions now hallucinations and delusions are not the same thing remember way back when we talked about sensation and perception okay sensation remember is picking up the stimulus from your senses so you're hearing things your ears are picking up the stimulus because there are sound waves out there you're seeing things there are light waves out there you're picking up on those okay that's the process of sensation remember the process of perception is when the senses sends all that information to the brain the brain interprets it and then sends it back out okay so that's perception when the brain collects all the information from the senses and interprets it that's perception okay with a hallucination there's no sensation there's no stimulus coming in to your senses okay so you're perceiving something your brain is perceiving that something is there whether it's a voice or another person standing there so your brain your perception is working but there's no stimulation being sent to the brain your eyes are not getting any any light waves your ears are not getting any sound waves but your brain is perceiving something that doesn't exist again that's a hallucination okay that's a hallucination with the delusion a delusion there is stimulation but the perception is off so is there is there somebody standing there in front of you yes that sensation you're seeing the person the light waves are coming in but when the information gets to the brain it doesn't make sense and that's a delusion so for example if a patient came into my office and they said you know I'm a little worried I'm very anxious because every night there is a white van parked outside my house and I I don't know what's going on it's there every night and I think you know is that somebody is playing on me I really think it's the government spying on me I think they they think I have some kind of secrets from you know from people from outer space I've been talking to me and they think that that I can can give them this information so they're out there in this fan and they're watching me in there and they're you know they're getting in my brain and it's making me very scared and very nervous I'm afraid to go outside I can't do anything and on and on okay let's say there really is a white band sitting outside their house because their neighbor drives a white band so there actually is a white band outside their house but there's no government agents in there it's their neighbors white man that's a delusion okay the stimulus is there the white van is there but the perception of what's going on in that white man is wrong if there is no white van on their street anywhere any night that's a hallucination the white man doesn't exist there's no stimulation coming in okay so that's the difference between a hallucination and a delusion and schizophrenic usually have one or both now there are other disorders that have hallucinations and delusions but they're not schizophrenia because to be schizophrenic you have to have these other symptoms that we talked about okay so that's schizophrenia so that's schizophrenia again as we talked about has the most the strongest what we call biological Lodhi meaning that we believe mostly its genetic of one identical twin has it the likelihood of the other one getting it is very very high if a parent has it your chances of getting it are high so we believe that there is some genetic component to being schizophrenic okay then we have childhood disorders there's several Chuck that are disorders that are just for children one of them is oppositional defiant disorder it's often called OD D but you know we just usually just call it oppositional defiant disorder most people who are not in the field are the ones that tend to want to abbreviate the diagnosis we tend to you know say them out oppositional defiant disorder when one parent first came into my office gosh this was probably don't know ten fifteen years ago and said you know my I'm you know I'm so worried I need you to see my kid they have you know they have Oh Dee Dee and I'm like Oh Dee Dee what are you talking about and they said oppositional defiant disorder they told me that he had oppositional defiant disorder and I said oh okay well no worries because most kids at some point in their life have oppositional defiant disorder because oppositional defiant disorder is basically not listening so you don't listen to your parents you don't want to do your schoolwork you know want to brush your teeth you you know your parents give you a request they want you to do something you say no I don't want to you know these are oppositional defiant disorder behaviors so if you think about back in your life I'm sure at some point when you were a child from the time you were young until definitely during adolescence you had oppositional defiant disorder and you just refused to do things and didn't want to do your schoolwork and your chores and you know all of that so oppositional defiant disorder is a common childhood disorder and again there's many others another one common is ADHD now ADHD attention deficit hyperactive disorder that one we usually do abbreviate there used to be ADHD and AD D now it's just ADHD attention deficit hyperactive disorder and then what we do with with ADHD is we we there are different like qualifiers you can have ADHD and be impulsive you can have ADHD and have the hyperactive part so not all kids with ADHD have the hyperactive component you can just have the inattentive part okay so ADHD attention deficit hyperactive disorder means that your attention span how long you can pay attention to something how long you can focus on something is shorter than it should be so do we expect two year-olds to have short attention spans absolutely you know their attention span is about two minutes and that's why shows like um Sesame Street you know if you ever watched sit down and watch Sesame Street their segments are very short they move from think to another to another to another because a two or three-year-old four-year-old who is who that show is meant for their attention span is very short so if they don't change it up every you know you know a couple of minutes then they're gonna lose the child's attention so now as the child gets older their attention their ability to stay focus should get longer and longer kids with attention deficit disorder and hyperactivity now ADHD their attention span doesn't get longer so they have trouble focusing for a long period of time for a period of time let's say that's normal for their age this is often wine teachers pick up on this because if you've got a classroom full of seven year olds you know what a normal seven year old can do how long they can pay attention and if you fight a seven-year-old whose attention span is maybe half of that then you know that there's a problem because their attention span you know yes it's not as big as attention span of a ten-year-old you don't expect a seven-year-old to have the attention span of a ten-year-old but you expect them to have the tension span of a normal seven-year-old and when they don't it becomes obvious now kids with just a 1080hd inattentive means that they can be sitting there they're not hyper they can be sitting there watching you you're the teacher you're talking away doing your lecture and they're sitting there and everything looks fine but they're paying attention to you it's just me for a short period of time then their mind is going over here and they're thinking about something else and then there may be back paying attention to you and then maybe their mind is over here and they're thinking about something else but they're looking at you you don't know that their mind is all over the place and you because you can't see what's going on inside their head so they're missing a lot of the lecture because they're thinking about other things okay now when a child has ADHD and they have the hyperactive part when their mind goes over here their body gets up and goes with it so then they're bouncing off the walls they're getting up out of their seat they can't sit still they're fidgeting they're doing all kinds of things because their attention is all over the place and so their body is doing the same thing then we have impulsivity they don't think before they act they just react to something they just you know there's standing in line they're supposed to be standing in line they're supposed to be straight they're supposed to be quiet they're getting ready to come to the classroom and they just knock the kid in front of them then I'm trying to hit em or trying to be mean they just don't know what else to do with themselves they're fidgeting their brother bothering other kids they're impulsive they don't think if I do this then the teachers gonna get mad at me they just do it so they don't think about the consequences that's the impulsivity they're very excitable they tend to be older emotions tend to be really big they have lots of big emotions so they're you know when they're sad they're really sad when they're happy though they're really happy so they tend to be excitable and what I call you know emotional meaning that all their emotions are big the anger the sadness but also the happiness and the joy is really big as well so that's attention deficit disorder now of course there are many other childhood disorders in the DSM and you can after you take psych 101 you can take abnormal psych and abnormal psych again this little bit that we're getting in just a couple of lectures they do the whole semester on on the DSM so you would get a lot more in depth into these into these lectures okay the next category of lectures are personality disorders there's a lot of personality disorder several personality disorders are very resistant to change because they are part of a person's personality they're who they are they often don't see that it's a problem very few personality disorders come into my office because they don't think there's anything wrong with who they are it's usually a spouse a parent but often a spouse that brings them in because they they're at loss and they don't know what to do you know because the person thinks there's nothing wrong with them so they don't need to come to treatment in fact when they do come to treatment with their spouse they're coming to fix this they're thinking I'm coming here to help you fix this person because they don't see things my way when their way is usually the one that's abnormal so there's several personality disorders we're just going to talk about a couple of them one is narcissistic narcissistic is anybody know who narcissus was narcissus as from the Greeks he was a Greek god he looked into a pool of water and fell in love with his own reflection that's a narcissist in in a nutshell they're in love with themselves they think they are God's gift to the world they can do no wrong they're usually males much more common in males they're usually a handsome good-looking people and so from childhood they get a lot of reinforcement for their looks a lot of people tell them how how good-looking they are how handsome they are this and that and so they start you know all the focus is on them and they they want all the focus on them they need constant reassurance that they're good because deep down inside a narcissus has low self esteem they don't feel good about themselves that's why they need somebody to continuously tell them how wonderful they are and what we call emotionally stroked them you're so good you're such a good person thank you for this I don't know what I would have done without you oh you're the best they need that and so they seek that out from other people from their partners from their friends from their co-workers from everybody they are seeking out that attention and that we that affirmation that they're a good person they need to hear that from other people and if you emotionally wound them yeah they're angry with you it's like you know you're wrong and so like you if they'll be late you're gonna meet them they'll be late it doesn't matter because you know after all they're God's gift to the world so why wouldn't you wait for them because you you can't wait to spend time with them but if if they're waiting for you in your late oh no they they won't wait they'll just leave it's like how dare you make me wait who do you think you are don't you know who I am I'm the one all-important on the God's gift to the world I'm the one that needs to be praised but remember deep down inside they have really low self-esteem so that's the narcissist the sense of self-importance that they're more important than anybody else and they expect to be treated that way as well that they're more important then we have the anti-social personality disorder now many people would call an antisocial a sociopath or a psychopath those are layman terms our diagnosis is antisocial personality disorder so when somebody comes into my office and they say you know one of the things worrisome to them or that they want to fix is that they're antisocial okay now and my psychologist brain it's like oh god they're you know there's sociopath know what they're talking about usually is that they have a hard time they're anxious they have social anxiety is it usually what it is is that they don't feel comfortable with other people they don't feel comfortable meeting new people so they see that as antisocial that they're against you know being around other people but I'm here to tell you don't tell anybody you're antisocial unless you mean that you're an antisocial personality disorder which is like a sociopath okay so they have no regard for other people they don't care about anybody they don't they would stab their own mother in the back if it got them what they wanted without any remorse at all they have no remorse they'll hurt people literally kill people and have no remorse for it they're impulsive they think without reacting if I think this is gonna bring me pleasure it doesn't matter what harm it's gonna cause to anybody else as long as it's gonna bring me pleasure that's all that matters and it doesn't matter if I'm gonna get arrested for it it doesn't matter I'm just gonna act and react and do what I want to do there's no guilt there's no remorse they disregard the rules they don't care about the rules it doesn't matter only thing that matters is their self pleasure they're one big it remember we talked about the ED with Freud this would be an anti-social personality disorder one bigot then borderline borderline is an interesting personality disorder a borderline there's an old joke in psychology that if you take all the personality disorders and you put them in a pot and you stir it up out pops a borderline because they have a little bit of all the personality disorders they're a little bit narcissistic they're a little bit antisocial because they'll come after you if you wound them they're a little paranoid they're a little history on egg meaning that their emotions are very big so they have these big mood swings because their emotions are huge all over the place they have this sense of emptiness it's it's almost as if they don't have their own sense of self so what a borderline will do because they don't have their own sense of self is that what I call glob on to somebody else so in the beginning a borderline will love you they'll tell you you're the best person on the earth and they want to be just like you and they want to you know because you're so great and they'll give you all these accolades how wonderful you are and they'll tell you why you're wonderful and that they want to be you and all these things they idolize somebody but then when that person who they idolize and they think is perfect and they want to become wounds them emotionally wounds them like by being late or going out with another friend instead of going out with them they turn on them and they can come after you literally and hurt you okay so that's the antisocial personality part of them their emotions are very big so when they get depressed they tend to become suicidal you don't usually want to die they don't want to commit suicide but so what they'll do is if you wound them they'll call you up and say oh I just wanted to say goodbye I'm I took a bunch of pills and I just wanted you to know that you know it's good to know you in hopes that you will come and rescue them and save them because that's what they want proof that you're you know that you still care about them so they have this sense of emptiness they have a lack of again sense of self so they try to take on somebody else's personality and come them when they come into my office I feel even the first session sometimes like I have to peel them off of me like they're sucking on me globbing on to me and I need to just get away from them because they're just too much and their emotions are very big they tend to call in therapy though you know it's always Bonnie Bonnie this and Oh Bonnie and you're such a good therapist Bonnie and I really I'm glad that I found you Bonnie it's always by my first name and they use my name over and over and over again in session and they tell me how great I am and then of course when I challenge them on something then I'm the bad person and then they either attack me verbally or they leave therapy and don't come back so borderlines can be difficult to deal with because you never know it's like you're on eggshells you you never know if you're the good person or the bad person in their mind because you're either one or the other and that's how they treat you so they either love you or they hate you and but yet they don't have a sense of self so they want to be you but then when you do something they don't like then they hate you it's it can be very confusing living with a borderline personality disorder they believe that that this is one of the personality disorders that was abused in childhood in almost all cases that's why they failed to develop this sense of self of who they are because of the abuse some research has shown that it's genetic and that it's caused by actually a brain or abnormality so there is some strong theories and borderline personality that believe that it's more genetic cause it's more of a biological cause again which makes it very you know it's difficult to treat because we can't go in and treat it medication doesn't usually work with borderlines sometimes when they get depressed and I'll give them an antidepressant but we can't put them on medication to kind of help them overcome you know this emotionality in this lack of sense of self that they have okay so I'm going to end back here so we'll pick it up in the next lecture and I hope you're all understanding these lectures again if you have any questions you can either email me call me or text me you